The natural history of urinary infection in adults.

The vast majority of otherwise healthy adults with anatomically and functionally normal urinary tracts experience few untoward long-term consequences from symptomatic or asymptomatic UTIs. Effective early treatment of symptomatic infection rapidly curtails bacterial invasion and the resulting inflammatory response. Rarely, uncomplicated acute pyelonephritis causes suppuration and renal scarring. Urinary infections in patients with renal calculi, obstructed urinary tract, neurogenic bladder, or diabetes are frequently much more destructive and have ongoing sequelae. Strategies to treat both the infection and the complications are often necessary to alter this outcome.