Talk:Urinary tract infection/Archive 1

Archive 1

Miscellany

would culture, sensitvity,bacterial, urine be the same as a urinary tract infection? —Preceding unsigned comment added by 67.87.129.82 (talk • contribs) 04:24, 21 January 2004

Well basically i try to go pee and its angry and red like a dinosaur. and i dont like it at all. i wish it would stop. i keep having anal sex to try and stop it but its not helping at all. thatsa makin me sada :*( —Preceding unsigned comment added by 70.71.97.248 (talk) 02:35, 19 October 2007 (UTC)

What treatment was used for UTI before antibiotics, and was it affective? —Preceding unsigned comment added by Barbhardt (talk • contribs) 18:56, 7 September 2006

Cranberry juice or cranberry tablets and increased water intake have been used for a long time to treat UTIs and some people still swear by both. Sarah Ewart (Talk) 21:09, 8 September 2006 (UTC)

I made the following edits to acupuncture section.

• After reviewing the three studies cited, all were by the same author and have not been independently reproduced. I added this comment to text.
• Also all were for preventing cystitis, none were for treating acute cystitis, so I removed claim for treatment (apologies to dissenters).
• The PMID for the 1983 trial (PMID 12356607) was incorrect and was the PMID to a commentary critical of the 1983 study. I fixed this.

Badgettrg 16:49, 31 October 2006 (UTC)

I divided the prevention section into measures with supporting empiric evidence versus those without. If I have done so incorrectly, please add WP:CITE from Wikipedia:Reliable_sources to WP:Verify

Badgettrg 17:12, 31 October 2006 (UTC)

The division seems entirely reasonable to me, but it's important that these have been suggested by others, and are not novel to Wikipedia. If none can be found, the division is still helpful, because it clearly identifies what needs to be removed. :-) Jakew 17:17, 31 October 2006 (UTC)

I made changes to the introduction.. feel free to change my wording. I got the information off of my father's website (http://www.braithwaite.yourmd.com/)Nonameplayer 19:38, 20 December 2006 (UTC)

Affects animals?

Does this affect animals as well? It would be nice to have either a little summary of the affliction in animals, or a link to a page about UTI in animals. -- 71.112.6.128 05:59, 14 January 2007 (UTC)

yes it effects animals. 65.10.129.40 18:47, 15 January 2007 (UTC)

"Discharge from the penis" ought to be edited to "discharge from the urethra" for both accuracy and to make it more inclusive.

—Preceding unsigned comment added by 154.20.51.93 (talk • contribs) 06:51, 22 January 2007

I added the discharge from the penis bit (I was anon at the time). After talking to a doctor, he said that 99% of penile discharges that he sees are because of Gonorrhea not because of a UTI. So i suggest removing that line completely. Nonameplayer 16:31, 22 January 20

Protein in urine

The article states that this is found in lower urinary tract infections. I'm not an expert in this area, but I always thought proteinuria was indicative of kidney damage. Hence, it does not normally appear in lower UTIs. I'm removing it unless someone can give a reliable reference. M0rt (talk) 07:35, 25 May 2009 (UTC).

Flank Pain' Symptoms from a lower urinary tract include painful urination and either frequent urination or urge to urinate (or both), while those of pyelonephritis include fever and flank pain in addition to the symptoms of a lower UTI In the are referring to flank pain. It should be pertaining to Upper UTI (NOT Lower UTI as it states)

Not sure to what you refer? Doc James (talk · contribs · email) (if I write on your page reply on mine) 18:55, 8 December 2013 (UTC)

Protein in urine The article also states that the prostate secretes bacteriostatic components too, probably prostatic acid phosphatase (PAP). Can anyone help me with information with the prostate secreting components that are present in urine? More so unrelated to semen residue left on the urethra wall and being collected in the urine when voiding. I am mostly curious about possible components found in urine that could serve as an antibody; adding to the knowledge that UTI's are more common in females than males. It cannot be simply just the length of the urethra; based on research I have been working on that shows a component in male urine (percipitated out of the urine in form of a "pellet" using ammonium sulfate) that inhibits formation of biofilm for E. coli that is not present in females. If anyone is able to aid in my questions I would greatly appreciate it. Thank you, Pete Johnson--209.250.214.90 (talk) 16:55, 8 October 2009 (UTC)

Diagnosis in children

JAMA - rational clinical examination. JFW | T@lk 18:51, 2 January 2008 (UTC)

Trials

in UTI are not of great quality doi:10.1007/BF01704370 JFW | T@lk 23:45, 22 July 2008 (UTC)

Treatment

This article should include aspects of treatment beyond antibiotics. High fluid intake, with frequent voiding (urination) is essential. In addition, various nutritional interventions, such as a highly alkaline diet, reduce frequency, severity, and duration of infections. 99.11.6.189 (talk) 06:45, 29 June 2009 (UTC)E Springer

We would need references for these.--Doc James (talk · contribs · email) 12:53, 12 April 2010 (UTC)

The sharp improvement in recurrent UTIs noted with intravaginal estrogen is hypothesized to relate to the resulting naturally acidic vaginal environment being less habitable by E. coli and more favorable instead to acidophilus. The probably healthy value of vaginal acidity give little reason to presume that an alkaline diet would be helpful.

There should be more information about why 100% cranberry juice is often suggested as a treatment for Urinary Tract Infections i.e. Tannins, being the key ingredient, help flush the urinary tract of infection. Tannins are also present in black tea which can be a more effective option than cranberry juice due to the fact that the fructose found in cranberry juice is counterproductive by feeding the E. Coli bacteria. Another point that should be mentioned is that moving urine out in a forceful jet will expel more bacteria then if the flow of urine is slower. Julia.noelle (talk) 08:26, 17 August 2012 (UTC)

Prevention

There is no mention of prophylactic application of antibiotic creams. It would seem that topical application at or near the urinary meatus after coitus might be tied to the prevention of some urinary tract infections. If so, such measures might have value, if not utilized frequently. — Preceding unsigned comment added by Homebuilding (talk • contribs) 16:53, 8 June 2014 (UTC)

Ammoxicillin Dosage Correction

It says the reccomended dosage for ammoxicillin is 2-3mg. This can not be correct, my doctor perscribed 500mg. —Preceding unsigned comment added by 173.19.33.54 (talk) 00:25, 27 July 2009 (UTC)

For Men?

This really lacks any real useful information about UTI in males. —Preceding unsigned comment added by 130.234.5.138 (talk) 20:56, 7 May 2010 (UTC)

Yes could us a section specifically on men. Doc James (talk · contribs · email) 04:25, 6 January 2011 (UTC)

Symptoms of dementia

My mother, 91 and with middle-stage Alzheimers, got rapidly worse over a period of just two weeks with a wide range of symptoms: great confusion and worsening cognitive ability, very poor mobility and coordination, loss of interest, loss of rationality, sleeping all day, hardly eating. The doctor thought it might have been a cardio-vascular episode but it just kept getting worse. A community matron suggested a urine test to "eliminate" UTI, which was the first mention of it. Hours later I called out paramedics as her knees had buckled and she was on the floor. They, and the various personal care helpers who came over the next few days, had no doubt whatever it was UTI-related, and all had seen patients "go into meltdown" caused by a UTI and then rapidly recover after antibiotics. I'm writing this on the third day after starting on amoxycillin, and she's starting to get back to the person she was before. Looking up Wiki to see more about this strange matter, and finding no mention of it, I thought it worth adding this to your pages: if the doctor who came 10 days ago had known, we would not have got into such a bad way. Bosnorth (talk) 12:41, 9 August 2010 (UTC)

Yes I have not gotten around to address UTIs in special population. But will at some point in time. This is a common cause of confusion / weakness in the elderly.Doc James (talk · contribs · email) 23:17, 9 August 2010 (UTC)

Moved here until rewritten to wiki standards

EPIDEMIOLOGY

Urinary tract infections in children may be symptomatic or asymptomatic. Symptomatic infections may be confined to the bladder (cystitis), or they may involve the upper collecting system (ureteritis, pyelitis), or extend into the renal parenchyma (pyelonephritis). Age, gender, race, circumcision status, the method of detection and presentation all influence the prevalence of symptomatic versus asymptomatic urinary infection. Overall, the incidence of neonatal bacteriuria has been reported as 1 to 1.4 per cent. [Abbott, 1972; O’Dougherty, 1968; Littlewood et al, 1969] The male-to-female ratio in infants is reversed from that seen in older children. From a compilation of screening studies of healthy newborns reviewed by Stamey, 1.5 per cent of boys versus only 0.13 per cent of girls had bacteriuria. [Stamey, 1980] However, the actual incidence of UTI during infancy has probably been underestimated in the past, partly because of the difficulty in diagnosing UTI in this age group. In a three year prospective study of 3581 infants (aged 0 to 1 year) in Goteborg, Sweden, asymptomatic bacteriuria was confirmed by suprapubic aspiration of urine in 2.5 per cent of boys and 0.9 per cent of girls. [Jodal, 1987] Symptomatic urinary infection occurred equally often in both sexes (1.2 per cent of boys and 1.1 per cent of girls). Overall, 3.7 per cent of boys and 2 per cent of girls had positive urine cultures during the first year of life. The male predominance noted in the Goteborg study during the first few months of life has also been reported by others. [Ginsburg et al., 1982; Majd et al, 1991; Bergstrom et al, 1972; Drew et al, 1976] Uncircumcised infant boys are eight to ten times more likely to have symptomatic urinary infection as compared to their circumcised counterparts. [Wiswell et al, 1985] During preschool and school age, the male-to-female ratio observed in neonates is reversed making screening bacteriuria more prevalent in girls. [ Bergstrom et al, 1972; Drew et al, 1976] (Table 1) In several large studies of school-age children the aggregate risk of screening bacteriuria has been reported to be 0.7-1.95 per cent of girls and 0.04-0.2 per cent of boys. [Kunin, 1970; Savage, 1973; Saxena et al, 1974; Newcastle Group, 1975; Lindberg et al, 1975] However, in as many as one-third of these children a prior history of UTI or voiding symptoms could be elicited. (Table 2) Based on an average annual incidence figure of 0.4 per cent, Kunin (1964) estimated that bacteriuria will develop in approximately 5 per cent of girls prior to graduation from high school. Additional data collected by Kunin (1970) revealed that infection will recur in up to 80 per cent of all white girls and 60 per cent of black girls within 5 years. [ Kunin, 1970] In a prospective population-based study of symptomatic UTI’s in children living in Goteborg, Sweden, Winberg et al estimated that the aggregate risk for symptomatic UTI up to age 11 was at least 3 per cent for girls and 1.1per cent for boys. [Winberg et al, 1974] In an update of a previous study, the incidence of culture documented UTI’s was twice as high as previously estimated, affecting 7.8 per cent of girls and 1.6 per cent of boys during the first six years of life. [Hellstrom et al, 1991] To confirm these findings, Marild and Jodal recently performed a retrospective population based study of 41,000 children of Goteborg, Sweden. [Marild and Jodal, 1998] The cumulative incidence rate of symptomatic UTI’s was 6.6 per cent for girls and 1.8 per cent for boys. These data probably do not reflect an increasing incidence of urinary tract infections since the publication of the earliest report, but instead a greater detection rate. In these epidemiologic studies, the incidence of febrile UTI’s was greatest in infant boys and girls as compared to children over 2 years of age. Gender differences in the incidence rates of first time febrile and non-febrile UTI’s were most evident in children greater than two years old. Girls greater than two years old were much more likely to present with first time UTI, both with and without fever, as compared to their age-matched male counterparts. (Figure 1, A and B) Once treated, infants with symptomatic urinary infections are at risk for recurrent infection (26 per cent), usually in the first 3 months of follow-up. In older girls the risk for recurrence following symptomatic urinary infection is as high as 40-60 per cent within 18 months. This risk persists into adulthood. [Bergstrom et al, 1972] In one study, sixty girls with childhood bacteriuria followed into adulthood (9 – 18 year follow-up) were compared with 38 non-bacteriuric controls. [Gillenwater et al, 1979] During pregnancy, a significantly greater incidence of bacteriuria was diagnosed in the group with the history of positive urine cultures in childhood (63.8 per cent) when compared to the controls (26.7 per cent). Interestingly, the propensity for urinary infection persisted in the children born to bacilluric women, whereas none of the children born to healthy controls demonstrated urinary infection. Further evidence supporting a lifelong risk for symptomatic urinary infection in individuals presenting during childhood is reported by the Goteborg Childhood UTI Research Group. These authors followed 111 women with renal scarring or recurrent UTI’s. Febrile UTI’s were more prevalent than non-febrile UTI’s during the first 10 years of life but continued to occur into the third decade. Although the prevalence of febrile UTI’s diminished in adulthood, women with renal scarring during childhood were significantly more likely to have subsequent febrile UTI’s. Overall, the median incidence of symptomatic UTI’s was 7 per individual. [Martinell et al, 1990; Martinell et al, 1996]

Doc James (talk · contribs · email) 21:18, 17 January 2011 (UTC)

Thanks for moving, instead of just erasing.

66.167.61.181 (talk) 01:40, 13 September 2011 (UTC)

Recurrent

RECURRENT I have seen not only here the phrase "effective treatment can also be delivered over the phone" which is meaningless, unfortunately I have no access to the full study but only to the abstract, someone who has might correct it and make it meaningful? --Sandribus (talk) 11:00, 15 June 2011 (UTC)

Urinalysis and midstream urine culture and sensitivity upon first presentation of symptoms

In a Nov. 2010 set of guidelines entitled: Recurrent Urinary Tract Infection

The first recommendation in the report, page one, addresses not a recurrence but the first presentation of symptoms:

"Recommendations

1. Urinalysis and midstream urine culture and sensitivity should be performed with the first presentation of symptoms in order to establish a correct diagnosis of recurrent urinary tract infection. (III-L)"

"SOGC CLINICAL PRACTICE GUIDELINE

...

This document reflects emerging clinical and scientific advances on the date issued and is subject to change. ...

66.167.61.181 (talk) 01:45, 13 September 2011 (UTC)

Reviews

• Epp A, Larochelle A, Lovatsis D; et al. (2010). "Recurrent urinary tract infection". J Obstet Gynaecol Can. 32 (11): 1082–90. PMID 21176321. {{cite journal}}: Explicit use of et al. in: |author= (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
• Dielubanza EJ, Schaeffer AJ (2011). "Urinary tract infections in women". Med. Clin. North Am. 95 (1): 27–41. doi:10.1016/j.mcna.2010.08.023. PMID 21095409. {{cite journal}}: Unknown parameter |month= ignored (help)
• Litza JA, Brill JR (2010). "Urinary tract infections". Prim. Care. 37 (3): 491–507, viii. doi:10.1016/j.pop.2010.04.001. PMID 20705195. {{cite journal}}: Unknown parameter |month= ignored (help)
• Williams GJ, Hodson EH, Isaacs D, Craig JC (2010). "Diagnosis and management of urinary tract infection in children". J Paediatr Child Health. doi:10.1111/j.1440-1754.2010.01925.x. PMID 21199053. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)

Doc James (talk · contribs ·email) 04:24, 6 January 2011 (UTC)

New 2011 Guideline

[1] Doc James (talk · contribs · email) 21:47, 5 March 2011 (UTC)

Updated Cochrane Vazquez JC, Abalos E (2011). "Treatments for symptomatic urinary tract infections during pregnancy". Cochrane Database Syst Rev. 1: CD002256. doi:10.1002/14651858.CD002256.pub2. PMID 21249652.Doc James (talk · contribs ·email) 19:36, 8 March 2011 (UTC)

A review looking at recurrent UTIs [2] --Doc James (talk · contribs · email) 14:02, 25 November 2011 (UTC)

GA Review

This review is transcluded from Talk:Urinary tract infection/GA1. The edit link for this section can be used to add comments to the review.

Reviewer: Visionholder (talk · contribs) 20:11, 12 January 2012 (UTC) I will be reviewing this article shortly. Although I do not have a medical background, I do have a background in biology. Anyone with medical experience (aside from the author, obviously) is also welcome to weigh in on this review. – VisionHolder « talk » 20:11, 12 January 2012 (UTC)

Notes for other reviewers:

• I have checked for copyright violations using only the online sources. I do not have access to the journal articles. If someone can check these sources, I would greatly appreciate it.
• Again, I am not a medical expert, so second opinion from someone with said training would be welcome. Otherwise I will treat it as a standard GAN.

GA review (see here for what the criteria are, and here for what they are not)

1. It is reasonably well written.

   a (prose): b (MoS for lead, layout, word choice, fiction, and lists):

   See comments below.

2. It is factually accurate and verifiable.

   a (references): b (citations to reliable sources): c (OR):

   From what I can see online, the sources check out.

3. It is broad in its coverage.

   a (major aspects): b (focused):

   Information about the history of the disease would be informative. (See comments below.)

4. It follows the neutral point of view policy.

   Fair representation without bias:

5. It is stable.

   No edit wars, etc.:

6. It is illustrated by images, where possible and appropriate.

   a (images are tagged and non-free images have fair use rationales): b (appropriate use with suitable captions):

   Just one caption needs clarification (see comments below).

7. Overall:

   Pass/Fail:

   Outcome pending on issues given below.

Comments:

• I have corrected the typos I found and knew how to fix. (For example, there were three typos in the second sentence of the lead.) Any additional bad grammar/spelling I find and cannot fix will be listed below. Otherwise, please review the document yourself and double-check everything.

Thanks.--Doc James (talk · contribs · email) 23:02, 12 January 2012 (UTC)

• If the material in the lead is already discussed and cited in the body (and it should be, by definition), and as long as the claims are not highly controversial, you do not need references in the lead. In the case of the two cited bits in the lead, I think it is safe to delete the references. The second citation is a little questionable, only because he discusses treatment, and I can see the importance of a citation for such crucial information. But again, it's in the body, so you could technically remove it.

Yes this is always a tough call. I know that the guidelines say refs are not needed but if you look at Talk:Syphilis many complains can result if the refs are not there. May be a good solution going forwards would be to use the "no wiki" formatting?--Doc James (talk · contribs · email) 23:02, 12 January 2012 (UTC)

Yes, comments are a good way to handle citations that some people might nit-pick over. – VisionHolder « talk » 22:27, 17 January 2012 (UTC)

• "Urinary tract infections occur most commonly in women with half having an infection at some point..." Do you mean "with most having an infection..."?

I mean occur more frequently in women than in men. Have reworded.Doc James (talk · contribs · email) 23:02, 12 January 2012 (UTC)

• "Pyelonephritis typically occurs secondary to a bladder infection..." This sounds like doctor lingo... which (IMO) is acceptable in the body, but not in the lead. Yes, it's perfectly acceptable English, but most people would say "Pyelonephritis usually follows an bladder infection..." or something like that. It's just good practice to make the lead as understandable as possible, especially since most page visitors will read the lead and only the lead.

Good idea thanks.Doc James (talk · contribs · email) 22:53, 12 January 2012 (UTC)

• I notice that you are very reluctant to use commas. Unfortunately, Wiki's Manual of Style just advises against overuse, but doesn't talk about standard cases. However it does mention the need for commas before conjunctions, such as: "In complicated cases longer course or intravenous antibiotics may be needed and if symptoms are not improving in two or three days further diagnostic testing is needed." You probably need to add a comma before "and" in this case (and others like it). Likewise, you will need a comma in situations like these: "The most common symptoms of a lower urinary tract infection, otherwise known as a bladder infection, are...". I have fixed this last one, as well as removed an unnecessary comma. Please let me know if this looks okay.

I never use commas and must admit I have no idea how... I am however looking for a volunteer copyediter for this project [3] --Doc James (talk · contribs · email) 22:53, 12 January 2012 (UTC)

Sorry, but I'm not that great of a copyeditor, plus I'm busy rewriting over 100 lemur articles more-or-less by myself. Unfortunately, Wiki needs more copyeditors than it needs editors. However, it's always good to review some basic writing guidelines, and this page can really help if you read it once a year: User:Tony1/How_to_improve_your_writing. If some of these ideas can stick, you'll be well on your way to not needing a copyeditor as much. (That's what I do.) Otherwise, since I'm reading the article again, I'll add comas where needed. – VisionHolder « talk » 22:27, 17 January 2012 (UTC)

• The article uses too many subheadings, especially given how short these subsections are. Personally, I feel that they would be better off as paragraphs within their parent section. In fact, in the section about causes, "Sex" and "Intercourse" are redundant. In fact, I suspect that all subheadings in the article could be removed given their brevity.

Sex refers to whether someone is male or female (cannot use gender as this is psychological rather than physical). Intercourse refers to a physical act. Thus the two sections. I find section are good to keep the subject matter organized and thus hesitant to remove them. It also makes navigation of the article by people who are looking for a specific issue easier.Doc James (talk · contribs · email) 22:53, 12 January 2012 (UTC)

Because the word "sex" can get confused, especially in this case, it may be best to use "gender". Otherwise, I do see the point of what you are saying. In fact, I thought of that originally, so I went looking for a hard, firm rule on subheader use. Unfortunately, there is none. I understand that there is a functional aspect to this organization, but in truth, most of these sections are so short the target material can easily be found without the headers. I'm not suggesting that you merge sections like "Causes" into a single paragraph. Instead, simply removing the subheaders and leaving the content broken into separate (small) paragraphs will still serve the same level of functionality. For example, if the subheaders under "Treatment" were removed, someone jumping to that section would immediately see what each paragraph is about just by a little bit of skimming (which people do anyway). Admittedly, other sections may take more work on your part—under "Diagnosis", for instance, the "In children" subheading provides the only introduction, so "In children" may have to be added to the very first sentence. As it stands, the page suffers from a lot of white-space and looks like it contains a lot less information than it actually does. Do you see what I'm saying, or do we need a second opinion? – VisionHolder « talk » 22:27, 17 January 2012 (UTC)

I have combined sex and intercourse under gender. The word is used in different ways and I do not have an issue with using it in a no technical sense in this place. Have combined a couple of other sections. I hope this balance is acceptable.Doc James (talk · contribs · email) 16:09, 20 January 2012 (UTC)

I think this is an acceptable compromise, but I can't promise that other editors will agree. But like I said, there are no rules that seem to apply to this, so it seems to boil down to opinion. – VisionHolder « talk » 01:56, 22 January 2012 (UTC)

• Could you write about the history of the disease? I'm sure some readers might like to know about its history and how it was treated before the advent of modern medicine.

I am unable to find any references that comment on the history of the disease.Doc James (talk · contribs · email) 23:40, 12 January 2012 (UTC)

I was able to find this. (I got lucky. This was a beast to search for on Google Books.) We don't need to be comprehensive, but for GA, we do need to cover all the major topics. For the medical articles, Wiki isn't just about providing medical details. The history of a disease (from antiquity) has encyclopedic value as well. – VisionHolder « talk » 22:27, 17 January 2012 (UTC)

Okay and I found one other ref.Doc James (talk · contribs · email) 17:12, 20 January 2012 (UTC)

• "Many elderly people however have preexisting incontinence." Maybe re-word to say: "Diagnosis can be complicated by the fact that many elderly people however have preexisting incontinence."

I like that.Doc James (talk · contribs · email) 23:02, 12 January 2012 (UTC)

• "Staph. aureus"—Is this a typical abbreviation in the medical field? I'm used to standard biology using S. aureus. If you feel that the genus needs clarification (since that species has not been mentioned), then you should probably spell it out.

Spelled out Doc James (talk · contribs · email) 09:54, 17 January 2012 (UTC)

• Overciting: "Women are more prone to UTIs than men because, in females, the urethra is much shorter and closer to the anus.^[9] As a women's estrogen levels decrease with menopause her risk of urinary tract infections increase due to the loss of protective vaginal flora.^[9]" Yes, you should cite your sources, but back-to-back references of the same source (unless you are differentiating page numbers) usually just requires a citation at the end of the content. As an example, see my latest good article nomination.

I have "no wikied" the first instances of a ref. I like one ref with each sentence as it prevents people from adding the "citation needed" tag.Doc James (talk · contribs · email) 09:54, 17 January 2012 (UTC)

I definitely understand where you're coming from, and the example I linked to wasn't the best... especially since it cites a single article and I'm waiting for the print version so that I can cite individual page numbers. Your "no wikied" tags (a.k.a. hidden comments) might be a good way to defend against "citation needed" tags, but often the best defense is monitoring the articles you work. I often revert edits that try to change or challenge cited content, stating in the edit comments the reason why (briefly) and encouraging discussion on the talk page. I guess this becomes less of an issue the more sources you cite, since each source will cover a specific topic in a slightly different way and possibly cover unique material. Either way, this isn't an issue for GAN, but something to consider if you ever gear up for FAC. – VisionHolder « talk » 22:27, 17 January 2012 (UTC)

I would need to learn grammar before I could write GAs :-) Doc James (talk · contribs · email) 17:14, 20 January 2012 (UTC)

In the sentence "Urinary tract infections are more concerning in pregnancy due to the increased risk of kidney infections" the word "concerning" should be replaced by "disconcerting". "Concerning" means related to, which is not what is meant in that sentence. Check the dictionary for further info. 2001:5C0:1100:2000:24C:69FF:FE6E:7579 (talk) 01:14, 3 February 2014 (UTC)

Break 1

• "The risk of bacteriuria is between..." You need to define technical terms on first use. For example, "The risk of bacteriuria (bacteria in the urine) is between..." Another example, vesicoureteral reflux.

Addressed.Doc James (talk · contribs · email) 10:36, 17 January 2012 (UTC)

Thanks. I'm reading through the article again to look for others. The key point here is that although wiki-linking can help explain terms, sometimes people don't want to follow the link to know what you're talking about. Sometimes they just want to understand the sentence. Trust me... this can be hard as an editor of technical articles. When I write about extinct lemurs, succinctly summarizing and paraphrasing material that talks (in gory detail) about dental anatomy or cranial/postcranial anatomy can be a nightmare! – VisionHolder « talk » 22:27, 17 January 2012 (UTC)

• Over-linking: There are several words that are linked multiple times throughout the body (not counting the lead). For example, Urinary catheterization, bacteriuria, incontinence, etc. Generally, you only need to link a word once, although I often treat lead links separate from body links.

Yes good point. Addressed all the ones I could find.Doc James (talk · contribs · email) 10:36, 17 January 2012 (UTC)

I fixed a few more, and will watch more closely on the second read. – VisionHolder « talk » 22:27, 17 January 2012 (UTC)

• I feel that "Cause" and "Pathogenesis" could be merged into one section, "Cause and pathogenesis".

Per WP:MEDMOS we tend to keep these separate. Doc James (talk · contribs · email) 10:36, 17 January 2012 (UTC)

• "...the use of vaginal estrogen pessaries was not as useful..." I know that you mean "in clinical trials", but here you should probably say as such.

As we are writing for a general audience I try to just state the facts without say what type of study or what journal it was published in.Doc James (talk · contribs · email) 10:36, 17 January 2012 (UTC)

I changed the wording from "was not" to "has not been". To me, "was" suggests a single case, whereas "has not been" sounds like a sort of track record. That's where I was coming from in my request for clarification. I'm fine with not saying something like "in clinical trials" as long as it doesn't raise questions about the source of the information. Does that make sense? Do you agree? – VisionHolder « talk » 22:27, 17 January 2012 (UTC)

• "voiding after sex" I would suggest explaining this term, although I know what you mean.

Sure Doc James (talk · contribs · email) 10:36, 17 January 2012 (UTC)

• "Reassuringly recurrent UTIs are a rare cause of..." The word "reassuringly" does not sound very encyclopedic. I advise dropping it. Also, that sentence needs to be reworded such that the qualifying sentence is not in paratheses.

Yes. Doc James (talk · contribs · email) 10:36, 17 January 2012 (UTC)

• Under "Diagnosis", you mention both leukocytes and white blood cells in the same sentence, link them both to the same page, yet don't associate the two. I suggest saying "leukocytes (white blood cells)" the first time, and either one of the two words thereafter.

Good idea.Doc James (talk · contribs · email) 10:36, 17 January 2012 (UTC)

• An image caption reads: "Multiple bacilli (rod-shaped bacteria, here shown as black and bean-shaped) shown between white cells at urinary microscopy. This is called bacteriuria and pyuria, respectively." I would note briefly in there that pus is made up of white blood cells, otherwise this might not make sense to some readers.

Pus contains white blood cells among other stuff. I have removed the confusing text.Doc James (talk · contribs · email) 10:36, 17 January 2012 (UTC)

• "The difficulty is contamination may be frequent depending on..." I suggest rewording... maybe: "Contamination poses a frequent challenge..." or something like that.

Sure Doc James (talk · contribs · email) 10:36, 17 January 2012 (UTC)

• "is used a "clean catch""—typo?

Added a hyphen. It is a "clean-catch midstream urine"Doc James (talk · contribs · email) 10:36, 17 January 2012 (UTC)

• "...infection with Chlamydia trachomatis or Neisseria gonorrheae much be ruled out." I assume you mean "must be ruled out"? If so, you need to reword, since Wiki articles shouldn't be written as a how-to manual. Instead, "clinicians will rule out..." We assume that they know what to do. ... And again in: "Interstitial cystitis should be considered in...", and so forth throughout the article.

Changed the "ruled out" to "may be the cause of the symptoms" Doc James (talk · contribs · email) 10:36, 17 January 2012 (UTC)

I made some changes to the section, and I would appreciate your review. Otherwise, that section should be good. – VisionHolder « talk » 22:27, 17 January 2012 (UTC)

• I am a bit hesitant about headings such as "Epidemiology" and "Pathogenesis"... they are technical terms, although I do see that several medical articles have become featured articles with these headings. If this is the norm for this project, ignore this concern.

Yes the norm per WP:MEDMOS with about 10,000 article following this convention.Doc James (talk · contribs · email) 10:36, 17 January 2012 (UTC)

• "In the United States urinary tract infections accounted for nearly seven million office visits, a million emergency department visits, and one hundred thousand hospitalizations a year." If this fluctuates, the way this sentence is worded suggests we need to state the year. If this number is pretty static, then "accounted" should be "account".

The ref in question presents it in this fashion and it is fairly constant per year.Doc James (talk · contribs · email) 10:36, 17 January 2012 (UTC)

Alright, I fixed it. – VisionHolder « talk » 22:27, 17 January 2012 (UTC)

All-in-all, this is a very concise article that seems to cover all the basics. I'm glad to see that you are using your expertise to help clean up Wikipedia. A lot of medical articles out there need attention. Are you taking requests? I could name a few... (Herpes labialis, given its prevalence in the general population and the stigmatization surrounding it, would be a good one...) Otherwise, keep up the good work! – VisionHolder « talk » 22:27, 12 January 2012 (UTC)

Thanks for the review. Will try to address the concerns. My work is part of this effort here [4] and it begins by bringing all the articles listed here [5] to GA at least. I have some work ahead of me. If things go well I will consider adding "herpes labialis" to the next round. Herpes simplex is at GA BTW... Doc James (talk · contribs · email) 22:48, 12 January 2012 (UTC)

Yes, I saw that Herpes simplex is GA, but most people are just as likely to search oral herpes as herpes. Anyway, it was just a suggestion. Malaria would also be another good one for GA... but I'm sure the list could go on and on. – VisionHolder « talk » 22:27, 17 January 2012 (UTC)

Malaria is indeed on the list and will be getting to it... Doc James (talk · contribs · email) 17:16, 20 January 2012 (UTC)

Additional comments

On the second read, I made the following corrections. Please review and correct me as needed. Otherwise, I also found the following:

• On re-reviewing the lead, I noticed that it only seems to hit the high points of the article. It does not thoroughly summarize the content, such as issues for children/elderly, catheters, or some of the statistics about the disease. The lead is close to being good enough, but it simply isn't long enough for an article this size. I'd say it's about 75% of the way there, if that helps you visualize it.
• "Staphylococcus aureus typically occurs secondary to blood born infections." Sorry for not catching this early, but this sentence needs to stated more clearly.

Changed wording.Doc James (talk · contribs · email) 15:57, 20 January 2012 (UTC)

• More phrases to word in plainer English:
  • "In older children, new onset incontinence may occur."

Fixed Doc James (talk · contribs · email) 15:57, 20 January 2012 (UTC)

• • "They may have a vague presentations with incontinence..."

Better?Doc James (talk · contribs · email) 17:24, 20 January 2012 (UTC)

Sorry, but I don't see the change in the history. – VisionHolder « talk » 02:28, 22 January 2012 (UTC)

• • "Sepsis may be the initial presentation in some cases."

Not sure what you have in mind? Some elderly present to a health care provider with sepsis being the first symptoms.Doc James (talk · contribs · email) 17:24, 20 January 2012 (UTC)

The issue here is that although "presents" is perfectly good English, it's not how most people would say it... and I was hoping we could make the article a little more accessible to the general public (e.g. not reading like medical book). But then again, maybe I'm out-of-line... – VisionHolder « talk » 02:28, 22 January 2012 (UTC)

• • "Staphylococcus aureus typically occurs secondary to blood born infections."

Fixed Doc James (talk · contribs · email) 17:24, 20 January 2012 (UTC)

• • "A prescription for an effective empirical treatment..."

Sure Doc James (talk · contribs · email) 17:24, 20 January 2012 (UTC)

• "In those who use spermicide or a diaphragm as a method of contraception, they are advised to use alternative methods." Does this mean for everyone or just for chronic sufferers? If so, I suggest: "For chronic sufferers of UTI who also use spermicide or a diaphragm as a method of contraception, clinicians suggest alternative methods of birth control." Or something like that...

Sure Doc James (talk · contribs · email) 17:24, 20 January 2012 (UTC)

• "The diagnosis can be difficult in the elderly with no reliable test." The second time through, I'm confused by this statement. Does it mean that there are no reliable tests for UTI for elderly patients?

Yes exactly. A UTI is a clinical diagnosis and in the elderly and children when the symptoms are vague the diagnosis is difficult.Doc James (talk · contribs · email) 17:24, 20 January 2012 (UTC)

• "some resistance has developed in the community..." Please clarify "the community".

Simply means outside of the hospital/health care environment(which would include long term care) Doc James (talk · contribs · email) 15:57, 20 January 2012 (UTC)

In that case, I don't think "in the community" is needed. If it is, please restore it. – VisionHolder « talk » 02:28, 22 January 2012 (UTC)

• "Rates among men over 75 are between 7-10%." This is for UTIs, right? The paragraph starts mixing rates of UTI, Pyelonephritis, and (more generally) bacteriuria, so it's hard to be clear.

No this is for asymtomatic pyuria.Doc James (talk · contribs · email) 15:57, 20 January 2012 (UTC)

• Can you offer a brief description of pre-eclampsia? I wasn't able to.

Sure Doc James (talk · contribs · email) 16:02, 20 January 2012 (UTC)

Very nice. Far better than I could have done. – VisionHolder « talk » 02:28, 22 January 2012 (UTC)

• Tweaking the image captions, I realized that the topics they contain are not mentioned or cited in the article. Images and captions, just like the lead, should summarize cited content in the body.

Have tweaked a little further.Doc James (talk · contribs · email) 16:02, 20 January 2012 (UTC)

In that case, maybe mention pyuria when talking about sepsis in the body? Anyway, the first mention of sepsis isn't explained in the body. – VisionHolder « talk » 02:28, 22 January 2012 (UTC)

Described sepsis and mentioned pyuria in the text.Doc James (talk · contribs · email) 10:36, 22 January 2012 (UTC)

• Citation #30 ("Nurse10") is missing the citation, and therefore broken.

FIxed --Doc James (talk · contribs · email) 12:29, 21 January 2012 (UTC)

• I noticed that you have a tendency to say "urinary tract symptoms". Is this standard (based on the written sources)? As an average reader, the term seems non-nonsensical, and that's why I've tried to catch them and change them to UTI symptoms (since "urinary tract infection symptoms" seems too long). The key thing is to mirror what the sources say or at least use a term that makes sense to people.

If you look at google books [6] it is a common term among docs. But I am happy with UTI symptoms if you think it is more under stable by the general population.Doc James (talk · contribs · email) 12:29, 21 January 2012 (UTC)

Good to know. In that case, I'm fine with urinary tract symptoms. It just sounded like a sloppy short-hand. As long as it follows the sources and isn't overly technical, I'm fine with it. – VisionHolder « talk » 02:28, 22 January 2012 (UTC)

• "...a culture of the urine is recommended." I'm cautious about this because anytime you say something is recommended, it sounds like Wikipedia giving advice. Remember, Wiki isn't a how-to manual, and we don't want to come across as though we are suggesting medical tests or treatment. That's why I had changed it to "physicians (or whatever...) may culture of the urine." Is there another way to say these things? – VisionHolder « talk » 02:28, 22 January 2012 (UTC)

the ref says "Most authorities recommend routine examination and culture of the urine in febrile girls 0 to 24 months of age." thus added "by many medical associations" Doc James (talk · contribs · email) 10:16, 22 January 2012 (UTC)

Sorry for the added items. I'm also sorry for what may feel like a unique type of review. I run a lot of articles through FAC, and I'm used to having to throw the rulebook out the window when a reviewer from a completely different project reviews my articles. Often, the different perspective helps you see when you are talking above the general audience, plus they bring out some of the sticking points their group has discovered but other groups have not yet addressed. I hope you can at least see the reasons behind my suggestions. – VisionHolder « talk » 22:27, 17 January 2012 (UTC)

These are excellent suggestions and will make the article better. While address in the next couple of days. Thanks again for the feedback.Doc James (talk · contribs · email) 02:54, 18 January 2012 (UTC)

Pyridium

Note to self. Must comment on this... Doc James (talk · contribs · email) 23:41, 12 January 2012 (UTC)

Is this something that concerns the GAN? Otherwise, I'm probably going to pass it very soon. Although there may still be some issues with technical language and possibly overuse of headers (depending on the reader's point of view), there's nothing in the MoS that gives me a reason not to pass it. If the article were to someday go on to FAC, then more work will certainly need to be done. – VisionHolder « talk » 21:20, 27 January 2012 (UTC)

Yes wrote something regarding pyridium a while ago.--Doc James (talk · contribs · email) 23:13, 27 January 2012 (UTC)

Closing comments

As best I can tell, this article meets the GA requirements. The article covers all the major topics adequately, and it appears to be technically accurate and well-referenced. – VisionHolder « talk » 00:32, 30 January 2012 (UTC)

Opening paragraph

One thing that really bothers me is the 2nd sentence in this article: "When it affects the lower urinary tract it is known as a bladder infection and when it affect the upper urinary tract it is known as pyelonephritis." It sounds a bit silly to use the lay term for one and the medical term for the other. Could "cystitis (bladder infection)" work? Watermelon mang (talk) 22:45, 26 January 2012 (UTC)

Sure. --Doc James (talk · contribs · email) 18:47, 27 January 2012 (UTC)

Treatment - redux

The "Treatment" section requires a total rework. Even though it lists numerous references, it is severely flawed; almost to the point of being incoherent. First, phenazopyridine (a.k.a. Pyridium) should be described as "being occasionally prescribed during the first few days of antibiotic/antibacterial treatment to help relieve the symptoms of urinary discomfort, burning, and the urinary urgency sometimes encountered during a UTI."

Agree and we worded Doc James (talk · contribs · email) (if I write on your page reply on mine) 11:15, 17 August 2012 (UTC)

I would also add that in the United States, a second, combination medication which contains methanamine, belladonna alkaloids, and methylene blue is sometimes prescribed for the same short duration and reasoning. This medication has additional anti-infective properties, and acts as an anti-spasmodic, which can be helpful in relieving both short-term discomfort and urinary urgency.

Do you have a reference for that? I have not heard of the stuff.Doc James (talk · contribs · email) (if I write on your page reply on mine) 11:15, 17 August 2012 (UTC)

Secondly, the text states that "paracetamol may be used for fevers."; the reference link to a Google books article is dead, and referenced a family practice guidelines book which is listed as being out of print. Any urologist worth their salt would never recommend that APAP be used during any of the phases of UTI treatment. Fever is a necessary indicator to warn the practitioner that the method of treatment isn't working. NEVER, EVER TRY TO MASK A FEVER DURING TREATMENT FOR A UTI, IT MAY HELP TO SAVE YOUR KIDNEYS AND/OR YOUR LIFE! This advice is potentially dangerous, and for that reason, I decided to remove that errant information from this article.

The link is here http://books.google.ca/books?id=4uKsZZ4BoRUC&pg=PA271 and works in my area of the world. The book was published in 2010. Have never come across this concern within the ER literature. The ref specifically deals with pylonephritis. Are there refs supporting it harm?Doc James (talk · contribs · email) (if I write on your page reply on mine) 11:15, 17 August 2012 (UTC)

My reasoning behind making the edit(s):

The article will be more accurate with this paragraph removed. It's great to have multiple references, however, it's also important that those references are directly attributable to the topic being discussed, and are as up-to-date as humanly possible. For that reason, I am deleting it until I have the chance to totally re-work the section. Any complaints, email me!, and Doc James, should you come across this before I complete the re-worked section, gimme a yell. PA MD0351XXE (talk) 07:30, 17 August 2012 (UTC)

Hey Joseph. Great to see you. Let make changes to it will the text is in place. If you have trouble getting access to sources am happy to send some to you. Doc James (talk · contribs · email) (if I write on your page reply on mine) 11:15, 17 August 2012 (UTC)

Terminology clarification

I updated some terminology to make some clarifications. In the world, 70% of men are intact (i.e. have a foreskin). Therefore, there is no such thing as "uncircumcised". There is a "man" and a "circumcised man". The same is true for women. In this article, a risk factor is "female anatomy". Likewise, a risk factor for male UTI is "male anatomy". I also made a change from "uncircumcised" to "intact" in the text. Saying "uncircumcised" implies that it is not the normal case; since most men are intact, we must refer to men the way we refer to women. We would NEVER say "uncircumcised" (i.e. Type II FGM) as a risk factor for females. Crimsoncorvid (talk) 01:33, 26 August 2012 (UTC)

We use the terminology used by the cited sources, not the preferred terminology of individual Wikipedia editors. Yobol (talk) 01:44, 26 August 2012 (UTC)

The terminology "uncircumcised" imparts bias. Is bias important to avoid? There are many sources that use "intact". We should strive for correctness. Crimsoncorvid (talk) 01:53, 26 August 2012 (UTC)

We strive for neutrality. In this case, neutrality would require us to use the terminology of our sources (the ones used in this article). Yobol (talk) 01:54, 26 August 2012 (UTC)

Use of a weasel word is not neutral. Crimsoncorvid (talk) 05:20, 5 February 2013 (UTC)

Cranberry Products

Hey Doc James, I thought I would add the 'Alt med' stuff from the general paragraph into the 'Alt Med' Section that I created, rather than vice-versa, but I got caught-up with RL work before I got a chance. My personal opinion is that I kind of like the organization with headings..... Do you prefer it without the headings? or is that just what resulted from combining the 2 discussions regarding cranberry products? I am not convinced either way is better than the other, but as there is a section for medication and for Children, it seems Alt Med makes another logical category? Thoughts? Puhlaa (talk) 23:50, 25 November 2012 (UTC)

Sure and done. It was just that we had this content twice. Simply wished to combine it. Doc James (talk · contribs · email) (if I write on your page reply on mine) 23:54, 25 November 2012 (UTC)

Great! Puhlaa (talk) 00:00, 26 November 2012 (UTC)

First and last sentences of the lead paragraph

I have a question about the wording of these two sentences. The first sentence states: "A urinary tract infection (UTI) is a bacterial infection that affects part of the urinary tract." To me, this is stating UTI=bacterial infection. While this is MOSTLY true, as the last sentence states: "The main causal agent of both types is Escherichia coli, however other bacteria, viruses or fungi may rarely be the cause." To me, stating that a UTI is a bacterial infection, then having a later statement say that E. Coli is the main cause, but there are other causes, some of which are non-bacterial, is a bit of a contradiction and possibly confusing to someone who isn't used to medical issues. Not everyone realizes that antibiotics will not treat a viral infection, and so while I know that a UTI is generally caused by bacterial, viral and fungal infections are possible, a person who does not know that they are different might be confused. As I read the article, I found it well written but something was just telling me to go back and read the lead paragraph again. Is this something that should be reworded, possibly stating something such as: "A urinary tract infection (UTI) is an infection of the urinary tract that is commonly caused by the Escherichia coli bacteria; however, other bacteria, as well viruses or fungi may also be the cause of infection." Or if that is too wordy (and I think it might be), another possibility could be: "A urinary tract infection (UTI) is an infection of the urinary tract that, while commonly caused by Escherichia coli bacteria, may also be caused by other bacteria, viruses or fungi." I don't know if others see it as I do though. WayneyP (talk) 04:26, 14 December 2012 (UTC)

Thanks agree and will fix. Doc James (talk · contribs · email) (if I write on your page reply on mine) 05:24, 14 December 2012 (UTC)

Cranberry juice

As a male sufferer of UTI, I swear by drinking cranberry juice as was recommended by a doctor, and the NHS.

http://www.nhs.uk/conditions/Urinary-tract-infection-adults/Pages/Introduction.aspx

2.30.188.195 (talk) 08:39, 22 January 2013 (UTC)

We already discuss it. Doc James (talk · contribs · email) (if I write on your page reply on mine) 08:50, 22 January 2013 (UTC)

UTIs in infant males

There do not seem to be any RCTs on the use of male circumcision to prevent UTIs in males. I do not have access to the original source, but I am doubtful that the current source backs up the claim that being "uncircumcised" is a risk factor for UTIs in infant males. See http://www.ncbi.nlm.nih.gov/pubmed/23152269 . Also, the word "uncircumcised" is a weasel word that promotes the viewpoint that "circumcised" is normal. Being circumcised is not normal worldwide (e.g. 70% of males are intact). I am aware that sources use it. The sources are incorrect in the use of this term. We NEVER refer to women as "uncircumcised". Why men? Wikipedia should not be hamstrung by the bias of sources. Crimsoncorvid (talk) 05:18, 5 February 2013 (UTC)

Source actually completely supports the content in question. Wikipedia is not the place to change the world. We only reflect the best available evidence. Doc James (talk · contribs · email) (if I write on your page reply on mine) 04:04, 9 February 2013 (UTC)

I guess the source isn't an RCT then? Crimsoncorvid (talk) 05:06, 9 February 2013 (UTC)

Prevention and risk factor are separate. The article does not state circ is effective for prevention. Only that groups who are uncirc have higher risks. Doc James (talk · contribs · email) (if I write on your page reply on mine) 05:11, 9 February 2013 (UTC)

So it's OK to justify this claim with only one study that's not an RCT? They don't allow statements like that on the circumcision page. It seems like editors have different standards for what's appropriate. Furthermore, it is my understanding that the study referenced did not properly control for babies who were forcibly retracted (which increases the UTI risk). Is there a quality study that controls for all variables? Crimsoncorvid (talk) 05:43, 9 February 2013 (UTC)

It is not a study that supports it but a review article. Have added the conclusions of the Cochrane review. Doc James (talk · contribs · email) (if I write on your page reply on mine) 12:25, 9 February 2013 (UTC)

Thanks for making the change! Crimsoncorvid (talk) 12:36, 9 February 2013 (UTC)

About file:Urinary tract

Please do not make undo action to remove file added by me.As this file is most relevant here to understand the mai article , what constitutes urinary tract elements.Moreover it depicts where in bodu these elements are located.This file has nowhere else used in en.wiki .To argue that it is used in subpage and delete it, is not a good decision.I have again undone action done by another user.--Guglani (talk) 06:16, 6 September 2013 (UTC)

I agree with Doc James that the images do not belong on this article, so removed them. This article is about UTIs, readers who want an overview of the locations of the components of the Urinary system can see the (better) images at that article through the Wikilinks. Zad68 12:35, 6 September 2013 (UTC)

We need to keep this article focused on the subject at hand. Doc James (talk · contribs · email) (if I write on your page reply on mine) 12:39, 6 September 2013 (UTC)

Please remember wiki articles are for commoners and not for specialists who can search a topic for some information any where with google or wiki links for finding relevant information.then what is the need for this article at all if one has to search relevant information here and there.in my opinion still image is most relevant here, but I have not made any revert further for wiki community to decide.--Guglani (talk) 00:32, 7 September 2013 (UTC)

If pneumonia had an overview of the respiratory system and MS an overview of the nervous system in the lead our articles would become a mess. Doc James (talk · contribs · email) (if I write on your page reply on mine) 01:52, 7 September 2013 (UTC)

A wiki link to urinary tract in this article leads to article on urinary system, image included there shows blood vessels as part of system and this link is confusing to define urinary tract and its location in body for a commoner.will you please consider writing a separate article for urinary tract for better understanding of UTI to a commoner and not a doctor . I leave it to my friend to include this macro level image there or not.Further I have seen at many places on web an article on UTI includes a macro level image of Urinary Tract for better reading there about uretra and other elements of Urinary Tract.--Guglani (talk) 11:32, 7 September 2013 (UTC)

Yes urinary system could use a section on urinary tract. Have added one of the pictures. Doc James (talk · contribs · email) (if I write on your page reply on mine) 12:20, 7 September 2013 (UTC)

Cranberry juice

JAMA clinical evidence synopsis - doi:10.1001/jama.2013.277509. JFW | T@lk 11:58, 2 October 2013 (UTC)

d-Mannose

Why isn't d-Mannose listed as a treatment? A quick search on google for d-mannose "Urinary_tract_infection"|cystitis returns 33,200 results! 67.206.163.33 (talk) 04:10, 31 December 2013 (UTC)

Please read WP:MEDRS and if you have an appropriate ref we can look at commenting on it. Doc James (talk · contribs · email) (if I write on your page reply on mine) 08:11, 31 December 2013 (UTC)

Treatment with antibiotics

This article was recently transferred to Swedish Wikipedia after being translated as part of Wikipedia:WikiProject Medicine/Translation Task Force. There was quite a bit of reaction concerning the statement that treatment should generally involve antibiotics. I live in Sweden, and the use of antibiotics is rather restrictive here. The recommendation for women is to drink plenty and let the body deal with it on its own. Here's link to the official recommendation from Stockholm County.[7]

Are these recommendations unusual from an international perspective?

Peter ^Isotalo 22:00, 15 January 2014 (UTC)

Okay will look into it. I mentioned this to the 4 other physicians I am sitting with and they are all amazing that women with a UTI are not given antibiotics. Is there any peer reviewed literature for this? I will ask the Swed I am with to translate the document you sent. Doc James (talk · contribs · email) (if I write on your page reply on mine) 02:43, 16 January 2014 (UTC)

Okay this line says "Man kan behandlas med olika antibiotika beroende på om det bara är urinblåsan som är infekterad eller om även njurarna är påverkade." that bladder infections could be treated with antibiotics. So not sure what you are referring to? It appears that the Swedish page you have provided is very much in line with the English version on Wikipedia. Doc James (talk · contribs · email) (if I write on your page reply on mine) 02:49, 16 January 2014 (UTC)

I've been looking into the issue and I have found a few small discrepancies, but nothing major. A possible contradiction may be these passages from [8]:

Asymtomatisk bakteriuri (ABU) är en term som används när det i upprepade urinprov kan visas att bakteriuri föreligger hos en individ som inte har symtom från urinvägarna. Det råder numera enighet om att ett sådant tillstånd, med få undantag, är ofarligt. Screening för att påvisa och behandla bakteriuri rekommenderas idag endast vid graviditet och inför urogenital kirurgi.

Translated: "Asymptomatic bateriuria (ABU) is a term used when in repeate urincultures bacturia can be seen in an invidual lacking symptoms from the urinary tracts. There is consensus that such a condition, with few exceptions, is not dangerous. Screening to show and treat bacturia is only rekommendera during pregnancy and before urogenital surgery."

UVI hos äldre kvinnor - UTI among older women

Prevalensen av ABU och incidensen av symtomgivande UVI ökar med åldern. Symtombilden är ofta diffus och svårtolkad, vilket ger diagnostiska problem. Dysuri orsakas inte sällan av slemhinneatrofi (östrogenbrist). Eftersom ABU är vanlig hos äldre kvinnor innebär inte förekomst av nitritpositiv urin att eventuell feber har sitt ursprung i urinvägarna.

Diagnosen symtomgivande UVI kan vara svår att ställa hos äldre kvinnor i särskilda boenden pga hög prevalens av ABU, förekomst av kroniska urogenitala besvär och svårigheter att kommunicera. Överdiagnostik är vanligt och bidrar till onödig antibiotikakonsumtion och resistensutveckling. Ospecifika symtom som förvirring och nedsatt aptit tillsammans med positivt nitrittest och/eller positiv urinodling ska inte misstolkas som symtomgivande UVI och inte heller behandlas med antibiotika.

Behandlingstidens längd vid cystit och pyelonefrit är densamma som för yngre kvinnor. Dosreduktion bör övervägas pga den fysiologiskt sänkta njurfunktionen hos äldre individer.

Otherwise the concerns were likely due to translation errors or the single passage highlighted which I took the liberty of translating:

"Overdiagosis is common and contributes to unecessary consumption of antibiotics and development of resistance. Unspecific symptoms such as confusion and low apetite together with positive nitrite and/or positive urine culture should not be missinterpreted as symptomatous UTI and should not be treated with antibiotics."

I can't find any recomendations of how to treat asymptomatic UTIs in our article, at least at a cursory glance.

Lastly from [9] you have the passage:

När ska man söka vård - When to seek care

För det mesta läker blåskatarr hos kvinnor av sig själv utan behandling. Men ger inte besvären med sig eller om man har stora besvär bör man kontakta vården.

For the most part cystitis in women will heal on its own without treatment, but if the symptoms/pain persists or if the symptoms/pain are great contact should be made with care-givers.

These are possible differences I can find quickly, but concerns were raised that the Swedish Wikipedia entry should include international treatment as well, as long as it is stated as such.

As for medication in Sweden [10]; Trimetoprim is not widely used due to resistance, quinolones are used for men (and not for uncomplicated infections in women), amoxicillin is not used widely due to resistance, and trimetoprim/sulfamethoxazole is very seldom used. Pivmecillinam which is not mentionrf in the article can be used for acute cystitis among women and children (could be added to the article here aswell). Nitrofurantoins are the recomended treatment option for women and children.

(Excuse the above clumbsy translations, I made an effort to have it as accurate as possible with concern to the original text) CFCF (talk) 06:14, 16 January 2014 (UTC)

I was looking at some of the same sources as you, CFCF, but you obviously understand them much better than I do.

Regarding research, I did find a reference to a study Västra Götaland that criticizes overuse of antibiotics in UTI's on elderly patients. It's on the website of Vårdfokus, the official magazine of Vårdförbundet, the Swedish union for nurses.[11] Don't know exactly how to find it, though.

There's also this article in Läkartidningen,[12] the magazine of the Swedish physician's union Läkarförbundet. Here's an interesting excerpt:

Graden av självläkning är betydande, och 30 procent av de kvinnor som får akut cystit blir symtomfria utan behandling inom en vecka. Det finns inga hållpunkter för att recidiverande cystiter eller asymtomatisk bakteriuri skulle leda till njursjukdom eller förhöjt blodtryck. Risken att en akut cystit utvecklas till en pyelonefrit är mycket liten. Detta innebär att behandling med antibiotika i första hand har syftet att förkorta tiden med symtom.

"The degree of self-healing is considerable and 30 percent of women who are afflicted with acute cystitis have no symtoms without treatment withing a week. There is nothing indicating that recurrent cystisis or asymptomatic bacteriuria lead to kidney disease or high blood pressure. The risk that an acute cystitis develops into pyelonephritis is very small. This means that treatment with antibiotics has the primary aim of reducing the duration of symtoms."

The article does mention that 50% of those who are afflicted don't need treatment. Is it possible that this could be made a bit clearer, though? I believe it to be of greater interest to the general reader than many of the finer details of treatment.

Peter ^Isotalo 13:02, 16 January 2014 (UTC)

Agree that asymtomatic bacteria should not be treated with antibiotics. We do not mention this explicitly in the article as asymtomatic bacteria is not a UTI. I agree however that we should more clearly state this and will add it. Doc James (talk · contribs · email) (if I write on your page reply on mine) 15:02, 16 January 2014 (UTC)

Elderly women

Common issue in primary care and geriatrics. doi:10.1001/jama.2014.303 (JAMA) JFW | T@lk 13:35, 28 February 2014 (UTC)

CAUSES: The German article states that GUT FLORA is in up to 98% of UTI the cause for it. What about the English? — Preceding unsigned comment added by 151.136.147.24 (talk) 15:39, 11 July 2014 (UTC)

UTI PATIENT CAN TRANSFER SICKNESS TO OTHERS?

UTI PATIENT CAN TRANSFER SICKNESS TO OTHERS? — Preceding unsigned comment added by 2.50.154.15 (talk) 14:56, 14 August 2014 (UTC)

post menopausal UTI

"In post-menopausal women, sexual activity does not affect the risk of developing a UTI."

I can't imagine why this statement is here. I'm pretty sure it isn't true. It reads as if sexual activity would not affect the risk of developing UTI in post-menopausal women because they aren't having any. This for certain isn't true. — Preceding unsigned comment added by Dorthanne (talk • contribs) 04:04, 15 September 2014 (UTC)

Review

doi:10.1001/jama.2014.12842 - JAMA. JFW | T@lk 09:14, 22 October 2014 (UTC)

Ref?

Not seeing where the ref supports this content?

"Diabetics have a high risk for a couple of reasons: First, higher glucose levels in urine create a more hospitable environment for bacteria, and second, some side effects of diabetes, such as nephropathy, create problems emptying the bladder." Doc James (talk · contribs · email) 04:36, 1 December 2014 (UTC)

Moving here for discussion

This article is not about LUTS but about UTIs. We should also be using secondary sources not primary sources per WP:MEDRS. We should also be using sources from the last 10 years at least, 1985 is a little old. Also some of the content is already covered earlier in the article with better sources. Doc James (talk · contribs · email) 05:14, 2 December 2014 (UTC)

Hi, @Doc James:. Thanks for initiating a conversation! I'm the campus ambassador for this class and am in discussion with User:Pumpkinravioli off-wiki.Megs (talk) 20:25, 1 December 2014 (UTC)

Great would be good to have them join this discussion. Their other edits used better sources. Doc James (talk · contribs · email) 05:14, 2 December 2014 (UTC)

Hi, @Doc James:. Thank you for your input. Looking at it now I agree that LUTS is outside the scope of this article. I have found more recent review articles and using them I will be making edits. Please refer to my sandbox if you would like to see my progress. Pumpkinravioli (talk) 21:51, 3 December 2014 (UTC)

Please make sure you read the article before adding more content. We do discuss the role of sexual activity here [13] Doc James (talk · contribs · email) 00:48, 4 December 2014 (UTC)

Extended content

UTI and Sexuality Urinary tract infections are associated with several types of sexual dysfunction in both men and women. Females Women with lower urinary tract symptoms (LUTS) are more prone to having a hypoactive sex drive, sexual arousal disorder, difficulty climaxing, and sexual pain disorder than are women without such symptoms. A significant sexual risk factor for primary and secondary urinary tract infections is diaphragm use as opposed to oral contraceptives as the chosen method of birth control. This is only a relevant factor for sexually active heterosexual women. The mechanism behind this could be due to the positioning of the diaphragm lessening the urgency to urinate and slow blood flow in the area. Both of these situations make it easier for bacteria to colonize, increasing the likelihood of an infection. Urinating after sexual intercourse can help prevent UTIs by removing bacteria from the area. Use of a diaphragm and/or spermicide can increase the rates of colonization of "uropathogenic flora, including Escherichia coli, ... other gram-negative uropathogens, ... group D streptococci, ... and group B streptococci" in the vagina. Sexual Intercourse Heteronormative sexual intercourse can increase risk of a urinary tract infection in females "in several ways. First, the trauma of intercourse might allow bacteria found around the distal opening of the urethra to move up the short female urethra and colonize the bladder. Second, if pathogenic bacteria have colonized the vagina, sexual intercourse may move these bacteria to the urethral opening. Third, the trauma of sexual intercourse may make the bladder more susceptible to descending infection." A correlation between the frequency of intercourse and infection has not been proved. However, some data does suggest that intercourse is the main cause of urinary tract infections in sexually active heterosexual women. Males Men with urogenital infections, including urinary tract infections, are at higher odds of having pain with ejaculation and having problems with affected sperm, in the most severe cases causing problems with fertility. In men with chronic bacterial prostatitis, characterized by recurrent UTIs, symptoms may be more severe and also include pelvic and/or genital pain and hemospermia, a condition in which blood is found in the seminal fluid. Sexual Intercourse Sexual intercourse is most heavily linked to urinary tract infections in females but there have been cases where sexual intercourse is a suspected vector of infection in males. This is a little studied area and so it is not clear what correlation intercourse and urinary tract infection in males there is.

Review

Grigoryan L, Trautner BW, Gupta K (2014). "Diagnosis and management of urinary tract infections in the outpatient setting: a review". JAMA. 312 (16): 1677–1684. doi:10.1001/jama.2014.12842. PMID 25335150.{{cite journal}}: CS1 maint: multiple names: authors list (link) Doc James (talk · contribs · email) 02:30, 31 January 2015 (UTC)

Content suggested by Richard Katz = richard8081

In 2011 United States patent 8,063,026 was granted for "Method of palliating lower urinary tract infections by treatment with mannan oligosaccharides". A published peer reviewed study documented the efficacy and safety of this method. This patent has been reduced to practice under the trade name SuperMannan.

References

COMMENTS INVITED any comments, in addition to beige box edit request Richard8081 (talk) 05:34, 17 August 2015 (UTC)

A mentioned we should use high quality secondary sources not primary sources. Doc James (talk · contribs · email) 21:00, 17 August 2015 (UTC)

That's it? Richard8081 (talk) 00:49, 20 August 2015 (UTC)

generally yes. unless there are review articles published in the biomedical literature that discuss this product. are there? Jytdog (talk) 09:37, 20 August 2015 (UTC)

None that I have heard of. It's an invention; it's new. Let's discuss it a little more.Richard8081 (talk) 04:08, 22 August 2015 (UTC)

Sounds like we should wait for the literature to discuss it more than. Doc James (talk · contribs · email) 04:25, 22 August 2015 (UTC)

Sounds to me like we should put in the information under Treatment that there is an intervention that's been discovered. that would be encyclopedic.

Since this intervention has not been the subject of a review article, and bears the imprimatur of the United States Patent and Trademark Office as having been reviewed with a fine toothed comb, and has been the subject of a peer reviewed medical journal article by urologists, there is Wikipedia superscripted notation to note that the information in secondary/tertiary sources is required for adherence to Wikipedia guidelines and policies. Richard8081 (talk) 11:52, 22 August 2015 (UTC)

No. Please see your talk page. Jytdog (talk) 13:03, 22 August 2015 (UTC)

If it has not been combined into a secondary or tertiary source we do not consider it notable enough for inclusion into Wikipedia. Doc James (talk · contribs · email) 17:00, 22 August 2015 (UTC)

I'll see dried dead autolyzed yeast mentioned as a palliative for cystitis in a review article and post that citation in the Talk page of Urinary Tract Infections. Richard8081 (talk) 22:58, 22 August 2015 (UTC)

Cystitis doesn't mean Urinary tract infection

Cystitis means inflammation of the bladder, and while it's often caused by a bladder infection, it doesn't have to be. So could we have an actual Cystitis page which doesn't redirect here, and also fix this page where it says cystitis IS bladder infection Hammerfrog (talk) 11:04, 22 March 2016 (UTC)

Cystitis is indeed used to mean bladder infection even though the Latin terminology simply means bladder inflammation.[14] Doc James (talk · contribs · email) 11:29, 22 March 2016 (UTC)

How a word is used and what it means are two different things. If Cystitis just means UTI, then explain the easy to find phrase "Cystitis without infection"? Hammerfrog (talk) 12:41, 25 March 2016 (UTC)

Yes that is "interstitial cystitis". When one uses the term cystitis without qualitifications it generally means simple cystitis or a bladder infection. Doc James (talk · contribs · email) 12:51, 25 March 2016 (UTC)

Intact/uncircumcised

There seems to be an issue on what exactly we should call someone that has not been circumcised. The article currently calls people with a foreskin "uncircumcised". I don't have an issue with this since reliable sources do seem to use that term. However, I made an edit to refer to it as "intact/uncircumcised" since some reliable sources refer to it as "intact". It is not uncommon for an article to list more than one way of saying something i.e. Non-penetrative sex/outercourse, Female genital mutilation/female genital cutting/female circumcision, clitoral hood/preputium clitoridis/clitoral prepuce, etc. Accusing me of "exporting politics" is a gross violation of WP:AGF as I was following WP:NPOV. Since "intact" is probably a secondary term for "uncircumcised" (although that may not even be the case) referring to someone with a foreskin as "uncircumcised (or intact)" would make it clear that "intact" is a secondary term (if it is) since it would be in parenthesis. Explicitly making it known that "intact" is a secondary term does not violate WP:UNDUE, just like explicitly making it known that "preputium clitoridis" is a secondary term is not a violation of WP:UNDUE. But outright reverting me and making nasty accusations was not okay. Also, having "uncircumcised" link to the "circumcision" article makes just as much since as linking "uncircumcised" to Female Genital Mutilation. Having a prepuce, labia, etc. has nothing to do with circumcision. In fact, since we don't even have a "uncircumcised/intact" article I don't necessarily see the point of linking to any article. [15] [16] [17] [18] Prcc27🍀 (talk) 09:42, 20 March 2016 (UTC)

Uncircumcised is the usual name for the situation in question. Whenever we use a word we do not typically list other names used for that term. Doc James (talk · contribs · email) 16:18, 20 March 2016 (UTC)

• @Doc James: You're right, we do not typically list other names for the term, but we do explain what the terms mean in the article. If you look at the article you will see that a term is used and then an explanation for what the term means is given. Here are some examples from this article: "kidney infection (pyelonephritis)", "bacteriuria (bacteria in the urine)", "Interstitial cystitis (chronic pain in the bladder)", etc. Since there isn't an article that explains exactly what "uncircumcised" means the readers have a right to have it defined just like these other words have been explicitly defined in the article. "Uncircumcised (men with an intact penis)" or "Uncircumcised (men with an intact foreskin)" would easily explain what it means just in case people don't know what it means. Heck, you could even say "uncircumcised (men with a foreskin)" if the word "intact" doesn't work for you (although I still think we should use it since the reliable sources use it). Yes, many readers will know what it means since it is a common term, but elaborating on what it means makes sure that nobody is unsure about its meaning. Prcc27🍀 (talk) 02:15, 21 March 2016 (UTC)

This is an article about UTIs not circumcision. Your focus on what to call a penis with or without a foreskin is entirely your issue and not something that the UTI literature dwells on. Jytdog (talk) 16:36, 20 March 2016 (UTC)

• @Jytdog: You and Ciflow were involved in an edit war on this article so this is where the discussion will take place. Just because you did not violate WP:3RR doesn't mean your behavior was acceptable. In fact, you can still get blocked for edit warring even if you only make 3 or less reverts on a page if you continue to edit war. Please stop accusing me of campaigning when I am merely asking for us to use the term that is also used in reliable sources. You are not going to get any where with your I don't like it argument so please try making arguments that actually have merit. Prcc27🍀 (talk) 02:15, 21 March 2016 (UTC)

Is anyone okay with the phrases I suggested above? Is so, which one do you prefer? If not, why (and try to refute my points)? Prcc27🍀 (talk) 19:15, 21 March 2016 (UTC)

the existing language is sufficient. this is only being contested by anti-circumcision activists, and enacting activist agendas is not what Wikipedia is for. We follow the mainstream sources. Period. Jytdog (talk) 19:38, 21 March 2016 (UTC)

• You mean the sources you agree with? How were my sources not mainstream? The sources I provided are not anti-circumcision, they are neutral and yet they happen to use "intact". One of the sources I provided used both terms interchangeably so how are they anti-circumcision activists? Prcc27🍀 (talk) 01:38, 22 March 2016 (UTC)

Jytdog- Prcc27 makes legitimate points. They are interchangeable terms, and the medical literature uses both. By blocking me and his edits you are now going against two editors logical justifications in favor of your "I don't like this" and WP:SOAPBOX arguments. Stop edit warring and stop forcing your views on this article.Cirflow (talk)

"Intact" is language used by a small community. Does not belong here. You could try a RfC if you like. Doc James (talk · contribs · email) 18:46, 15 April 2016 (UTC)

If I read the phrase "intact penis" in an article, I would think it's a penis (not foreskin) that hasn't been subjected to an avulsion. If I read the phrase "uncircumcised penis", I'd think "a penis that hasn't been circumcised". The former term shouldn't be used to refer to the latter, as they're not equivalent terms. Seppi333 (Insert 2¢) 18:57, 15 April 2016 (UTC)

• Agree with the several others above, the reliable sources overwhelmingly use "uncircumcised". "Intact" is used very rarely by reliable sourcing but it used quite a bit by a very small community of anti-circumcision advocates. There is no real reason to use a loaded term like it in the article. Zad68 19:02, 15 April 2016 (UTC)

agree same reasons as Zad68--Ozzie10aaaa (talk) 19:09, 15 April 2016 (UTC)

Both terms are used though, and since it appears to be raising contention I think saying both is an acceptable compromise. The term uncircumcised is inflammatory, as has been made apparent. Also, you state that the term intact is used by a minority, when it is in fact considered the acceptable term of use in Europe. If that were not the case, then I would not be defending Prcc27s argument, and I would not of brought it up in the first place.Cirflow (talk) 19:02, 15 April 2016 (UTC)

As a compromise to appease advocates? I don't see that as a valid reason. Zad68 19:05, 15 April 2016 (UTC)

I think a better question is: why does the article need to use TWO terms to refer to this? Seppi333 (Insert 2¢) 19:07, 15 April 2016 (UTC)

I am not an advocate. I am simply a good intentioned editor who is forced to argue against what is written on the English Wiki because it has a noticeable and strong lean in favor of circumcision, and to answer Seppis question: the reason why two terms need to be used is because a penis is only considered "uncircumcised" instead of intact in America and most English sources. Two terms is in fact a compromise made by prcc27 to allow for mutual acceptance, but even compromises are not acceptable to all of you. Your version and your version only is what can be published because to you, me and him are a minority viewpoint and an advocate. Tell me then, If my view was that of a small minority- then why do a majority of the European medical sources call it intact? There is a strong bias in favor of circumcision on this wikipedia that is noticeable simply by comparing different language wikis pages on it, specifically the English version versus the German.

Despite what you seem to portray and think all the people that are against circumcision are, shockingly, (to you anyway) not members of a tiny group of a couple thousand soapboxers who go out in public with signs and make blogs on the Internet against it. In Europe attempts are being made and have been enacted by national Governments to criminalize the elective circumcision of minors for nonmedical reasons. Hundreds of millions of people who have views which are in some cases far more anti-circ then mine, yet I am the one who is an advocate! I wouldn't be surprised if the Somali wiki has a pro female genital cutting leaning view as well, as it is part of their culture, just as the English wiki has a pro circ leaning view because America had male circumcision ingrained into its culture 100 years ago, and because America takes up a significant portion of the English speaking population and world, and most literature in favor of circumcision is American or anglophone in nature. I am only a minority in this section of Wikipedia. A significant amount of the worlds population ultimately agrees with me. I am just trying to balance this and other pages to universally acceptable and nonbiased standards as wikipedia policy requires. If things were switched and there was a strong and unjustified bias against circumcision I would do the exact same thing as I am doing now in order to write the information that's in favor of it, and if my view was truly a minority viewpoint I would of stopped editing on these topics long ago.Cirflow (talk) 21:26, 15 April 2016 (UTC)

If the only sources that use the word "intact" are largely non-English, I don't see how this argument supports the use of that term. It doesn't actually answer my question though: why are TWO TERMS to describe an uncircumcised state necessary, not why are UNCIRCUMCISED AND INTACT necessary? Seppi333 (Insert 2¢) 21:39, 15 April 2016 (UTC)

The reason why it justifies it is because a significant amount of people think the term "uncircumcised" is unjustified and inflammatory, so intact is better to use just based off of worldwide consensus. The reason why I mentioned that there are lots of nonenglish sources that use the term intact is because people seem to think I am advocating something and take a radical minority viewpoint, when in fact I am backed by a fair amount of people. And on why two terms need to be used, I honestly only support the term intact being used, but because you and a few of the other editors are going against that, two terms being used will be a compromise on the issue. Both me and Prcc27 would be fine with this compromise, and it would end the issue and allow for more neutrality.Cirflow (talk) 22:13, 15 April 2016 (UTC)

On English-language Wikipedia we draw our wording from English-language sources. Zad68 23:36, 15 April 2016 (UTC)

We could debate how many people constitute "significant" (my friends on wiki may tell you that "significant" means "any number including me"  ;-), but a majority of English speakers do not hold any such negative opinions about the term uncircumcised. It's just not an emotionally charged word for typical English speakers.

As Seppi noted above, the word intact is also unfortunately vague. A person who has had a penectomy is not "intact", even if "uncircumcised". WhatamIdoing (talk) 03:02, 16 April 2016 (UTC)

Yep. the literature overwhelmingly uses "uncircumstanced". Jytdog (talk) 04:00, 16 April 2016 (UTC)

"Uncircumcised" yes, obviously. We should use plain language and not weird terms that make you go "huh?". Alexbrn (talk) 04:53, 16 April 2016 (UTC)

Saying "intact foreskin" solves the issue that some of the users here brought up with "intact" or "intact penis" being too vague. I actually proposed "intact foreskin" so I wonder how that was even overlooked. Alexbrn, "pyelonephritis" is a "weird" word too and yet we use that word as well as the less "weird" term "kidney infections". Just because you are more familiar with "uncircumcised" than "intact foreskin" doesn't mean that is the case for every reader. I highly doubt that most people that are proficient or fluent in English are going to say "huh?" to the term "intact foreskin" (which is self-explanatory). But there are certainly other words in this article that will invoke that response. Prcc27🎂 (talk) 05:16, 16 April 2016 (UTC)

Alright, I suppose the term uncircumcised makes sense in this particular case, as it is more specific. I will attempt one potential adjustment however, although In this particular instance the usage of the term is at least somewhat acceptable. Cirflow (talk) 06:57, 16 April 2016 (UTC)

What if the patient chooses to not undergo any treatment?

In the "Treatment" section, information should be added about what outcomes may be expected if the patient chooses to not undergo any treatment (i.e., chooses not to take antibiotics for her/his UTI). Mksword (talk) 18:20, 27 October 2016 (UTC)

We already say "About 50% of people will recover without treatment within a few days or weeks." Doc James (talk · contribs · email) 22:44, 27 October 2016 (UTC)

OK, thank you. I didn't see that. Mksword (talk) 06:59, 28 October 2016 (UTC)

What happens to the other half? Went looking for sources briefly yesterday. Would like to add that. Jytdog (talk) 16:56, 28 October 2016 (UTC)

Bacterial colonisation of the catheterised bladder

Hello,

Could we please add a stress to the point that bacteriuria is entirely normal in the context of the catheterised bladder. This is in an effort to reduce antimicrobial prescribing for asymptomatic patients on the basis of a positive urine dipstick test. — Preceding unsigned comment added by Chadler69 (talk • contribs) 11:00, 26 June 2017 (UTC)

Acinetobacter infection

Add information on this pathogen in the cause section please. Its pathogenesis is frequently reported.

109.206.156.72 (talk) 21:20, 3 July 2017 (UTC)

Which ref should we use? Doc James (talk · contribs · email) 05:17, 6 July 2017 (UTC)

Add more information in Alternative treatment options

There are several promising alternative treatment options: 1) Mannosides 2) Vaccines 3) Destruction of bacterial biofilms 4) Anti-inflammatory drugs more here with sources: https://www.stoputiforever.com/treatment/5-uti-treatment-research-trends-2017-2018/ — Preceding unsigned comment added by Avisotsky (talk • contribs) 23:36, 7 July 2017 (UTC)

Semi-protected edit request on 2 May 2018

this edit is in regards to the prevention of childhood UTIs.

There is good evidence that prophylactic antibiotic prevent recurrent UTIs. The RIVUR study is a double blinded placebo controlled trial where children were randomized to Bactrim versus placebo. Patient receiving the low dose antibiotic daily had half as many UTI's as those in the placebo group. Renal scarring rates were similar in both groups. https://www.nejm.org/doi/full/10.1056/NEJMoa1401811 Tgaither07 (talk) 00:32, 2 May 2018 (UTC)

 Not done: it's not clear what changes you want to be made. Please mention the specific changes in a "change X to Y" format and provide a reliable source if appropriate. JTP ^{(talk • contribs)} 02:19, 2 May 2018 (UTC)

Please see WP:MEDRS for sourcing. Doc James (talk · contribs · email) 04:22, 2 May 2018 (UTC)

A strange sentence

"About 150 million people developed a urinary tract infection each year."

Developed? When? Does this mean the number has changed recently? 93.136.3.190 (talk) 02:33, 22 June 2018 (UTC)

Sure adjusted Doc James (talk · contribs · email) 17:41, 16 September 2018 (UTC)

Terminology

This "young sexually active women" is a common term used. Typically no absolute age range is applied to this, as this is simple common English.

Per "A predisposition for bladder infections may run in families". Yes this is believed to be due to genetics.

The Jagannath article comments on being uncircumcised being a risk factor. Basically how this is determined is a population of people circ and those not circ are looked at and the rates of UTIs in these two populations are determined.

The reason they came to the conclusion that they did is here "We were unable to identify any randomised controlled trials on the use of routine neonatal circumcision". No one has studied this is a randomized controlled trial because, well seriously what parent would sign their kid up for this? Doc James (talk · contribs · email) 17:49, 16 September 2018 (UTC)

New guidelines cite benefits of cranberry proanthocyanidins (PAC) for UTI prophylaxis

Healthcare providers seek effective and safe alternatives for preventing recurrent UTIs in wake of widespread antibiotic issues

The newest clinical guidelines for the management of recurrent uncomplicated urinary tract infections (UTIs) further validate the trailblazing efforts of urinary tract supplements like ellura. These supplements contain an ingredient called proanthocyanidins (PAC), the bioactive ingredient from cranberry responsible for preventing bacterial adhesion to the bladder and its subsequent role in UTI prophylaxis, as referenced in the American Urological Association’s (AUA) Guidelines. The recommendations cite the importance of validating PAC type, dosage and concentration to substantiate effectiveness.

The AUA’s endorsement of cranberry as the only non-antibiotic prophylactic option for the management of recurrent UTIs is significant in light of widespread antibiotic issues impacting patients and healthcare providers. UTIs account for up to 60% of antibiotic prescriptions3, a “treat and repeat” cycle that has been associated with overuse, adverse events and bacterial resistance. In clinical trials, 36 mg of bioactive PAC, constituted an effective alternative to prophylactic antibiotics for UTI prevention, without the associated drawbacks.

Despite many proposed interventions to alleviate the large economic and clinical burden of UTIs on patients, providers, and the healthcare system, incidence rates have remained high. These supplements can be easily incorporated into practice as a proven non-antibiotic intervention that aids in reducing UTI recurrence and supports best practices for driving optimal antibiotic stewardship and prescribing protocols.

SethMohs (talk) 19:25, 25 June 2019 (UTC)

References

Organize imvolved

EColi is 75% followed by K pneumoniae, S saprophyticus, and Enterococcus. Proteus is only 2%. Belongs in the body. Doc James (talk · contribs · email) 07:27, 19 December 2019 (UTC)

Can someone make Pyelonephritis under Complicated in the treatment chapter?

Thanks Medhekp (talk) 17:42, 25 January 2021 (UTC)

Semi-protected edit request on 25 of January

Can someone make Pyelonephritis under Complicated in the treatment chapter? Medhekp (talk) 17:44, 25 January 2021 (UTC)

Semi-protected edit request on 28 May 2021

MoinTheQueen (talk) 13:41, 28 May 2021 (UTC)

 Not done: it's not clear what changes you want to be made. Please mention the specific changes in a "change X to Y" format and provide a reliable source if appropriate. ScottishFinnishRadish (talk) 14:19, 28 May 2021 (UTC)

Add causes for UTI categorized for easier understanding

— Preceding unsigned comment added by Avisotsky (talk • contribs) 23:31, 7 July 2017 (UTC)

Diabetics – Their urine contains sugar in dilution. This is a perfect medium for the growth of the bacteria and so diabetics must take extra care.

Sexual activity – Chlamydia and Mycoplasma are also frequently found to be the causes of infection and their presence is usually the cause of sexual activity. These bacteria and E.coli have the ability to attach themselves to the cells lining the urinary tract.

Pregnancy – Pregnancy does not increase the likelihood of infection, but because of the way in which things are pushed out of place the infection is more likely to travel up into the kidneys.

Holding Urine – increases the risk of the bacteria that may be present. This can lead to an infection.

Bacteria of the digestive system - when bacteria from the digestive system into the urinary canal, they multiply and cause infection.

That article presents zero evidence for those claims. In particular, given that urine is not sterile (contrary to what the article states), is there much reason to believe that sugar or holding urine would encourage the growth of pathogenic species in particular? Uncontrolled diabetes impairs immune function, which sounds like a more plausible explanation for the increased risk of infection. As for holding urine, I don’t know of any evidence that urinating more often reduces the risk, in fact there is tentative evidence that it doesn’t. The article contains other doubtful advice such as the debunked advice on cranberry juice. Spidermario (talk) 11:21, 12 June 2021 (UTC)

This article contains other proven advice such as the recently proved cranberry juice* BruhtatoChips (talk) 14:48, 28 April 2023 (UTC)