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  • UTI

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  • 590.9 Infection of kidney, unspecified
  • Associated ICD-9-CM PT diagnoses/treatment diagnosis that may be directly related to urogenital (UG) disorders or consequences from bed rest, surgery, or inactivity or directly related to UG disorders specifically
    • 315.4 Developmental coordination disorder
    • 718.45 Contracture of joint, pelvic region and thigh
    • 719.70 Difficulty in walking
    • 728.2 Muscular wasting and disuse atrophy
    • 728.89 Other disorders of muscle, ligament, and fascia
    • 729.9 Other and unspecified disorders of soft tissue
    • 780.7 Malaise and fatigue
    • 781.2 Abnormality of gait
    • 782.3 Edema
    • 786.0 Dyspnea and respiratory abnormalities
    • 786.05 Shortness of breath

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  • N15.9 Renal tubulointerstitial disease, unspecified

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  • As of January 2013, the APTA Guide to Physical Therapist Practice does not include practice patterns for organ system pathology; therefore, the associated or secondary musculoskeletal, cardiovascular/pulmonary, or potential neuromuscular patterns would be indicated.1

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Description

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  • Can occur in any component of the urinary system: upper UTIs (kidneys and ureters) and lower UTIs (urethra and bladder)
  • Sudden onset of confusion in elderly without fever
  • Severe pain with or without attempts at urination in males and females or no pain at all, especially in the elderly and children
  • Changes in color, volume (decrease), and odor of urine
  • Most common in bladder and urethra
    • Cystitis
    • Urethritis
  • If spread to kidneys, symptoms more severe, and pain is located in the lower back with possible tenderness to palpation of the kidneys

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Essentials of Diagnosis

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  • Difficulty urinating
  • Painful urination
  • Malodorous urine
  • Pelvic pain in women
  • Rectal pain in men
  • Change in color of urine
  • Positive cultures

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General Considerations

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  • Diagnosis for more occult problems may take time and require intensive medical diagnostic testing
  • May refer pain to back, pelvic region, or rectal area (men)
  • May result in secondary problems such as
    • Aerobic capacity and muscle endurance impairment
    • Sarcopenia
    • Weakness/impaired muscle performance
    • Musculoskeletal problems
    • Neuromuscular problems
  • May mimic colon cancer or tumors, irritable bowel, colitis, or gynecological problems in females such as endometriosis, uterine fibroids, or ectopic pregnancies
  • May or may not be associated with fever

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Demographics

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  • More common in women than men in general
  • Women more susceptible to cystitis, secondary to the anatomical proximity of the urethra to the anus and the urethra to the bladder
  • Frequently associated with sexual intercourse
  • Women more susceptible to urethritis because of anatomical proximity of urethra to vagina, and can be caused by sexually transmitted diseases such as herpes, gonorrhea, and chlamydia
  • About half of all women will have a UTI in their lifetime
  • Children are at greater risk, 8% of girls and 2% of boys will acquire UTIs in childhood.2

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Signs and Symptoms

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  • It is not the purview of a PT to medically diagnose a UG pathology but rather to recognize the possibility in the differential diagnosis process, especially when the findings are not ...

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