Urosepsis as a clinical challenge: diagnosis, treatment, and medical perspectives

Abstract

Urinary tract infections are among the most common bacterial diseases in adults and, in some cases, may lead to the development of urosepsis, defined as a septic syndrome originating from the urinary tract. In civilian healthcare settings, urosepsis is generally straightforward to recognise and manage; however, military medicine presents additional challenges, such as delayed evacuation, limited diagnostic capabilities, and restricted therapeutic resources. The aim of this study was to analyse the epidemiology, diagnostic criteria, and therapeutic strategies in urosepsis, based on a literature review of PubMed, Scopus, and Web of Science databases (2019–2025), as well as current international guidelines (Sepsis-3, Surviving Sepsis Campaign, European Association of Urology). Particular emphasis was placed on rapid diagnostic methods, simplified risk-assessment tools, and treatment procedures feasible, for example, in field hospitals. Urosepsis is the most common septic syndrome in urology, which accounts for approximately 25% of all sepsis episodes. Under field conditions, the use of simplified clinical criteria (fever, hypotension, altered mental status) and bedside tests (urinalysis, basic inflammatory markers) is of primary importance, as complex clinical scoring systems such as SOFA or qSOFA are often impractical. Management requires immediate initiation of empirical antibiotic therapy, fluid resuscitation, early administration of vasopressors, and rapid removal of the source of infection. Early recognition using simple criteria, prompt initiation of empirical treatment, and adaptation of therapeutic procedures to field conditions are critical for improving patient outcomes.