小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 排尿困难
- 尿急
- 尿频
- 耻骨弓上疼痛
- 既往泌尿道感染 (urinary tract infection, UTI) 史和治疗史
其他诊断因素
- 近期尿路操作史
- 腰部疼痛
- 腹痛
- 发热
- 阴道分泌物
- 阴道瘙痒
- 性交痛
- 结构性或功能性膀胱异常
危险因素
- 频繁性交
- 泌尿道感染病史
- 泌尿道内解剖或功能异常
- 杀精凝胶剂
- 尿道置管
- 妊娠期间或泌尿外科手术前的无症状菌尿
- 糖尿病
- 脊髓损伤
- 妊娠
- 免疫抑制
- 老年
- 未做包皮环切术
- 年龄<15岁的初发泌尿系感染
- 过去1年内更换性伴侣
- 母亲的泌尿系感染病史
- 使用阴道隔膜
- 肥胖
- 阴道萎缩
- 低等社会经济状况
诊断性检查
首要检查
- 尿液分析
- 尿显微镜检查
- 尿液培养及药敏
需考虑的检查
- 妊娠试验
治疗流程
单纯性泌尿道感染 (UTI)：非妊娠
复杂性泌尿道感染：非妊娠
单纯性或复杂性泌尿道感染：妊娠
慢性复发性泌尿道感染风险
撰稿人
作者
Christopher Chapple, BSc, MD, FRCS (Urol), FEBU
Honorary Senior Lecturer of Urology
University of Sheffield
Consultant Urological Surgeon
Department of Urology
Royal Hallamshire Hospital
Sheffield
UK
利益声明
CC is a consultant for MUVON Therapeutics, Proverum (on safety committee), Symimetic (non-financial), and Urovant Sciences. He is an author for Astellas and Ferring. He is a speaker for Allergan.
Altaf Mangera, MBChB (Hons), MD, FRCS (Urol), FEBU
Consultant Urologist
Department of Urology
Royal Hallamshire Hospital
Sheffield
UK
利益声明
AM declares that he has no competing interests.
鸣谢
Dr Christopher Chapple and Dr Altaf Mangera would like to gratefully acknowledge Dr Michael K. Park, a previous contributor to this topic.
利益声明
MKP declares that he has no competing interests.
同行评议者
James Malone-Lee, MD, FRCP
Professor of Medicine
Department of Clinical Physiology
Division of Medicine
Whittington Campus
University College London Medical School
London
UK
利益声明
JML declares that he has no competing interests.
David Chelmow, MD
Chair
Department of Obstetrics and Gynecology
Virginia Commonwealth University
Richmond
VA
利益声明
DC declares that he has no competing interests.
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