Urinary tract infection

• UTI

• 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

• N15.9 Renal tubulointerstitial disease, unspecified

• 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

Description

• 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

Essentials of Diagnosis

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

General Considerations

• 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

Demographics

• 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

Signs and Symptoms

• 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 ...