II. Epidemiology

  1. Significant underlying disorder in 50% of men with UTI

III. Causes

  1. Upper urinary tract causes
    1. Hydronephrosis
    2. Nephrolithiasis (in Kidney or ureter)
      1. Common cause in younger men
    3. Scarred or atrophic Kidney
    4. Pelvic Kidney
    5. Ureter dilation
  2. Lower urinary tract causes
    1. Outflow obstruction with residual urine
      1. Most common cause in men over age 50 years
    2. Diverticulum
    3. Bladder stone

IV. Differential Diagnosis

V. Management

VI. Diagnostic Approach to UTI source

  1. Initial Studies to consider
    1. Abdominal Ultrasound
    2. Abdominal XRay
    3. Urine flow rate
  2. Further evaluation based on initial studies
    1. No abnormalities
      1. No further imaging needed
    2. Upper tract abnormality
      1. Obtain Intravenous pyelogram
    3. Lower tract abnormality
      1. Cystoscopy
      2. Urodynamics
      3. Transrectal Ultrasound
  3. Modifications to algorithm
    1. Consider IVP or Spiral CT in younger patients

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