Cystitis is one of the most common urological diseases. One in four women will suffer from this disease at some point in their lives, 30% of them may experience a recurrence of the disease within a year and 10% may experience a form that is often exacerbated.
This disease is known firsthand to many girls and women and significantly affects the quality of life. During the first episode of cystitis, patients often experience intense pain and anxiety and do not know what to do. Our article is intended to help prevent cystitis from occurring and provide guidance on how to proceed in the event of symptoms.
cystitisis an inflammation of the bladder mucosa.
The reasons
Infections are the main cause of cystitis, non-infectious causes are much less common. The fact that women get cystitis is related to the anatomical and physiological characteristics of the body, which include a short and wide urethra, the proximity of the external opening of the urethra to the vagina and rectum, and hormonal features. Men do not suffer from cystitis because their urethra is long and the prostate acts as a kind of anatomical barrier for microorganisms to ascend into the bladder. Frequent urination in men, pain in the perineum, pain at the end of micturition are a sign of prostatitis.
It is important to note that in the vast majority of cases, cystitis is not caused by microorganisms that enter the body from the external environment or during sexual intercourse, but by their own bacteria that normally inhabit the intestines and female genital tract. All factors that lead to a decrease in immunity (hypothermia, stress, etc. ) cause increased reproduction of endogenous (internal) microorganisms, which lead to inflammation of the bladder mucosa. The presence in these bacteria of special fimbriae (hooks for sticking to the bladder wall), their large number and a decrease in the protective ability of the mucopolysaccharide layer of the bladder lead to the development of inflammation.
If cystitis is not treated or antibiotic therapy is not properly selected, these infections can travel up the urinary tract and cause kidney inflammation, the characteristic symptoms of which are:
- increase in body temperature;
- pain in the lumbar region;
- Symptoms of intoxication (general weakness, headache, drowsiness, chills).
The main bacteria that cause cystitis are:
- Escherichia coli (E. coli) accounts for 75% of cases;
- In 10% - Klebsiella spp. ;
- Staphylococcus saprophyticus is the cause in 5–10% of cases;
- Other enterobacteria are even rarer.
Risk factors for cystitis
- sexual activity;
- insufficient hygiene;
- use of intravaginal contraceptives;
- Hypothermia of the legs or general hypothermia;
- Pregnancy;
- postmenopausal;
- Decreased immune response of the body (in diabetes, HIV infection, chemotherapy, etc. );
- The presence of obstructions to the outflow of urine (e. g. , a bladder stone, an underactive bladder due to neuropathy due to diabetes mellitus).
Symptoms of acute cystitis
- pain at the end of urination (when the bottom of the bladder touches her throat;
- Frequent (more than 8 times a day) urination;
- The presence of an increased number of leukocytes in the general analysis of urine;
- Urgent compelling urge to urinate;
- feeling of pressure or cramps in the pubic area;
- The appearance of an admixture of blood in the urine, especially at the end of urination;
- absence of vaginal itching and discharge;
- Absence of hyperthermia (body temperature below 37. 5 degrees).
The first three symptoms above are always present in acute cystitis.
Clinical forms of cystitis
Acute uncomplicated cystitis
In the vast majority of cases, the diagnosis is obvious by the presence of characteristic symptoms (frequent urination, pain at the end of urination). As a rule, with this variant of cystitis, additional diagnostics are not required, but you can immediately start empirical (proven in practice) administration of the recommended antibacterial drug. Currently, a single dose is usually sufficient. An additional examination is only indicated in the event of treatment failure. Control of the general urinalysis with signs of a full recovery is also not required.
With acute cystitis, an increased number of leukocytes is always detected in the general analysis of urine.
If this is not the case, the diagnosis is doubtful and other causes of frequent and painful urination should be sought.Acute Cystitis Masksmay be:
- overactive bladder;
- Inflammation of the urethra caused by explicit sexual infections (chlamydia, mycoplasma genitalium, gonorrhea, trichomonads);
- vaginitis (inflammation of the vagina);
- Bladder disease (stones and tumors);
- bladder tuberculosis.
Often recurrent cystitis
Commonly recurrent cystitis is the presence of 2 or more episodes in six months or 3 or more episodes in a year.
Scientists are not exactly sure why cystitis is an episode in some women's lives, while for others it leads to frequent recurrences.
Possible causes of recurrent cystitis:
- genetic predisposition (decrease in the barrier function of the mucopolysaccharide layer of the bladder mucosa);
- abnormalities in the development of the urinary system;
- Prolapse (prolapse) of the internal genital organs;
- estrogen deficiency;
- lack of vitamin D;
- Iron deficiency anemia, including latent (ferritin deficiency);
- hypothyroidism (decreased production of thyroid hormones);
- diabetes mellitus;
- vaginal dysbiosis;
- intestinal dysbiosis;
- use of diaphragms and spermicides;
To diagnose the causes of frequently recurring cystitis use:
- general urinalysis;
- bacterial urine analysis with determination of sensitivity to antibiotics;
- Ultrasound of the kidneys, bladder with determination of residual urine;
- Consultation with a gynecologist (detection of vaginal dysbiosis);
- FSH, estradiol (evidence of estrogen deficiency);
- blood glucose, glycated hemoglobin, insulin, C-peptide (diagnosis of diabetes mellitus);
- TSH, T4-free, T3-free (diagnosis of hypothyroidism);
- general blood analysis;
- blood ferritin (detection of latent anemia);
- Uroflowmetry (determining the speed of urination).
If the cause of this form of cystitis cannot be found, the use of special immune preparations is considered the "golden" standard in first-line therapy. Their mechanism of action is the ingestion of weakened Escherichia coli strains and the development of protective antibodies on them, which then stop the multiplicationprevent microbes.
Antibacterial drugs are also used in small doses at night, herbal and diuretic drugs, the introduction of hyaluronic acid into the bladder (increases the protective ability of the bladder).
Postcoital cystitis
This is a bladder infection that occurs up to 36 hours after sexual contact. Most often, women encounter it when a new sexual partner appears or with the beginning of family life. At the same time, obvious pathogens that require treatment are not always detected in men.
An important differentiatorCauses of postcoital cystitisiscondom test:
- there are no relapses when using condoms - the male factor (search for genital infections in the urethra, on the head of the penis, in the prostate, in the testicles);
- constant relapses in the use of condoms. One possible cause is a latex allergy. The use of spermicides is recommended;
- the use of condoms does not lead to recovery, with the use of lubricants there are no relapses. Sexual factor, possibly local traumatization of the dry mucosa during sexual intercourse. The use of lubricants is recommended;
- Using condoms will not lead to recovery, using lube will not lead to recovery. The female factor. Examination by a gynecologist to exclude the deep location of the external urethral opening (intravaginal dystopia), symptoms of vaginitis.
In the treatment of postcoital cystitis, antibacterial drugs are used, even in small doses, after intercourse.
Prevention of postcoital cystitis includes:
- Hygiene procedures for all partners before and after sex;
- Women are advised to urinate immediately after sex;
- Avoid vaginal dryness by using water-based and estrogen-based lubricants;
- Do not use deodorants, aerosols and cosmetics in the perineal area;
- Do not wear synthetic underwear.
Chronic cystitis
This variant of cystitis is due to the obligatory presence of a pathology in the wall or cavity of the bladder:
- stones;
- tumors;
- Foreign body;
- cystocele;
- diverticula (outward protrusion of the wall);
- Ulcer;
- leukoplakia
Cystoscopy (examination of the inner surface of the bladder) plays an important role in making or confirming the diagnosis.
In the treatment of chronic cystitis, causal measures, mostly surgical, are important.
Cystitis in menopause
It occurs due to insufficient levels of estrogen, like other menopausal symptoms in the body. The hormone-related bladder mucosa becomes thinner and more sensitive. The woman notices frequent urges to urinate. At the same time, with the general analysis of urine, there are no significant deviations from the norm.
Treatment involves long-term use of topical estrogens in the form of creams and suppositories. In addition, it is recommended to reduce or eliminate the use of caffeinated beverages and maintain an optimal body weight.
How to collect urine for analysis
- On the eve of the test, it is recommended not to drink mineral water and exclude the use of foods (for example, carrots, beets) and drugs (riboflavin, rifampin, aspirin, triamterene, phenolphthalein, etc. ) that can change the color of urine;
- On the eve of the test, it is recommended not to drink mineral water and exclude the use of foods (for example, carrots, beets) and drugs (riboflavin, rifampin, aspirin, triamterene, phenolphthalein, etc. ) that can change the color of urine;
- If possible, avoid taking diuretics;
- It is not recommended to do a urine test during menstruation;
- Before collecting urine, it is recommended to conduct a toilet of the external genitals, but without the use of antiseptics.
- The outer labia are spread laterally with the index and middle fingers to prevent contact with the flow of urine;
- A morning portion of urine is collected for analysis: the first third of the urine sinks, the second third of the urine is collected in a container for analysis, the third is settled again;
- The walls of the container and the genitals should not touch;
- It is recommended to use special containers for collecting urine;
- The urine must be delivered to the laboratory no later than 2 hours after collection in a tightly closed container.
- Don't forget to take your referral with you to the analysis.
How to relieve the pain of a bladder infection
- A heating pad on the lower abdomen relieves pain and heaviness in the pelvic area;
- take hot sitz baths for 15-20 minutes;
- Drink plenty of fluids so that about 2. 5 liters of urine come out: urine mechanically flushes out bacteria;
- Avoid foods that irritate the bladder: caffeinated drinks, alcohol, citrus juices, spicy foods.
Prevention of recurrence of cystitis
- frequent urination;
- Drinking regime - 1. 5 liters or more per day. Helps flush bacteria from the bladder.
- Proper daily hygiene of the perineal area without the use of irritants;
- Hygienic shower for all partners before and after sex. Women are advised to urinate immediately after sex;
- Avoid hypothermia of the legs and the whole body;
- However, according to recent data, the reception of cranberry juice or fruit drinks is not so effective.
- Do not use deodorants, aerosols and cosmetics in the perineal area, as they can irritate the urethra;
- Don't use toilet paper to dry the external genitals.
If you experience symptoms of cystitis, we recommend that you consult a doctor to choose the right treatment that will minimize the risk of recurrence. Health!
frequently asked Questions
In what cases is it necessary to immediately consult a doctor?
We recommend that you consult a doctor immediately at the first symptoms of cystitis, during pregnancy or if symptoms reappear after stopping treatment, if gross hematuria (visible blood in the urine) occurs. The doctor will talk to you, examine you and decide whether other methods of research and treatment need to be prescribed, as well as inform you about preventive measures.
How do you prepare for a doctor's appointment?
Write down all of your symptoms, even if you don't think they're related to a bladder infection. Write down any medical conditions you have and any medications and supplements you are taking. Think about what might herald the onset of symptoms (hypothermia, sexual intercourse, etc. ). Be sure to write down any questions for the doctor so you don't forget to ask them and discuss any issues that bother you.
When is hospitalization indicated?
Emergency admission to an emergency hospital is indicated:
- if signs of kidney inflammation (acute pyelonephritis) appear, namely: back or side pain, fever over 38 ° C and chills, nausea and vomiting;
- if there is blood in the urine (gross hematuria) but there are no symptoms of cystitis;
- Deterioration of the condition against the background of ongoing therapy (severe pain syndrome, prolonged persistent hyperthermia).