Is the incidence rate of urinary tract infection related to gender? What are the general types of infection routes

Urethral infections are generally divided into upper urinary tract infections and lower urinary tract infections. The methods of bacterial invasion are divided into bloody infection, ascending infection, and descending infection. Most women have ascending infections because their urethra is straight and short, and bacteria can easily ascend to the bladder to cause infection. In addition, the external opening of the female urethra, which is close to the vaginal opening and anus, is easily contaminated by feces and bacteria excreted in the open channel. In addition, the complete bladder discharge capacity of elderly women is reduced, and bacteria are prone to reproduce in residual urine. It is common clinically that lower urinary tract infection is cystitis, which is a common and frequently occurring disease in elderly women. Its incidence rate is 8-10 times higher than that of men. Prevention is very important.

Route of infection

It is generally believed that there are four pathways of urinary tract infection: ascending infection, hematogenous infection, lymphatic infection, and direct infection.

(1) Upward infection: Most urinary infections are caused by upward infection. Usually, bacteria parasitize the urethral opening and its surroundings, but do not cause infection. When the body's resistance decreases or there is slight damage to the urethral mucosa, or when bacteria are highly toxic and have strong adhesion to the urethral mucosa and ascending ability, it is easy to invade the bladder and kidneys, causing infection. The female urethral opening is close to the anus, and the female urethral opening is shorter and wider than the male urethral opening. The female urethral opening is often contaminated with feces and is prone to illness.

(2) Hematological infection: bacteria invade the blood stream from the infection furnace in the body (such as tonsillitis, sinusitis, caries or skin infection) and reach the kidney. First, they cause multiple small abscesses in the renal cortex, and then spread down the renal tubules to the renal papilla and renal pelvis mucosa. However, the inflammation also spreads upward from the nipple collecting tube (crystal damage in urine, etc.) with slight damage to the renal breast head. Hematological infection routes are rare, less than 10%. Hematological infections are more common in newborns or in patients with Staphylococcus aureus sepsis.

(3) Lymphatic infection: There are many communicating branches between the lymphatic vessels in the lower abdomen and pelvic organs and the lymphatic vessels around the kidneys, and there is also lymphatic communication between the colon and the right kidney. When pelvic organ inflammation, appendicitis, and colitis occur, bacteria can also infect the kidneys through the lymphatic system. This route of infection is even rarer, and there is still debate about its existence.

(4) Direct infection: During trauma or infection of nearby kidney organs, bacteria can directly invade the kidney and cause infection, but it is very rare in clinical practice.

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