Cystitis

Cystitis is inflammation of the bladder walls. In practical urological terminology, the word "cystitis" is usually used to denote a symptomatic urinary infection, with manifestations of inflammation of the bladder mucosa, impaired function and changes in the urinary sediment.

Signs of cystitis appear sharply:

• frequent urination (every 15-20 minutes);
• sharp pain when urinating in small doses;
• a mixture of blood in the urine (sometimes);
• subfebrile fever.

If not treated immediately, cystitis can become chronic or the infection will spread along the kidneys (kidney disease) or along the urethra (urethral disease).

According to statistical experience, women aged 14 to 60 have had cystitis at least once in their life, particularly sexually active women aged 20 to 50 who had diabetes mellitus and a history of decreasing of the functions of the immune system.

Modern children, as can be seen from practice, very often suffer from cystitis, even infants and children. 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 (fever, general weakness) symptoms;
• chronic: found in laboratory tests, symptoms are slow or absent, but during an exacerbation it takes the form of an acute one.

Based on the causative factor, cystitis also occurs:

• non-specific: 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 proved 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 genital ureaplasma infections and mycoplasma infections.

Today it is known that cystitis, the causes of which are quite clear, cannot be caused by just one factor.

The complex of factors leading to the appearance of cystitis:

1. Promiscuous sex: The close proximity of the opening of the urethra to the vagina contributes to easy infection during intercourse with both female and male flora.
2. Non-compliance with such rules of intimate hygiene as daily washing of the external genital organs, frequent change of sanitary pads and underwear during menstruation, washing of the genitals after sexual contact, cleaning of underwear, use of daily sanitary pads.
3. Chronic dysbacteriosis or vaginal candidiasis: Disturbed intestinal and / or vaginal microflora sometimes contributes to the growth of the population of conditionally pathogenic microflora, so microflora unusual for the genital and urinary system provokes an inflammatory process, damaging the whole body.
4. Dysfunctions of the immune system: a decrease in the immune defenses or local allergic diseases considerably reduce the organism's resistance to diseases, which give pathogenic bacteria carte blanche to easily enter the bladder cavity.
5. Rare urination: A woman's bladder can accumulate 250-500ml of urine inside and its regular premature emptying leads to structural changes in the bladder, sphincter and the creation of greenhouse conditions for infection and reproduction of microorganisms pathogens.
6. The decrease in protective forces leads to the fact that the infection freely penetrates upward into the bladder cavity and excites an inflammatory process in it.
7. The presence of Escherichia coli E. coli (in 70-95% of patients).
8. The presence of staphylococcus aureus (Staphylococcus saprophyticus) in 5-20% of patients.
9. Existence of Klebsiella spp and Proteusmirabilis (Proteus) in other patients.
10. Bladder catheterization in men and women: sometimes leads to urethral infections. This procedure is especially dangerous for pregnant women and women in labor, especially in the postoperative period, when the tone of the urinary tract is reduced and gram-negative bacteria have shown activity.
11. 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 rarely develops, as a rule, after inflammation of the urethra, prostate gland, epididymis and seminal vesicles. The chance of developing cystitis is increased during bladder catheterization in men with prostate adenoma, one of the symptoms of which is constant urinary retention.

Symptoms of cystitis

Cystitis is a very unpleasant and painful disease that offers a lot of unpleasant and painful sensations to a sick person, who often endures bravely, unaware of the dangers that can later cause complications of untreated cystitis. As a rule, acute cystitis appears suddenly, and cystitis after sexual intercourse declares itself after 8-10 hours.

Symptoms of cystitis are very painful, the most characteristic:

• sharp pains when urinating;
• burning and cutting at the end of the act of urination;
• aching pains in the lower abdomen, sometimes unbearable;
• feeling of incomplete emptying of the bladder;
• sometimes urinary incontinence with a strong urge to urinate (more often in children);
• cloudy or bloody urine (hematuria);
• sometimes a slight increase in body temperature with a slight shiver.

A rise in temperature during cystitis can also signal possible inflammation in the kidneys or elsewhere, so contacting a specialist immediately would be a very reasonable act.

It is known that women and girls suffer from cystitis much more often than men and boys. Strangely, but the likelihood of contracting 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 is aware of it. And for everything else, cystitis is often referred to as a non-specific or relative sign of pregnancy.

Cystitis in early pregnancy manifests itself with the following symptoms:

• varied pain that can range from moderate pain in the lower abdomen with mild pain at the end of urination to sharp and cutting pain with urinary incontinence;
• frequent need 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 the elderly and children, the symptoms of cystitis are often not as noticeable. Fever, abdominal pain, and nausea may be the only symptoms of cystitis.

With a disease such as cystitis, symptoms and treatment always completely depend on the patient's sense of responsibility for their own health.

Prevalence of cystitis

Acute cystitis is one of the most common diseases in urology. Most often, simple cystitis is observed when bacteria affect only the mucous membrane of the bladder, leaving the submucosal layer intact.

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

The higher prevalence of cystitis among 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 in women goes directly to the perineum, which contributes to the easy penetration of infection from the genital tract;
• the external opening of the urethra is located near the anus, which contributes to the development of 80% of cystitis from infection with intestinal bacteria (E. Coli) that entered the bladder from the intestinal lumen.

Cases of cystitis among girls are three to four times higher than the incidence among boys. In infants and children under 1 year of age, cystitis is extremely rare, most often the disease is detected at the age of 1-3 and in adolescence (13-15 years), but most often they are sick in children from 4 to 12 years.

cystitis in the summer

Strangely, however, in the hot summer season, especially during the holiday period, when most women go on vacation to other climatic zones, cases of cystitis become more frequent for reasons:

• accommodation on vacation with the impossibility of high-quality hygienic care for intimate places;
• hypothermia of the body after an excessively long bath in a cold tank;
• failures in the usual mode of urination (flying, moving, new place), when you have to endure for a long time;
• a sharp change in the climatic zone, causing a decrease in the functions of the immune system;
• often increased sexual activity on vacation and so on.

You should contact a urologist urgently if you have suddenly failed to avoid cystitis while relaxing at a resort. Clarify the diagnosis, do a urinalysis, and undergo an ultrasound.

The latest antibacterial and antibiotic drugs will effectively accelerate healing and prevent complications (transition from acute to chronic cystitis). 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 effective in the treatment of cystitis in the summer is taking a drug from the fosfomycin group, which has no phototoxicity, like other drugs from the same series. The drug, which does not contain components with photosensitizing and photoreactive properties, does not increase the sensitivity of the skin to ultraviolet radiation from the sun even at low intensity, so it does not cause redness and burns of the skin, which means that it can be taken without violating the regimen of beach.

The phosphonic acid derivative also has an almost complete absence of side effects, which allows you to effectively and safely treat cystitis in children and pregnant women, taking it once for uncomplicated acute cystitis. Chronic and other more severe forms of cystitis will also be successfully treated with this drug, however, the remedy will be taken according to a certain scheme.

When you leave for a long-awaited summer vacation, it will not be superfluous to replenish the 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 in pregnancy will be considered complicated and therapy must only be carried out under hospital medical supervision.

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 bladder emptying difficult, leading to chronic urinary retention in the bladder and infections. At the first suspicion of cystitis, a pregnant woman should immediately contact a specialist in charge of her pregnancy, who will refer her, if necessary, to a urologist.

Childhood cystitis

Childhood cystitis affects the younger generation at any age, but girls of preschool and school age - five to six times more often, and the reasons behind this are:

• the lack of the ability of girls' ovaries to produce estrogen;
• low barrier capacities of the mucous membranes and skin;
• a short and wide urethra is "open" for the passage of pathogenic microorganisms into the bladder;
• irregular or insufficient hygiene care of the genitals;
• concomitant diseases that contribute to a decrease in the body's immune defense.

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 reveal all the factors that led to the development of cystitis. Reliable diagnostics will help prescribe adequate therapy and provide medical recommendations to avoid future relapses of the disease and prevent the transition of cystitis to a chronic form.

The following studies will help the urologist make the correct diagnosis:

• questioning and examination by a doctor;
• obvious symptoms;
• laboratory tests on urine and blood;
• bacteriological studies of urine and smear from the urethra;
• conduct special tests for the presence of nitrites and leukocytes in the urine;
• Bladder ultrasound
• determine 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 depends on the timeliness of diagnosis and well-chosen tactics of complex treatment of the disease.

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

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

The effectiveness of a drug for the treatment of cystitis lies in the strength of its suggestion for one or another microorganism. It should be noted that pathogenic bacteria mutate and become insensitive to antibiotics. Decades ago, cystitis was successfully treated with many bactericidal drugs. However, today one of the main causative agents of cystitis - E. coli - has become resistant to the effects of these drugs. Furthermore, the previous generation of antibiotics had a very high level of toxicity and many negative side effects.

When choosing a drug against cystitis pathogens, one must also 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 existing risk to health. of the patient.

Modern drugs for the treatment of cystitis selectively act on pathogens, concentrating in the bladder, thereby increasing its effectiveness. The use of the latest generation antibiotics reduces the treatment time of cystitis, reduces the risk of side effects, which causes less harm to the health of patients. A broad-spectrum antibiotic from the fosfomycin group, as an effective and safe drug, is used to treat cystitis in both pregnant women and children.

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

• anti-inflammatory and analgesic therapy with antispasmodics;
• stimulation and modulation of the immune system;
• a diet without fatty and spicy foods;
• increased alcohol consumption regimen;
• fear of hypothermia;
• hot heating pad on the lower abdomen;
• exclusion of anxiety, stressful situations;
• active lifestyle;
• phytotherapy;
• use of iontophoresis, UHF or inductothermy.

Remember that the presence of some gynecological diseases prohibits the use of physiotherapy and spa procedures.

Useful tips to prevent cystitis

To prevent and prevent the onset of cystitis and its recurrence, follow simple tips:

1. Respect the rules of personal intimate hygiene: wash your face at least once a day, and preferably 2 or more times, using baby soap (without harmful additives) and running water.
2. Monitor your sexual partner for simple genital hygiene.
3. Before and after any sexual contact, be sure to wash yourself with soap and your sexual partner must too.
4. Exclude oral sex in the presence of stomatitis, tonsillitis, candidiasis and other infections of the oral cavity to avoid infection of the external genitalia and urethra through saliva.
5. Wear clothes based on time, not fashion. The payback for a miniskirt in cold weather can be cystitis, and not just cystitis, but also recurrent chronic inflammation and even inflammation of the appendages, which threatens with many years of medical procedures, infertility and hopes of recovery.
6. Please note that frequent acute respiratory infections and acute respiratory viral infections indicate a decrease in the functions of the immune system and measures should be taken to improve its condition.
7. Try not to hold back urination when you want to urinate, otherwise holding back urine will lead to a bladder infection.
8. Stick to a normal drinking regime - 2 liters of water per day, and in the heat - 1-1. 5 liters more.
9. Women are advised to use sanitary pads rather than tampons, which can compress the urethra and become a source of infection and, consequently, the bladder.
10. Men are advised to change their underwear every day, which will protect as much as possible from the occurrence of non-specific urethritis.
11. When using the toilet, it is recommended to clean from front to back and not vice versa, to avoid introducing intestinal bacteria into the external genitalia, from where they can enter the urethra and bladder.

Compliance with these tips will not be able to get rid of cystitis 100%, but it will help to minimize the risk of getting sick.