From the Guidelines
Ureaplasma urinary tract infections (UTIs) often present with symptoms similar to conventional bacterial UTIs, though they may be milder or more persistent, including painful urination, increased urinary frequency and urgency, cloudy or foul-smelling urine, pelvic pain or pressure, and occasionally low-grade fever, as noted in the European Association of Urology guidelines on urological infections 1.
Common Symptoms of Ureaplasma UTIs
- Painful urination (dysuria)
- Increased urinary frequency and urgency
- Cloudy or foul-smelling urine
- Pelvic pain or pressure
- Low-grade fever
- Burning during urination
- Incomplete emptying of the bladder
- Lower abdominal discomfort
- Vaginal discharge in women
- Urethral discharge in men
Importance of Proper Diagnosis
Many people with Ureaplasma UTIs have recurrent or persistent symptoms that don't fully resolve with standard UTI antibiotics because Ureaplasma lacks a cell wall, making it naturally resistant to commonly prescribed antibiotics like penicillins and cephalosporins. Instead, these infections typically require treatment with antibiotics from the tetracycline class, macrolides, or fluoroquinolones. It's crucial to note that some individuals may carry Ureaplasma without symptoms, as it can be part of the normal genital flora, making proper diagnosis through specific testing crucial before treatment.
Treatment Considerations
Treatment should be guided by the results of nucleic acid amplification tests to ensure the appropriate choice of antibiotic, considering the resistance patterns and the specific needs of the patient, as emphasized in the guidelines for the management of urinary tract infections 1.
From the Research
Common Symptoms of Ureaplasma UTI
- Lower abdominal pain
- Dysuria (painful urination)
- Urinary urgency or frequency
- Chronic voiding symptoms
Specific Symptoms in Women
- The study 2 found that women with Ureaplasma urealyticum infections often experience chronic urinary symptoms, including voiding symptoms and possible interstitial cystitis.
- The mean symptom severity score improved with treatment, and the mean urinary frequency decreased 2.
Specific Symptoms in Men
- The study 3 found that men with prostate infection caused by Ureaplasma urealyticum often experience symptoms of chronic prostatitis, including urethral, prostatic, and sexual symptoms.
Duration of Clinical Symptoms
- The study 4 found that the duration of clinical symptoms is significant in the treatment of female patients with acute urethral syndrome caused by Ureaplasma urealyticum.
- Patients with clinical symptoms present for less than 3 weeks before the start of treatment had different outcomes compared to those with symptoms lasting 3 weeks or longer 4.
Complications of Ureaplasma UTI
- The study 5 found that Ureaplasma urealyticum can cause invasive infection in immunosuppressed patients, leading to complications such as intra-abdominal abscesses and empyema.
- The study 6 found that urinary tract infections, including those caused by Ureaplasma urealyticum, can lead to complications such as sepsis or septic shock, obstructive pyelonephritis, emphysematous pyelonephritis, perinephric abscess, and kidney transplant rejection.