Upper Urinary Tract Infection
“Inflammations or infections of the upper urinary tract (kidney and ureters) are considered to be more serious because these lesions can be a direct threat to renal tissue itself.” (Goodman and Snyder 2007)
Signs & Symptoms
- Unilateral costovertebral tenderness
- Flank pain
- Ipsilateral shoulder pain
- Fever and chills
- Skin hypersensitivity (hyperesthesia of dermatome)
- Hematuria (blood in urine)
- Pyuria (pus or white blood cells in urine)
- Bacteriuria (bacteria in urine)
- Nocturia (unusual or increased nighttime need to urinate)
- Pain may manifest or be perceived as groin pain
Some conditions have similar symptoms and can mimic a UTI. Acute or chronic conditions affecting other viscera outside the urologic system can refer pain and symptoms to the upper or lower urinary tract. Such conditions are:
- Being female
- Being sexually active
- Using certain types of birth control
- Undergoing menopause
- Having urinary tract abnormalities
- Having blockages in the urinary tract
- Having a suppressed immune system
- Using a catheter to urinate (click the link for more information)
Questions to ask
- Have you had any side (flank) pain or pain just above the pubic area?
- During the last 2-3 weeks, have you noticed a change in the amount or number of times that you urinate?
- Do you have pain or a burning sensation when you urinate?
- Does your urine look brown, red, or black?
- Is your urine clear or cloudy? If not clear, describe. How often does this happen?
- Have you noticed an unusual or foul odor coming from you urine?
- Have you noticed any changes in your sexual activity/function caused by your symptoms?
- For women:
- When you urinate, do you have trouble starting or continuing the flow of urine?
- Have you noticed any unusual vaginal discharge during the time that you had pain?
- For men:
- Have you noticed any unusual discharge from you penis during the time that you had pain (especially pain in the pubic area)?
When to refer
- UTI is not a musculoskeletal condition that can be treated in by Physical therapy, so when this condition is suspected the patient should be referred to a physician.
- Furthermore, many of the signs and symptoms of UTI coincide with signs of symptoms of bladder and renal cancer; this further emphasizes the need to refer the patient to a physician.
Once the patient is referred to their primary care provider, the following tests may rule in or rule out a UTI:
- Urine sample and lab culture
- Imaging, such as Ultrasound or CT Scan