Stone-related urinary tract infections
Introduction
Urinary tract infections can be aggravated by the presence of urinary calculi. When a stone partially or totally blocks the flow of urine, it creates an environment conducive to bacterial proliferation.
These infections can range from simple cystitis to more serious forms such as acute pyelonephritis.
⚠️ If not treated in time, they can lead to serious complications.
💡 Appropriate management can identify the infectious origin, eliminate the stone responsible and prevent recurrence.
What are the symptoms?
Clinical signs may vary according to stone location and size. Here are the main reasons for consultation:
1️⃣ Urinary burning + fever
A stone in the kidney, ureter or near the bladder can cause partial obstruction, leading to ascending infection.
- Urine stasis creates a breeding ground for bacteria.
- If obstruction is severe → risk of acute pyelonephritis, sometimes serious.
2️⃣ Recurrent urinary tract infections
Repeated episodes (several times a year) should raise the suspicion of an obstacle:
- Residual calculation,
- Urethral stricture,
- Prostatic hypertrophy,
- Malformation, diverticulum, reflux.
These recurrent infections are often accompanied by resistant bacteria.
3️⃣ Chronic pelvic pain
The pain may persist for several months:
- Suprapubic, perineal, testicular discomfort,
- Pain associated with chronic prostatitis, stenosis, reflux, incomplete emptying...
📌 They are sometimes aggravated by exertion, during urination or after intercourse.
What are the most common causes?
1. Classical uropathogenic bacteria
✔ Escherichia coli, Proteus, enterococci…
✔ Multi-resistant germs in case of recurrences.
2. Urinary calculi
✔ Local irritation + obstruction → superinfection.
3. Anatomical barriers
✔ Stretching of urethra or ureter
✔ Prostate adenoma
✔ Valves, diverticula, malformations
4. Chronic prostatitis
✔ Low-noise infection may maintain symptoms.
5. Vesicoureteral reflux
✔ Backflow of infected urine to the kidneys.
6. Bladder emptying disorders
✔ Stagnant urine → repeated infections.
⚠️ Aggravating factors: diabetes, immunodepression, inadequate hydration, repeated urinary catheterization.
Recommended check-ups and examinations
To identify the exact cause, a complete check-up is often necessary:
1️⃣ Interview + history
- Symptoms, frequency, previous treatments.
2️⃣ Clinical examination
- Palpation, rectal examination, abdominal and perineal examination.
3️⃣ Blood and urine tests
- ECBU, blood cultures if fever
- CBC, CRP, renal function
3️⃣ Imaging
- Renal and bladder ultrasound
- Non-injected CT scan: reference examination for calculi
- Cystoscopy if bladder anomaly suspected
4️⃣ Functional tests (depending on symptoms)
- Flowmetry, post-micturition residual measurement, urodynamics.
5️⃣ Prostate exploration
- Specific ECBU, ultrasound, MRI if chronic prostatitis is suspected.
- In the case of calculi, a full metabolic work-up may be recommended.
What treatments are available for stone-related infections?
1️⃣ Targeted antibiotics
- Adapted after antibiotic susceptibility testing.
- Hospitalization if high fever or severe pyelonephritis.
2️⃣ Responsible calculation processing
- Laser (ureteroscopy)
- Lithotripsy
- Endoscopy or NLPC depending on size
- Extraction of residual fragments
3️⃣ Treatment of the anatomical obstacle
- Adenoma, stenosis, valve → medical or surgical treatment.
4️⃣ Symptom management
- Analgesics, anti-inflammatories, alpha-blockers, antispasmodics.
5️⃣ Recurrence prevention
- Hydration, diet, regular drainage, modification of risk factors. Sometimes low-dose antibiotic treatment (limited indications).
6️⃣ Long-term follow-up
- Control ECBU, imaging, field monitoring.
Why consult a specialist urologist?
A consultation allows :
- Expertise to identify the underlying cause
- Assessing the risk of complications
- Access to specialized examinations and minimally invasive techniques
- Preventing recurrence and protecting renal function
Delayed management can lead to serious infection or kidney damage.
Are you suffering from a urinary tract infection?
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Do you suffer from recurrent urinary burning?
Don’t let these symptoms set in. Dr. Sébastien Dominique offers a personalized approach, based on a comprehensive assessment, tailored treatment and regular follow-up.
Cabinet Urologie Paris Opéra – Paris 17th district
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