Cystitis

Cystitis is an inflammation of the bladder wall. In practical urological terminology, the word "cystitis" is usually used to denote a symptomatic urinary tract infection with inflammation of the bladder mucosa, impaired functioning, and changes in urine sediment.

Signs of cystitis appear sharply:

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

If not treated right away, cystitis can become chronic, or the infection can spread through the kidneys (kidney disease) or the urethra (urethritis).

Statistically, women between the ages of 14 and 60 have suffered from cystitis at least once in their lifetime, especially sexually active women between the ages of 20 and 50 who have diabetes and a history of reduced immune function.

Modern children, as can be seen from practice, often suffer from cystitis, even babies and infants. It is sad that many parents cannot predict the development of this disease in a child.

Cystitis occurs depending on the nature of the process:

• acute: appears suddenly, accompanied by local (frequent and painful urination) and general symptoms (fever, general weakness);
• chronic: during laboratory tests, the symptoms are sluggish or absent, but during exacerbation it takes an acute form.

Based on the triggering 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 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 genital ureaplasma and mycoplasma infections.

It is now known that cystitis, the causes of which are completely clear, cannot be caused by just one factor.

The complex of factors leading to the development of cystitis:

1. Promiscuous sex: the proximity of the urethral opening to the vagina contributes to easy infection during intercourse with both female and male flora.
2. Failure to observe the rules of intimate hygiene, such as daily washing of the external genitalia, frequent change of sanitary pads and underwear during menstruation, washing of the genitals after sexual contact, keeping underwear clean, using daily pads.
3. Chronic dysbacteriosis or vaginal candidiasis: the disturbed intestinal and/or vaginal microflora sometimes contributes to the growth of the conditionally pathogenic microflora population, and then the unusual microflora for the genitourinary system causes an inflammatory process that damages the entire organism.
4. Immune system dysfunctions: a decrease in immune protection or allergic local pathologies significantly reduce the body's resistance to disease, which gives pathogenic bacteria carte blanche to easily enter the bladder cavity.
5. Infrequent urination: 250-500 ml of urine can accumulate in a woman's bladder, and its premature emptying leads to changes in the structure of the bladder and the sphincter and creates greenhouse conditions for infection and the growth of pathogenic microorganisms.
6. The decrease in protective forces leads to the fact that the infection freely penetrates upwards into the cavity of the bladder and provokes 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. Occurrence of Klebsiella spp and Proteusmirabilis (Proteus) in other patients.
10. Bladder catheterization in men and women: sometimes leads to urethral infection. This procedure is especially dangerous for pregnant and laboring women, especially in the postoperative period, when the tone of the urinary tract decreases and gram-negative bacteria show activity.
11. The content of various fungi (Candida and others), chlamydia, Trichomonas, mycoplasmas and viruses in the body.

Cystitis in its acute form, a woman can get sick several times, and the disease often becomes chronic.

In men, cystitis rarely develops, usually after inflammation of the urethra, prostate gland, epididymis and seminal vesicles. The possibility of developing urethritis increases 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, painful disease that causes many unpleasant and painful sensations to the patient, which he often bravely endures, not knowing the dangers that may later cause complications of untreated cystitis. Acute cystitis usually occurs suddenly and occurs 8-10 hours after sexual intercourse.

The symptoms of cystitis are very painful, the most typical are:

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

A rise in temperature during cystitis can indicate a possible inflammation of the kidneys or elsewhere, so it would be a very reasonable step to consult a specialist immediately.

It is known that women and girls suffer from cystitis much more often than men and boys. Oddly enough, the probability of cystitis during pregnancy increases significantly, although any disease during this period is very undesirable. It often happens that cystitis develops in the early stages of pregnancy, sometimes even before the woman knows about it. And besides everything else, cystitis is often cited as a non-specific or relative sign of pregnancy.

In the early stages of pregnancy, cystitis is manifested by the following symptoms:

• varied pain, which can range from moderate pain in the lower abdomen to mild pain at the end of urination to sharp, cutting pain associated with urinary incontinence;
• frequent urge to urinate with small amounts of urine;
• urine may have a pungent smell, 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 in children, the symptoms of cystitis are often not as 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 their health.

Occurrence of cystitis

Acute cystitis is one of the most common diseases in urology. Most often, uncomplicated cystitis is observed when the bacteria affect only the mucosa of the bladder, leaving the submucosa intact.

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

The higher incidence of cystitis among women can be explained by the following factors:

• the female urethra is shorter and its lumen wider than that of the male urethra;
• the external opening of the urethra 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 the infection of intestinal bacteria (E. Coli) that entered the bladder from the intestinal cavity.

Cystitis is three to four times more common in girls than in boys. Cystitis is extremely rare in newborns and children younger than 1 year, the disease is more often detected at the age of 1-3 years and in adolescence (13-15 years), but most often occurs at the age of 4-15 years. 12 years.

cystitis in summer

Strangely, however, during the warm summer season, especially during vacations, when most women go on vacation to other climates, cystitis becomes more common due to certain reasons:

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

Urgently consult a urologist if you suddenly could not avoid cystitis while resting at the resort. To clarify the diagnosis, take a urinalysis and do an ultrasound.

The latest antibacterial drugs and antibiotics effectively speed up healing and prevent complications (turning acute cystitis into a chronic one). The fact is that they act exclusively on the inflammatory process of the bladder, almost without affecting other organs and systems of the body, concentrating as much as possible in the urine and the mucous membrane of the patient's bladder. The toxicological effect on the body is minimal.

In the treatment of cystitis in the summer, it is particularly successful to take a drug belonging to the fosfomycin group, which does not have phototoxicity, like other drugs of the same series. The drug, which does not contain photosensitizing and photoreactive ingredients, does not increase the skin's sensitivity to the sun's ultraviolet radiation, even at low intensity, and therefore does not cause skin redness and burns, which means that it should be taken without violating the beach rules.

The phosphonic acid derivative is also almost completely devoid of side effects, which makes it possible to effectively and safely treat cystitis in children and pregnant women, in case of acute cystitis without a single complication. Chronic and other more severe forms of cystitis are also successfully treated with this medicine, however, the remedy must be taken according to a certain scheme.

When you go on a long-awaited summer vacation, it will not be superfluous to stock the first aid kit with a broad-spectrum antibiotic just in case.

cystitis during pregnancy

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

The main causes of cystitis during pregnancy:

• hemodynamic disorders;
• the mechanical effects of the enlarged uterus on the displaced internal organs of the pelvis;
• hormonal imbalance.

All of these causes can make it difficult to empty the bladder, which can lead to chronic urinary retention and infection. At the first suspicion of cystitis, a pregnant woman should immediately contact the specialist responsible for her pregnancy, who will refer her to a urologist if necessary.

Cystitis in children

Cystitis in children affects the younger generation at any age, but girls of kindergarten and school age - five to six times more often, and the reasons for this are as follows:

• the lack of ability of the ovaries to produce estrogen in girls;
• low protective capacity of mucous membranes and skin;
• a short and wide urethra is "open" for pathogenic microorganisms to enter the bladder;
• irregular or insufficient hygienic care of the genitals;
• accompanying diseases that contribute to a decrease in the body's immune defenses.

The combination of these factors contributes to creating favorable conditions for the growth of pathogenic bacteria in the urethra and bladder.

Diagnosis of cystitis

Before starting treatment, it is important to find out all the factors that led to the development of cystitis. A reliable diagnosis will help to prescribe the appropriate therapy and give medical recommendations to avoid the recurrence of the disease in the future and prevent the transition of cystitis to a chronic form.

The following tests help the urologist to establish the correct diagnosis:

• interrogation and examination of a doctor;
• obvious symptoms;
• laboratory examination of urine and blood;
• bacteriological examination of urine and urethral smear;
• carrying out special tests for the presence of nitrites and leukocytes in the urine;
• Bladder ultrasound;
• determining the presence of comorbidities.

If necessary, other urological examination methods are used.

Treatment of cystitis

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

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

• duration of illness;
• severity of symptoms;
• the presence of concurrent factors and pathologies;
• side effects of medicines, their absorption, method, speed of their elimination from the body, etc.

The effectiveness of the medicine for the treatment of cystitis depends on the strength of the suggestiveness to one or another microorganism. It should be noted that pathogenic bacteria mutate and become insensitive to antibiotics. Decades ago, cystitis was treated very successfully with a number of antibacterial drugs. Today, however, one of the main pathogens of cystitis - E. coli - has become resistant to the effects of these drugs. In addition, the previous generation of antibiotics had very high levels of toxicity and many negative side effects.

When choosing a drug against the pathogens of cystitis, the cost of the treatment must also be taken into account, which is expressed not so much in the cost of the drug itself, but in its effectiveness, long-term use and the existing risk. the patient's health.

Modern drugs for the treatment of cystitis have a selective effect on the pathogens, they are concentrated in the bladder, thereby increasing their effectiveness. The use of the latest generation antibiotics reduces the time of cystitis treatment, reduces the risk of side effects, which is less harmful to the health of patients. The broad-spectrum antibiotic of the fosfomycin group, as an effective and safe drug, is used to treat cystitis in both pregnant women and children.

How can cystitis be cured? In addition to antibiotic treatment, other treatment methods 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 drinking regime;
• fear of hypothermia;
• a warm heating pad on the lower abdomen;
• exclusion of anxiety and stressful situations;
• active lifestyle;
• phytotherapy;
• application of iontophoresis, UHF or inductothermy.

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

Useful tips to prevent cystitis

To prevent and prevent cystitis and its recurrence, follow simple recommendations:

1. Follow the rules of personal intimate hygiene: wash your face at least once a day, preferably 2 or more times, with baby soap (without harmful additives) and running water.
2. Monitor your sexual partner for simple genital hygiene.
3. Be sure to wash with soap before and after every sexual encounter, and so should your sexual partner.
4. Exclusion of oral sex in cases of stomatitis, tonsillitis, candidiasis and other infections of the oral cavity to avoid infection of the external genitalia and urethra through saliva.
5. Dress for the weather, not the fashion. In cold weather, the return of the miniskirt can be cystitis, and not only cystitis, but also chronically recurring inflammation of the appendages, which threatens with many years of medical interventions, 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 your urine when you want to urinate, otherwise retention will lead to a bladder infection.
8. Adhere to the normal drinking regime - 2 liters of water per day, and another 1-1. 5 liters in hot weather.
9. Women are advised to use pads instead of tampons, which can compress the urethra and become a source of infection, and consequently the bladder.
10. Men are advised to change their underwear daily, which is the best way to prevent the occurrence of non-specific urethritis.
11. When using the toilet, it is recommended to wipe from front to back, and not the other way around, to prevent intestinal bacteria from entering the external genitalia, from where they can enter the urethra and bladder.

Following these tips cannot get rid of cystitis 100%, but it will help to minimize the risk of getting sick.