Cystitis

12 July 2022

Cystitis is an inflammation of the bladder wall. In practical urological terminology, the word "cystitis" is commonly used to refer to a symptomatic urinary tract infection, which manifests as inflammation of the bladder lining, impaired function, and changes in urinary sediment. urine.

Inflammation of the mucous membrane of the bladder with cystitis

Signs of bladder infection appear obvious:

frequent urination (15-20 minutes at a time);
acute pain when urinating in small doses;
a mixture of blood in the urine (sometimes);
subfebrile sauce.

If not treated right away, cystitis can become chronic, or the infection will travel up the kidneys (kidney disease) or down the urethra (urethritis).

According to expert statistics, women between 14 and 60 years old have cystitis at least once in their life, especially 20-50 year old sexually active women with diabetes and a history of decline. immune system function.

Modern children, as can be seen from reality, quite often get cystitis, even babies and infants. The sad thing is that many parents cannot predict the development of this disease in their children.

Cystitis, based on the nature of the process, occurs:

acute: sudden onset, accompanied by local symptoms (frequent and painful urination) and general symptoms (fever, general weakness);
chronic: found on tests, symptoms are sluggish or absent, but in exacerbation, it has an acute form.

Depending on the causative factor, cystitis also occurs:

nonspecific: against the background of conditionally pathogenic microflora (intestinal bacteria, candida, staphylococci, proteus, klebsiella);
specific: due to sexually transmitted diseases (chlamydia, ureaplasmosis, syphilis) or renal tuberculosis.

Causes of cystitis

Most episodes of the disease show that the main cause of cystitis is infection by representatives of the conditional pathogenic environment of the human body - staphylococcus, streptococci, Escherichia coli, as well as infectionsureaplasma and genital mycoplasma.

Today it is known that cystitis, the cause of the disease is quite clear, can not be caused by just one factor.

The complex of factors that lead to the occurrence of cystitis:

Promiscuous sex: the proximity of the urethral opening to the vagina contributes to the ease of infection during intercourse for both women and men.
Non-compliance with the rules of intimate hygiene such as washing the external genitals daily, changing tampons and underwear frequently during menstruation, washing the genitals after sex, keeping pants cleanlining, use pads daily.
Chronic bacterial or vaginal candidiasis: Distorted intestinal and/or vaginal microflora contributes to the growth of a conditionally pathogenic microflora, and subsequently to an abnormal microflorato the genitourinary and urinary systems, causing an inflammatory process, causing harm to the whole body.
Immune system dysfunction: reduced immune defenses or local allergic diseases significantly reduce the body's resistance to disease, making it easier for bacteria to cause disease. enter the bladder cavity.
Frequent urination: A woman's bladder can accumulate 250-500 ml of urine inside, and the frequent and untimely emptying of urine leads to structural changes in the bladder, sphincter and createsgreenhouse conditions for the infection and reproduction of pathogenic microorganisms.
The reduction of the protective force leads to the fact that the infection freely penetrates up into the cavity of the bladder and provokes the inflammatory process in it.
Presence of Escherichia coli E. coli (in 70-95% of patients).
Presence of Staphylococcus aureus (Staphylococcus saprophyticus) in 5-20% of patients.
Persistence of Klebsiella spp and Proteusmirabilis (Proteus) in other patients.
Bladder catheterization in men and women: sometimes leads to urethral infection. This procedure is especially dangerous for pregnant women and women in labor, especially in the postoperative period, when the vagina of the urinary tract is reduced and gram-negative bacteria are already active.
Content in the body of various fungi (Candida and others), chlamydia, Trichomonas, mycoplasmas and viruses.

Cystitis in an acute form, a woman can have several episodes of the disease, the disease often becomes chronic.

In men, cystitis rarely develops, as a rule, after inflammation of the urethra, prostate, epididymis and seminal vesicles. The likelihood of developing cystitis is increased with bladder catheterization in men with an enlarged prostate, one of the symptoms of which is persistent urinary retention.

Symptoms of cystitis

Cystitis is a very uncomfortable, painful disease, bringing a lot of uncomfortable and painful feelings to the patient, they often bravely endure without knowing the dangers that can cause complications. cystitis is not curable. As a rule, acute cystitis comes on suddenly, and cystitis after sexual intercourse goes away on its own after 8-10 hours.

The symptoms of cystitis are very painful, the most characteristic of which are:

cut pain when urinating;
burning and cutting at the end of the act of urinating;
persistent pain in the lower abdomen, sometimes intolerable;
incomplete feeling of the bladder;
sometimes incontinence with a strong urge to urinate (more often in children);
cloudy or bloody urine (hematuria);
sometimes a slight increase in body temperature is accompanied by a slight chill.

An increase in temperature during cystitis can also signal the possibility of inflammation in the kidneys or elsewhere, so immediately contacting a specialist would be a very sensible course of action.

It is known that women and girls get cystitis much more often than men and boys. Oddly enough, the chance of getting cystitis during pregnancy increases dramatically, although it is highly undesirable to have any disease during this period. Usually, cystitis develops in the early stages of pregnancy, sometimes even before the woman knows about it. And for everything else, cystitis is generally considered a nonspecific or relative sign of pregnancy.

Cystitis in early pregnancy is manifested by the following symptoms:

varied pain, which can range from moderate pain in the lower abdomen, mild pain when urinating to sharp pain, stopping with urinary incontinence;
frequent urination with small amounts of urine;
urine may have a pungent, dark color;
constant pain in the lumbar region;
mild hematuria (not always);
sauce (optional)
menstrual disorders in women of childbearing age.

In the elderly and children, the symptoms of cystitis are often not so obvious. Fever, abdominal pain, and nausea may be the only symptoms of cystitis.

With a disease like cystitis, symptoms and treatment always depend entirely on the patient's sense of responsibility for his or her health.

Rate of cystitis

Acute cystitis is one of the common diseases in urology. Usually, uncomplicated cystitis is observed when the bacteria only affect the mucous membrane of the bladder, leaving the submucosa intact.

According to scientific and statistical studies in the practice of urology, the rate of cystitis in women is 500-700 episodes per 1000 patients, and in men aged 21-50 years, only 6-8 cases. per 1000 patients and acute cystitis in men. observed very rarely.

The higher rate of cystitis in women is explained by the following factors:

the urethra (urethra) of women is shorter and its lumen is wider than that of men;
the external opening of a woman's urine pipe that goes directly into the perineum, which makes it easier for infections from the genital tract to enter;
The external opening of the urethra, located near the anus, contributes to the development of 80% of cystitis caused by intestinal bacterial (E. Coli) infection that has entered the bladder from the intestinal lumen.

Cases of cystitis in girls are three to four times higher than in boys. In infants and children under 1 year of age, cystitis is extremely rare; it is usually detected between the ages of 1 and 3 years and in adolescence (13-15 years), but it is more common. in children aged 4 to. 12 years.

cystitis in the summer

Strangely, however, in the warm summer, especially during the holidays, when most women go on vacation in other climates, cases of cystitis become more frequent for the following reasons:

holiday accommodation with the impossibility of high-quality hygienic care for intimate places;
hypothermia after a long bath in a cold water bath;
failure in the usual mode of urination (airplane, move, new place), when you have to suffer for a long time;
a sharp change in the climate zone, which causes a decline in the functions of the immune system;
often increase sexual activity on vacation and so on.

You should urgently contact a urologist if suddenly you cannot avoid cystitis while relaxing at a resort. Clarifying the diagnosis, urinalysis and ultrasound.

The latest antibacterial drugs and antibiotics will effectively speed up recovery and prevent complications (shifting from acute to chronic cystitis). The fact is that they act purely on the inflammatory process in the bladder, have almost no effect on the rest of the organs and systems of the body, are concentrated as much as possible in the urine and diseased mucous membranesof the bladder. Toxic effects on the body are minimal.

Especially successful in the treatment of cystitis in the summer is the use of a drug of the group fosfomycin, which does not have phototoxicity like other drugs of the same class. The drug does not contain photosensitive and photoactive components, does not increase the skin's sensitivity to the sun's ultraviolet radiation even at low intensity, thus does not cause redness and burning of the skin, means can be done without breaking the beach mode.

Phosphonic acid derivatives also have almost no side effects, so they can effectively and safely treat cystitis in children and pregnant women, once for uncomplicated acute cystitis. More severe and chronic forms of cystitis will also be successfully treated with this drug, however, the remedy will be carried out according to a certain plan.

When it comes to a long-awaited summer break, it won't be superfluous to add a broad-spectrum antibiotic to your first aid kit just in case.

cystitis during pregnancy

The inflammatory process in the bladder can begin in a woman at any stage of pregnancy. In all cases, cystitis during pregnancy would be considered complicated and therapy should be carried out entirely under inpatient medical supervision.

The main causes of cystitis during pregnancy:

hemodynamic disorders;
mechanical effect of the enlarged uterus on displaced internal organs of the small pelvis;
hormone imbalance.

All of these reasons can make it difficult to empty the bladder, leading to chronic urinary retention in the bladder and infection. When cystitis is first suspected, a pregnant woman should immediately contact a pregnancy specialist, who will refer her to a urologist if necessary.

Cystitis in children

Childhood cystitis affects the younger generation of all ages, but preschool and school-age girls - 5 to 6 times more often, and the basic reasons for this are:

deficiency in the ability of the ovaries to produce estrogen in girls;
low barrier ability of mucous membranes and skin;
the short and wide urethra "opens" for pathogenic microorganisms to enter the bladder;
infrequent or inadequate genital hygiene care;
at the same time suffer from diseases that contribute to the reduction of the body's immune defense.

The complex of these factors contributes to favorable conditions for the reproduction of pathogenic bacteria in the urethra and bladder.

Diagnosis of cystitis

Before starting treatment, it is important to reveal all the factors that lead to the development of cystitis. A reliable diagnosis will help prescribe the right therapy and make medical recommendations to avoid future recurrences of the disease and prevent the transition of cystitis to a chronic form.

The following studies will help the urologist make an accurate diagnosis:

ask and see a doctor;
obvious symptoms;
laboratory urine and blood tests;
bacteriological study of urine and urethral discharge;
conduct special tests for the presence of nitrites and white blood cells in the urine;
Bladder ultrasound;
determine the presence of comorbidities.

If necessary, other methods of urological examination are used.

Treatment of cystitis

How is cystitis treated? The speed and quality of treatment of cystitis, reconstruction of the mucous membrane of the bladder always depends on the timeliness of diagnosis and well-chosen tactics of complex treatment of the disease.

The choice of antibacterial drugs for the treatment of cystitis is determined by the following parameters:

duration of illness;
severity of symptoms;
the presence of concomitant factors and pathologies;
side effects of drugs, their absorption, method, rate of excretion from the body, etc. v.

The effectiveness of a drug for the treatment of cystitis includes the strength of its suggestive ability against one or another microorganism. It should be noted that pathogenic bacteria mutate and become insensitive to antibiotics. Decades ago, cystitis was treated with great success with a variety of bactericidal drugs. However, today one of the main causative agents of cystitis - E. coli - has become resistant to the effects of these drugs. In addition, previous generations of antibiotics had very high levels of toxicity and many negative side effects.

When choosing a drug against the causative agent of cystitis, one must also take into account the cost of treatment, which will not be reflected so much in the cost of the drug itself but in the effectiveness, thelong-term use and existing risks to the patient's health.

Modern drugs in the treatment of cystitis selectively act on pathogens, concentrated in the bladder, thereby increasing their effectiveness. The use of the latest generation of antibiotics helps to reduce the time to treat cystitis, reduce the risk of side effects and less harmful to the patient's health. A broad-spectrum antibiotic of the group fosfomycin, which is an effective and safe drug, is used to treat cystitis in both pregnant women and children.

How to cure cystitis? In addition to antibiotic therapy, other methods of treatment should not be forgotten:

anti-inflammatory and analgesic therapy with antispasmodics;
stimulates and regulates the immune system;
a diet without fatty and spicy foods;
increase alcohol intake;
fear of hypothermia;
warm compress lower abdomen;
eliminate anxiety, stressful situations;
active lifestyle;
botanical therapy;
using iontophoresis, UHF or inductance.

Remember that the presence of some gynecological diseases prohibits the use of physiotherapeutic and thermal procedures.

Useful tips to prevent cystitis

To prevent and prevent the occurrence of cystitis and its recurrence, follow these simple recommendations:

Observe the rules of personal hygiene: wash your face at least once a day, and preferably 2 or more times, using baby soap (without harmful additives) and running water.
Watch your partner for simple genital hygiene.
Before and after each sex, make sure to wash with soap, and your partner should do the same.
Exclude oral sex for stomatitis, tonsillitis, candidiasis and other infections in the oral cavity to avoid transmission of the infection to the external genitalia and urethra through saliva.
Dress based on weather, not fashion. Reimbursement for a miniskirt in cold weather can be cystitis, and not just cystitis but chronic recurrent, even adnexitis, threatening medical procedures that take a long timeyears, infertility and hope of recovery.
Please note that frequent acute respiratory infections and acute respiratory viral infections indicate a decline in the functions of the immune system and measures should be taken to improve its condition. .
Try not to hold your pee when you want to pee, otherwise it will lead to a bladder infection.
Stick to a normal drinking regimen - 2 liters of water per day, and when hot - add 1-1. 5 liters.
Women should use pads instead of tampons, as they can compress the urethra and become a source of infection, and consequently the bladder.
Men should change their underwear daily, this will protect as much as possible the occurrence of nonspecific urethritis.
When going to the toilet, wipe from front to back, do not wipe back, avoid bringing intestinal bacteria to the external genitalia, from where they can enter the urethra and bladder.

Following these tips won't cure cystitis 100%, but it will help reduce your risk.