The pathogenesis of recurrent urinary tract infection: the bowel, bladder hypokalemia connection.

A conceptual approach to the understanding of the pathogenesis of recurrent nonobstructive urinary tract infections is presented. Abnormal colonic function is associated with potassium wastage which alters smooth muscle function of both the bowel and bladder. Hypokalemia additionally results in the elaboration of an alkaline urine and bladder dysfunction leads to urinary stasis. Vaginal and perineal contamination from the bowel flora are etiologically important in the genesis of such infections. Thus, a linkage exists between bowel dysfunction, potassium wastage and recurrent urinary tract infection.