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cystitis in women

cystitis symptoms and treatment

Cystitis is one of the common urinary tract diseases. Over the course of a lifetime, for every fourth woman with the condition, 30% of them may experience a relapse within a year, and 10% may experience frequent exacerbations.

This disease is familiar to many girls and women, significantly reducing quality of life. Often, in the early stages of cystitis, the patient will feel pain and fear, not knowing what to do. Our article is intended to help avoid the occurrence of cystitis and, in the event of symptoms, to guide further action.

Cystitisis an inflammation of the lining of the bladder.

The reasons

Infection is the main cause of cystitis, non-infectious causes are much less common. The prevalence of cystitis in women is related to anatomical and physiological features of the body, including the short and wide urethra, the proximity of the urethral opening to the vagina and rectum, and other features. Hormonal. Men do not get cystitis, because their urethra is long and the prostate gland is a kind of anatomical barrier to the entry of microorganisms into the bladder. Men urinating frequently, perineal pain, burning pain when urinating are signs of prostatitis.

It is important to note that cystitis in the vast majority of cases is not caused by microorganisms that enter the body from the external environment or during sexual intercourse, but by their own bacteria, which normally reside in the body. resides in the intestines and female genital tract. Any factor that leads to a decrease in immunity (hypothermia, stress, etc. ) increases the reproduction of endogenous (internal) microorganisms, leading to inflammation of the bladder mucosa. The presence of specific fimbria in these bacteria (hook to attach to the bladder wall), their large number, and a decrease in the protective capacity of the mucopolysaccharide layer of the bladder lead to the development of inflammation.

If cystitis is left untreated or antibiotic therapy is not chosen properly, these infections can travel up the urinary tract, causing inflammation of the kidneys, characteristic symptoms of which are:

  • increased body temperature;
  • pain in the lumbar region;
  • signs of intoxication (general weakness, headache, drowsiness, chills).

The main bacteria that cause cystitis are:

  • Escherichia coli (E. coli) accounted for 75% of cases;
  • In 10% - Klebsiella spp. ;
  • Staphylococcus saprophyticus is the cause in 5–10% of cases;
  • Other gut bacteria are even less common.

Risk factors for cystitis

  • sexual activity;
  • Inadequate hygiene;
  • Using intravaginal contraceptives;
  • Hypothermia of the legs or hypothermia in general;
  • Pregnancy;
  • Premenopausal;
  • Impaired immune response of the body (diabetes, HIV infection, chemotherapy, etc. );
  • Presence of obstructions to urine flow (eg, bladder stones, underactive bladder due to diabetic neuropathy).

Symptoms of acute cystitis

  1. Pain when urinating (when the bottom of the bladder touches the neck;
  2. Frequent urination (more than 8 times a day);
  3. The presence of a leukocytosis in the general analysis of the urine;
  4. Urgent imperative to urinate;
  5. Feeling of pressure or constriction in the pubic area;
  6. The appearance of a mixture of blood in the urine, especially when urinating;
  7. No itching and vaginal discharge;
  8. No hyperthermia (body temperature below 37. 5 degrees).

The first three symptoms above are always present in acute cystitis.

Clinical forms of cystitis

Uncomplicated acute cystitis

In the vast majority of cases, the diagnosis is clear from the presence of characteristic symptoms (frequent urination, pain during urination). As a rule, with this variant of cystitis, no additional diagnosis is required, but you can immediately start using the recommended (practically proven) antibacterial drug. Currently, as a rule, a single dose is enough. Only in cases of unsuccessful treatment is an additional examination indicated. General analytical control of urine showing signs of complete recovery is also not required.

In acute cystitis in the general analysis of urine, an increased number of leukocytes is always detected.

If this is not the case, the diagnosis is doubtful and other causes of frequent and painful urination should be sought.Acute cystitis maskmaybe:

  • overactive bladder;
  • urethritis caused by a sexually transmitted infection (chlamydia, mycoplasmaroductionium, gonorrhea, trichomonas);
  • vaginitis (vaginitis);
  • bladder disease (stones and tumors);
  • bladder tuberculosis.

Frequent recurrence of cystitis

Frequent recurrent cystitis is the presence of 2 or more episodes in six months or 3 or more episodes in a year.

Why in some women cystitis is a life stage, while in others it leads to frequent relapses, science still doesn't know exactly.

Possible causes of recurrent cystitis:

  • genetic predisposition (reduced barrier function of the mucopolysaccharide layer of the bladder mucosa);
  • abnormalities in the development of the urinary system;
  • prolapse (sa) of the internal genitalia;
  • estrogen deficiency;
  • Vitamin D deficiency;
  • iron deficiency anemia, including latent (ferritin deficiency);
  • hypothyroidism (decreased thyroid hormone production);
  • Diabetes;
  • bacterial vaginosis;
  • intestinal dysbacteriosis;
  • use diaphragms and spermicides;

To diagnose the cause of frequently recurring cystitis, use:

  • general urinalysis;
  • analysis of bacteria in the urine with the determination of sensitivity to antibiotics;
  • Ultrasound of kidneys, bladder with residual urine determination;
  • consultation with a gynecologist (detection of vaginosis);
  • FSH, estradiol (detects estrogen deficiency);
  • blood glucose, glycated hemoglobin, insulin, C-peptide (diabetes diagnosis);
  • TSH, no T4, no T3 (diagnosis of hypothyroidism);
  • general blood analysis;
  • blood ferritin (detects latent anemia);
  • flow measurement (determining the rate of urination).

If the cause of this form of cystitis cannot be found, the use of special immunological preparations is considered the "gold standard" in the first line of treatment. Their mechanism of action is to absorb weakened strains of Escherichia coli and develop protective antibodies on them, which then stop the bacteria from multiplying.

Antibacterial drugs are also used in small doses at night, for long periods of time, herbal medicines and diuretics, which bring hyaluronic acid into the bladder (increasing the bladder's defenses).

Post-surgery cystitis

This is cystitis that occurs up to 36 hours after sex. Usually, women experience it when a new sexual partner appears or when starting a family life. At the same time, men do not always discover pathogens that clearly require treatment.

An important differentiatorcauses of cystitis post-survivalTo betest condom:

  • no recurrence with condom use - male factor (look for genital infections in the urethra, at the tip of the penis, prostate, testicles);
  • recurrent recurrences when using condoms. One possible cause is an allergy to latex. The use of spermicide is recommended;
  • The use of condoms did not lead to recovery, when using lubricants, there was no recurrence. Sexual factors, possible local trauma to dry mucous membranes during intercourse. The use of lubricants is recommended;
  • use of condoms does not lead to recovery, use of lubricants does not lead to recovery. Female element. Examination by a gynecologist to rule out the low position of the external opening of the urethra (astigmatism in the vagina), symptoms of vaginitis.

In the treatment of cystitis behind the neck, antibacterial drugs are also used in small doses after intercourse.

Prevention of cystitis behind the neck includes:

  • Hygiene procedures for all partners before and after sexual intercourse;
  • Women are advised to urinate immediately after sex;
  • Avoid vaginal dryness by using a water-based and estrogen-containing lubricant;
  • Do not use deodorants, sprays and cosmetics in the perineal area;
  • Do not wear synthetic underwear.

Chronic cystitis

This variant of cystitis is caused by the obligatory presence of pathology in the wall or cavity of the bladder:

  • rock;
  • tumor;
  • foreign agencies;
  • cysts;
  • diverticulum (protruding wall);
  • sores;
  • leukoplakia

Cystoscopy (examination of the inner surface of the bladder) plays an important role in diagnosing or confirming it.

In the treatment of chronic cystitis, first of all, measures aimed at eliminating the root cause, usually surgery, are important.

cystitis in menopause

It occurs due to insufficient amount of estrogen, like other menopausal disorders in the body. The lining of the hormone-dependent bladder becomes thinner and more sensitive. The woman noted a frequent urge to urinate. At the same time, there were no significant deviations from the standard in the general analysis of urine.

Treatment is with long-term use of topical estrogens in the form of creams and suppositories. In addition, the use of caffeinated beverages should be reduced or completely eliminated and optimal body weight should be maintained.

How to take urine for analysis

  1. On the eve of the test, mineral water should not be drunk and the use of foods (eg, carrots, beets) and medications (riboflavin, rifampin, aspirin, triamterene, phenolphthalein, etc. ) should be excluded. change the color of urine;
  2. On the eve of the test, mineral water should not be drunk and the use of foods (eg, carrots, beets) and medications (riboflavin, rifampin, aspirin, triamterene, phenolphthalein, etc. ) should be excluded. change the color of urine;
  3. If possible, do not use diuretics;
  4. Do not test urine during menstruation;
  5. Before collecting urine, it is recommended to clean the external genitalia, but do not use antiseptics;
  6. The outer labia are separated to the sides by the index and middle fingers to prevent contact with the flow of urine;
  7. For analysis, a portion of morning urine is collected: 1/3 of the first urine is reduced, 1/3 of the second urine is collected in a container for analysis, 1/3 of the waterthe third sub-primary continued to go down;
  8. The walls of the container and the genitals should not touch each other;
  9. It is recommended to use special containers for collecting urine;
  10. Urine in a sealed container should be brought to the laboratory no later than 2 hours after collection;
  11. Don't forget to bring your referrals to analyze with you.

How to relieve pain from cystitis

  1. Applying heat to the lower abdomen will relieve pain and heaviness in the pelvic area;
  2. Take a hot bath for 15-20 minutes;
  3. Drink plenty of water to have about 2. 5 liters of urine: urine mechanically expels bacteria;
  4. Avoid foods that irritate the bladder: caffeinated beverages, alcohol, citrus juices, spicy foods.

Prevention of recurrence of cystitis

  • Frequent urination;
  • Drinking regimen - 1. 5 liters or more per day. Helps remove bacteria from the bladder.
  • Clean perineal area daily properly, do not use stimulants;
  • Sanitize showers for all sexual partners before and after sex. Women are advised to urinate immediately after sex;
  • Avoid hypothermia for legs and whole body;
  • Reception of cranberry juice or fruit drinks, however, according to recent data, this method is not so effective.
  • Do not use deodorants, aerosols and cosmetics in the perineal area, as they can irritate the urethra;
  • Do not use toilet paper to dry the external genitalia.

In case there are symptoms of cystitis, we recommend that you consult your doctor to choose the right treatment method, minimizing the risk of recurrence. Be healthy!

frequently asked Questions

Which cases require immediate medical attention?

We recommend that you consult your doctor immediately at the first symptoms of cystitis, during pregnancy or when symptoms return after the end of the course of treatment, the appearance of gross hematuria (visible blood in the urine). Your doctor will talk to you, examine you, and decide on the need to prescribe other research and treatment methods, as well as tell you about precautions.

How to prepare for a doctor's appointment?

Write down all of your symptoms, even if you don't think they are related to cystitis. Write down any medical conditions you have and any medications and supplements you take. Think about what might herald the onset of symptoms (hypothermia, sexual intercourse, etc. ). Remember to write down all your questions for your doctor, so you don't forget to ask them and discuss all the points that concern you.

In what cases is hospitalization indicated?

Emergency admission to a designated emergency hospital:

  • when signs of nephritis (acute pyelonephritis) appear, namely: back or side pain, fever above 38°C and chills, nausea and vomiting;
  • if blood is present in the urine (gross hematuria), but there are no symptoms of cystitis;
  • condition worse than the background of ongoing therapy (severe pain syndrome, persistent persistent hyperthermia).