Current concepts of the urinary bladder defenses against infection

✍ Scribed by D. T. Uehling

• Book ID: 104757848
• Publisher: Springer
• Year: 1991
• Tongue: English
• Weight: 801 KB
• Volume: 2
• Category: Article
• ISSN: 0937-3462
• DOI: 10.1007/bf00400040

✦ Synopsis

There are several important components to the defenses of the bladder against infection. Bacteria intermittently gain access to the urinary tract via nonlaminar retrograde flow in the urethra. In susceptible patients, an infection is more likely to be established than in non-susceptible ones. Anatomic abnormalities and alterations of bladder filling and emptying predispose the patient to an infection. The bladder mucin layer acts as a barrier to infection by decreasing adherence of bacteria to the bladder mucosa. A local immune response produces urinary antibody which also lessens bacterial adherence to urinary tract epithelium. Susceptible patients exhibit a different arrangement or density of receptors for bacteria on their epithelial cells which influences susceptibility. Since periurethral colonization by pathogenic bacteria precedes bladder infection, colonization of the introitus with urinary tract pathogens facilitates access of these bacteria to the bladder and increases susceptibility to urinary tract infections. These components of the bladder defense mechanisms may offer opportunities for innovative treatment.