Cystitis is inflammation of the bladder walls. In practical urological terminology, the word "cystitis" is usually used to denote a symptomatic urinary tract infection with manifestations of inflammation of the bladder mucosa, functional disorders and changes in the urine sediment.
![Inflammation of the mucous membrane of the bladder with cystitis](/images/articles/805/Inflammation%20of%20the%20mucous%20membrane%20of%20the%20bladder%20with%20cystitis.jpg)
Signs of cystitis appear sharply:
- frequent urination (every 15-20 minutes);
- acute pain when urinating in small doses;
- an admixture of blood in the urine (sometimes);
- subfebrile fever.
If not treated promptly, cystitis can become chronic or the infection can travel up the kidneys (kidney disease) or down the urethra (urethral disease).
According to statistical expertise, women aged 14 to 60 have had cystitis at least once in their lives, particularly sexually active women aged 20 to 50 who had diabetes mellitus and a history of reduced immune system function.
Modern children, as can be seen from practice, often suffer from cystitis, even babies and babies. It is sad that many parents cannot predict the development of this disease in a child.
Cystitis, based on the nature of the process, occurs:
- acute: manifests itself suddenly, accompanied by local (frequent and painful urination) and general symptoms (fever, general weakness);
- chronic: detected in laboratory tests, the symptoms are sluggish or absent, but during an exacerbation it takes the form of an acute one.
Based on the causative factor, cystitis also occurs:
- nonspecific: against the background of conditionally pathogenic microflora (enterobacteria, candida, staphylococci, proteus, klebsiella);
- specific: due to sexually transmitted diseases (chlamydia, ureaplasmosis, syphilis) or renal tuberculosis.
Causes of cystitis
Most episodes of the disease have shown that the main cause of cystitis is infection by representatives of the conditionally pathogenic environment of the human body - staphylococci, streptococci, Escherichia coli, as well as infection with genital ureaplasma and mycoplasma infections.
Today it is known that cystitis, the causes of which are quite clear, cannot be caused by only one factor.
The complex of factors leading to the appearance of cystitis:
- Promiscuous sex: The proximity of the opening of the urethra to the vagina contributes to easy infection during intercourse with both female and male flora.
- Failure to observe such rules of intimate hygiene as daily washing of the external genitals, frequent changing of sanitary napkins and underwear during menstruation, washing of the genitals after sexual contact, keeping underwear clean, use of daily pads.
- Chronic dysbacteriosis or vaginal candidiasis: disturbed intestinal and / or vaginal microflora at times contributes to the growth of the population of conditionally pathogenic microflora, and then the microflora, unusual for the genital and urinary systems, causes an inflammatory process that damages the whole body.
- Immune system dysfunction: a decrease in immune defense or allergic local pathologies significantly reduces the body's resistance to diseases, which gives pathogenic bacteria a free hand to easily penetrate into the bladder cavity.
- Infrequent urination: 250-500 ml of urine can accumulate in a woman's bladder, and regular untimely emptying leads to structural changes in the bladder, sphincter and the creation of greenhouse conditions for infection and reproduction of pathogenic microorganisms.
- The decrease in protective forces leads to the fact that the infection freely enters the cavity of the bladder upwards, provoking an inflammatory process in it.
- The presence of Escherichia coli E. coli (in 70-95% of patients).
- The presence of Staphylococcus aureus (Staphylococcus saprophyticus) in 5-20% of patients.
- Presence of Klebsiella spp. and Proteusmirabilis (Proteus) in other patients.
- Bladder catheterization in both men and women: sometimes leads to infection of the urethra. This procedure is especially dangerous for pregnant and childbearing women, especially in the postoperative period, when the tone of the urinary tract is reduced and gram-negative bacteria have shown activity.
- The content in the body of various fungi (Candida and others), chlamydia, trichomonas, mycoplasma and viruses.
Cystitis in acute form, a woman can get sick several times, and the disease often becomes chronic.
In men, cystitis usually rarely develops after inflammation of the urethra, prostate, epididymis, and seminal vesicles. The likelihood of cystitis is increased during bladder catheterization in men suffering from prostatic adenoma, one of the symptoms of which is constant urinary retention.
Symptoms of cystitis
Cystitis is a very unpleasant, painful disease that causes a sick person to experience a lot of unpleasant and painful sensations, which they often bravely endure, unaware of the dangers that can later lead to complications from incurable cystitis. As a rule, acute cystitis occurs suddenly, and cystitis after sexual intercourse is explained after 8-10 hours.
The symptoms of cystitis are very painful, the most characteristic of them:
- cutting pains when urinating;
- burning and cutting at the end of urination;
- drawing pains in the lower abdomen, sometimes unbearable;
- feeling of incomplete emptying of the bladder;
- sometimes urinary incontinence with a strong urge to urinate (more common in children);
- cloudy or bloody (hematuria) urine;
- sometimes a slight increase in body temperature with a mild cold.
A rise in temperature during a bladder infection can also indicate possible inflammation in the kidneys or elsewhere, so it would make a lot of sense to see a specialist right away.
It is known that women and girls suffer from cystitis much more often than men and boys. Oddly enough, the likelihood of getting cystitis during pregnancy increases significantly, although during this period any disease is highly undesirable. Quite often, cystitis develops in the early stages of pregnancy, sometimes even before the woman knows about it. And on top of everything else, cystitis is often referred to as a non-specific or relative sign of pregnancy.
Cystitis in early pregnancy is manifested by the following symptoms:
- various pains, which can range from moderate pain in the lower abdomen with mild soreness at the end of urination to sharp, cutting pains with urinary incontinence;
- frequent urge to urinate with a small amount of urine;
- urine may have a pungent odor, dark color;
- constant pain in the lumbar region;
- mild hematuria (not always);
- fever (optional)
- Menstrual disorders in women of childbearing age.
In older people and children, the symptoms of cystitis are often not as obvious. Fever, abdominal pain, and nausea can be the only symptoms of a bladder infection.
With a disease like cystitis, the symptoms and treatment are always entirely dependent on the patient's sense of responsibility for their health.
Prevalence of cystitis
Acute cystitis is one of the most common diseases in urology. Most commonly, uncomplicated cystitis is seen when bacteria invade only the mucosa of the bladder, leaving the submucosal layer intact.
According to scientific and statistical studies in urological practice, the prevalence of cystitis in women is 500-700 episodes per 1000 patients, and in men aged 21-50 years it is only 6-8 cases per 1000, and the acute form of cystitis in men becomes extremerarely observed.
The higher prevalence of cystitis in women is explained by factors:
- a woman's urethra (urethra) is shorter and its lumen is wider than that of the male urethra;
- the external opening of the urinary canal of women goes directly to the perineum, which contributes to the easy penetration of infections from the genital tract;
- The external opening of the urethra is located near the anus, which contributes to the development of 80% of cystitis due to infection with intestinal bacteria (E. Coli) that got into the bladder from the intestinal lumen.
Cases of cystitis in girls are three to four times more common than in boys. In newborns and children under 1 year old, cystitis is extremely rare, more often the disease is detected at the age of 1-3 years and adolescence (13-15 years), but most often they get sick in children 4-12 years old.
cystitis in summer
Oddly enough, however, in the warm summer season, especially the holiday season, when most women go on vacation to other climates, cases of cystitis become more common for the following reasons:
- accommodation on vacation with the impossibility of high-quality sanitary care of intimate places;
- Hypothermia of the body after too long a bath in a cold reservoir;
- failure to urinate normally (flight, moving house, new place) when you have to endure it for a long time;
- a sharp change in the climatic zone, leading to a decrease in the functions of the immune system;
- often increased sexual activity on vacation and so on.
You should urgently contact a urologist if, while relaxing in a resort, you suddenly could not avoid a bladder infection. Clarification of the diagnosis, urine test and ultrasound examination.
The latest antibacterial drugs and antibiotics will effectively speed up your recovery and prevent complications (transition from acute cystitis to chronic). The fact is that they act exclusively on the inflammatory process in the bladder, almost without affecting the rest of the organs and systems of the body, concentrating as much as possible in the urine and diseased mucous membrane of the bladder. The toxicological effect on the body is minimal.
Especially successful in the treatment of cystitis in the summer is taking a drug from the fosfomycin group, which, like other drugs of the same series, does not have phototoxicity. The drug, which does not contain components with photosensitizing and photoreactive properties, does not increase the skin's sensitivity to solar ultraviolet radiation, even at low intensity, and therefore does not cause redness and burns on the skin, which means that it can be taken without the beach regimeto hurt.
The phosphonic acid derivative is also almost free of side effects, which enables effective and safe treatment of cystitis in children and pregnant women with a single dose of uncomplicated acute cystitis. Chronic and other, more severe bladder infections are also successfully treated with this drug, but the drug is taken according to a specific scheme.
Going on a long-awaited summer vacation, it will not be superfluous to stock up on your first-aid kit with a broad-spectrum antibiotic, just in case.
Cystitis during pregnancy
The inflammatory process in the bladder can begin in a woman at any stage of pregnancy. In any case, cystitis during pregnancy is considered complicated and therapy should only be carried out under the supervision of an inpatient.
The main causes of cystitis during pregnancy:
- hemodynamic disorders;
- mechanical effects of the enlarged uterus on the displaced internal organs of the small pelvis;
- hormonal imbalance.
All of these reasons can make it difficult to empty your bladder, which can lead to chronic urinary retention and infections. At the first suspicion of a bladder infection, a pregnant woman should immediately contact a specialist responsible for her pregnancy, who may refer her to a urologist.
Bladder infection in children
Cystitis in children affects the younger generation at any age, but girls of preschool and school age - five to six times more often, and the underlying reasons for this are:
- the lack of ability of girls' ovaries to produce estrogens;
- low barrier ability of mucous membranes and skin;
- a short and wide urethra is "open" for the passage of pathogenic microorganisms into the bladder;
- irregular or insufficient hygienic care of the genitals;
- Concomitant diseases that contribute to a decrease in the body's immune defenses.
The complex of these factors contributes to the creation of favorable conditions for the reproduction of pathogenic bacteria in the urethra and bladder.
diagnosis of cystitis
Before starting treatment, it is important to uncover all the factors that led to the development of cystitis. Reliable diagnostics will help prescribe adequate therapy and provide medical recommendations to avoid future recurrences of the disease and prevent the transition of cystitis into a chronic form.
The following studies will help the urologist to make the correct diagnosis:
- questioning and examination of a doctor;
- obvious symptoms;
- laboratory tests of urine and blood;
- bacteriological examinations of urine and smear from the urethra;
- Conducting special tests for the presence of nitrites and leukocytes in the urine;
- bladder ultrasound;
- Determining the presence of comorbidities.
If necessary, other methods of urological examination are used.
treatment of cystitis
Cystitis how to treat? The speed and quality of treatment of cystitis, regeneration of the mucous membrane of the bladder always depend on the timeliness of the diagnosis and well-chosen tactics of complex treatment of the disease.
The choice of antibacterial drugs for the course of treatment of cystitis is determined by the following parameters:
- the duration of the illness;
- severity of symptoms;
- the presence of concomitant factors and pathologies;
- Side effects of drugs, their reception, method, speed of their elimination from the body, etc.
The effectiveness of a drug for the treatment of cystitis consists in the strength of its suggestiveness to one or another microorganism. It should be noted that pathogenic bacteria mutate and become insensitive to antibiotics. Bladder infections were treated very successfully with many bactericidal drugs decades ago. However, today one of the main causes of cystitis - E. coli - has become resistant to the action of these drugs. In addition, the previous generation of antibiotics had very high toxicity and many negative side effects.
When choosing a drug against cystitis pathogens, it is also necessary to take into account the cost of treatment, which will be expressed not so much in the cost of the drug itself, but in its effectiveness, long-term use and the risk it poses to the patient's health.
Modern drugs for the treatment of cystitis act selectively on pathogens, concentrating in the bladder, thereby increasing its effectiveness. The use of the latest generation of antibiotics shortens the treatment time for cystitis, reduces the risk of side effects, due to which there is less harm to the health of patients. A broad-spectrum antibiotic from the group of fosfomycins is used as an effective and safe drug for the treatment of cystitis in both pregnant women and children.
How to cure cystitis? In addition to antibiotic treatment, one should not forget about other methods of treatment:
- anti-inflammatory and analgesic therapy with antispasmodics;
- stimulation and modulation of the immune system;
- a diet without fatty and spicy foods;
- increased drinking regime;
- fear of hypothermia;
- warm heating pad on the lower abdomen;
- exclusion of fear, stressful situations;
- active lifestyle;
- phytotherapy;
- Use of iontophoresis, UHF or induction thermal.
Remember that the presence of some gynecological diseases prohibits the use of physiotherapy and thermal procedures.
Helpful tips for preventing cystitis
To prevent and prevent the occurrence of cystitis and its recurrence, follow simple recommendations:
- Observe the rules of personal intimate hygiene: wash your face at least once a day, preferably twice or more, with baby soap (without harmful additives) and running water.
- Monitor your sexual partner for basic genital hygiene.
- Be sure to wash yourself with soap before and after any sexual contact and your sexual partner must do the same.
- Exclusion of oral sex in stomatitis, tonsillitis, candidiasis and other infections of the oral cavity in order to avoid infection of the external genitals and urethra with saliva.
- Wear clothing that suits the weather, not fashion. Payback for a miniskirt in cold weather can be cystitis, and not just cystitis, but chronically recurring, and even inflammation of the appendages, threatening years of medical intervention, infertility and hope of recovery.
- Please note that frequent acute respiratory infections and acute viral infections of the respiratory tract indicate a decrease in the functions of the immune system and measures should be taken to improve its condition.
- Try not to hold your urination when you want to urinate, otherwise holding your urine will lead to cystitis.
- Stick to a normal drinking regime - 2 liters of water per day, and in the heat - 1-1. 5 liters more.
- Women are advised to use pads instead of tampons, which compress the urethra and can become a source of infection and, consequently, the bladder.
- Men are advised to change their underwear daily to protect as much as possible from the onset of nonspecific urethritis.
- When using the toilet, it is recommended to wipe from front to back and not the other way around to avoid introducing intestinal bacteria to the external genitals, from where they can enter the urethra and bladder.
Following these tips will not eliminate cystitis 100%, but it will help minimize your risk of contracting it.