Nac in urodynamics

Urinary tract infections (UTIs) are defined as the presence and the proliferation of bacteria which are pathogens in one or more parts of the urinary tract with subsequent invasion of tissue and the onset of symptoms. UTIs represent a great problem for the public health systems, because they are responsible for high morbility and are also one of the main causes of antibiotic prescriptions associated to an increased resistance to them (1).
In Europe UTIs represent the second cause of bacterial infection, after the respiratory, and are the most frequent form of nosocomial infections, associated mostly to the bladder catheterism (2, 3). Furthermore, the high volume of antibiotics used to face UTIs determines high costs for the sanitary systems and their abuse has significantly contributed to the development of resistance mechanisms of the germs to these drugs (4). Females are usually more exposed to this pathologic condition due to anatomical factors. However, after the age of 50, the risk of UTI increases also for men because of obstructive problems
due to the benign prostatic hypertrophy (Table 1).
Some other factors may contribute to increase the risk of developing UTI, and they should not be underestimated, such as intrauterine contraceptives (spiral), pregnancy (because it causes urinary stasis), menopausal status, anatomical and endocrine disrupters, constipation, wrong behavioural habits, various types of urinary catheterisms (ureteral stent, nephrostomy, intermittent or indwelling bladder catheterization). The Annual Epidemiological report of the European Centre for Disease Prevention and Control (ECDC) published in April 2015, reported that pathogenic agent which is responsible of most UTIs (about 70%) is Escherichia coli, a bacteria of faecal origin which belongs to the gram-negative (5). E. coli is an emerging problem also regarding community acquired UTI either in pediatric population either in the adult and elderly subjects (4).