Cystitis

Cystitis is an 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 functionality and changes in the urinary sediment.

Signs of cystitis appear sharply:

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

If not treated immediately, cystitis can become chronic, or the infection will travel up through the kidneys (kidney disease) or down the urethra (urethral disease).

According to statistical expertise, women aged 14 to 60 had cystitis at least once in their lives, especially 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, quite often suffer from cystitis, even babies and babies. It is unfortunate that many parents cannot predict the development of this disease in their child.

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

• acute: manifested suddenly, accompanied by local (frequent and painful urination) and general symptoms (high temperature, general weakness);
• chronic: found in laboratory tests, symptoms are slow or absent, but during exacerbation takes the form of acute.

Based on the causative agent, cystitis also occurs:

• non-specific: on the background of conditionally pathogenic microflora (enterobacteria, candida, staphylococci, proteus, klebsiella);
• specific: due to sexually transmitted diseases (chlamydia, ureaplasmosis, syphilis) or kidney tuberculosis.

Causes of cystitis

Most episodes of the disease showed 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 infection.

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

A complex of factors that lead to the appearance of cystitis:

1. Promiscuous sex: the close proximity of the urethral opening to the vagina contributes to easy infection during intercourse with female and male flora.
2. Non-observance of intimate hygiene rules such as daily washing of external genital organs, frequent change of sanitary pads and underwear during menstruation, washing of genitals after sexual contact, keeping underwear clean, use of daily pads.
3. Chronic dysbacteriosis or vaginal candidiasis: disturbed intestinal and/or vaginal microflora occasionally contributes to the growth of the population of conditionally pathogenic microflora, and then microflora unusual for the genital and urinary system causes an inflammatory process that harms the whole body.
4. Dysfunctions of the immune system: reduction of immune defenses or allergic local pathology significantly reduce the body's resistance to diseases, which gives carte blanche to pathogenic bacteria to easily enter the bladder cavity.
5. Infrequent urination: in a woman's bladder, 250-500 ml of urine can accumulate inside, 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.
6. The reduction of protective forces leads to the fact that the infection freely penetrates upwards into the bladder cavity and causes an inflammatory process in it.
7. The presence of Escherichia coli E. coli (in 70-95% of patients).
8. 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 infection. This procedure is particularly 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 show activity.
11. Content in the body of various fungi (Candida and others), chlamydia, trichomoniasis, mycoplasma and viruses.

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

In men, cystitis develops rarely, as a rule, after inflammation of the urethra, prostate, epididymis and seminal vesicles. The possibility of cystitis is increased during bladder catheterization in men suffering from prostate adenoma, one of the symptoms of which is constant retention of urine.

Symptoms of cystitis

Cystitis is a very unpleasant, painful disease that causes a lot of unpleasant and painful sensations to the affected person, which they often bear bravely, unaware of the dangers that can subsequently cause complications of untreated cystitis. As a rule, acute cystitis appears suddenly, and cystitis after sexual intercourse manifests itself after 8-10 hours.

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

• cutting pains during urination;
• burning and cutting at the end of urination;
• 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 (hematuria) urine;
• sometimes a slight increase in body temperature with a slight chill.

An increase in temperature during cystitis can also signal a 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. It's strange, but the probability of getting cystitis during pregnancy increases significantly, although during this period any disease is very undesirable. Cystitis often develops in the early stages of pregnancy, sometimes even before the woman knows about it. And for everything else, cystitis is often called a non-specific or relative sign of pregnancy.

Cystitis in early pregnancy is manifested by the following symptoms:

• a variety of pain that can vary from moderate pain in the lower abdomen with mild pain at the end of urination to sharp, cutting pain with urinary incontinence;
• frequent urge to urinate with a small amount of urine;
• urine may have a sharp smell, dark color;
• constant pain in the lumbar region;
• mild hematuria (not always);
• fever (optional)
• menstrual disorders in women of reproductive 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.

In diseases such as cystitis, symptoms and treatment always depend entirely on the patient's sense of responsibility for his health.

Prevalence of cystitis

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

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

The higher prevalence of cystitis among women is explained by the following factors:

• the urethra (urethra) of women is shorter, and its lumen is wider than the lumen of the male urethra;
• the external opening of the female urinary tract goes directly to the perineum, which contributes to easier penetration of the infection from the genital tract;
• the external opening of the urethra is located near the anus, which contributes to the occurrence of 80% of cystitis from infection with intestinal bacteria (E. Coli) that entered the bladder from the lumen of the intestine.

Cystitis cases in girls are three to four times higher than the incidence in boys. Cystitis is extremely rare in infants and children up to 1 year of age, the disease is more often detected at the age of 1 to 3 years and in adolescence (13-15 years), but children from 4 to 12 years of age are most often affected.

cystitis in summer

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

• accommodation on vacation with the impossibility of high-quality hygienic care of intimate places;
• hypothermia of the body after excessively long bathing in a cold tank;
• malfunctions in the usual way of urination (flight, movement, new place), when you have to endure 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.

You should immediately contact a urologist if suddenly you could not avoid cystitis while relaxing at the resort. To clarify the diagnosis, do a urine test and undergo an ultrasound examination.

The latest antibacterial drugs and antibiotics will effectively speed up your recovery and prevent complications (transition of acute cystitis into chronic). The fact is that they act exclusively on the inflammatory process in the bladder, almost without affecting other organs and systems of the body, concentrating as much as possible in the urine and the diseased bladder mucosa. The toxicological effect on the body is minimal.

Taking a drug from the fosfomycin group, which does not have phototoxicity, like other drugs from the same series, is particularly successful in the treatment of cystitis in the summer. 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, therefore it does not cause redness and burns of the skin, which means that it can be taken without violating the beach regime.

The phosphonic acid derivative also has an almost complete absence of side effects, which allows effective and safe treatment of cystitis in children and pregnant women, taking it once for uncomplicated acute cystitis. This drug will successfully treat both chronic and other, more serious forms of cystitis, however, the drug will be taken according to a certain scheme.

When you go on a long-awaited summer vacation, it will not be superfluous to replenish 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 will be considered complicated, and the therapy should be carried out exclusively under hospital 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 it difficult to empty the bladder, leading to chronic bladder retention and infection. At the first suspicion of cystitis, a pregnant woman should immediately contact the specialist managing her pregnancy, who will, if necessary, refer her to a urologist.

Children's cystitis

Children's cystitis affects the younger generation at any age, but girls of preschool and school age - five to six times more often, and the main reasons for this are:

• lack of ability of the ovaries of girls to produce estrogens;
• low barrier capabilities of the mucous membrane and skin;
• the short and wide urethra is "open" for the passage of pathogenic microorganisms into the bladder;
• irregular or insufficient hygienic care of the genitals;
• accompanying diseases that contribute to the reduction of 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 find out all the factors that led to the development of cystitis. Reliable diagnostics will help in prescribing adequate therapy and giving medical recommendations in order 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 the correct diagnosis:

• doctor's examination and examination;
• obvious symptoms;
• laboratory tests of urine and blood;
• bacteriological studies 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 methods of urological examination are also used.

Treatment of cystitis

How to treat cystitis? The speed and quality of treatment of cystitis, regeneration of the mucous membrane of the urinary bladder always depend 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:

• duration of illness;
• severity of symptoms;
• the presence of accompanying factors and pathologies;
• side effects of drugs, their absorption, method, speed of their excretion from the body, etc.

The effectiveness of the drug for the treatment of cystitis consists in the strength of its suggestibility for one or another microorganism. It should be noted that pathogenic bacteria mutate and become insensitive to antibiotics. A few decades ago, cystitis was very successfully treated with many bactericidal drugs. 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 a very high level of toxicity and many negative side effects.

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

Modern drugs for the treatment of cystitis selectively act on pathogens, concentrating in the bladder, thereby increasing their effectiveness. The use of antibiotics of the latest generation shortens the time of treatment of cystitis, reduces the risk of side effects, which harms the health of patients less. 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 treatment methods should not be forgotten:

• anti-inflammatory and analgesic therapy with antispasmodics;
• stimulation and modulation of the immune system;
• diet without fatty and spicy food;
• increased drinking regime;
• fear of hypothermia;
• a warm heating pad on the lower part of the abdomen;
• exclusion of anxiety, stressful situations;
• active lifestyle;
• phytotherapy;
• using iontophoresis, UHF or inductothermy.

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

Useful tips for the prevention of cystitis

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

1. Follow the rules of personal intimate hygiene: wash your face at least once a day, and preferably 2 or more times, with baby soap (without harmful additives) and running water.
2. Follow your sexual partner for simple genital hygiene.
3. Be sure to wash yourself with soap before and after every sexual contact, and your sexual partner must do the same.
4. Exclude oral sex in case 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 according to the weather, not according to fashion. The payoff for a miniskirt in cold weather can be cystitis, and not just cystitis, but chronic relapsing and even inflammation of the appendages, which threatens long-term medical procedures, infertility and hope for 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 it is necessary to take measures to improve its condition.
7. Try not to hold your urine when you want to urinate, otherwise holding your urine will lead to a bladder infection.
8. Stick to the normal drinking regime - 2 liters of water a day, and in the heat - 1-1. 5 liters more.
9. Women are advised to use pads instead of tampons, which can compress the urethra and become a source of infection and thus the bladder.
10. Men are advised to change their underwear daily, which will maximally protect against the occurrence of non-specific urethritis.
11. When using the toilet, it is recommended to wipe from front to back, not the other way around, to avoid introducing intestinal bacteria to the external genitalia, from where they can enter the urethra and bladder.

Following these tips won't get rid of cystitis 100%, but it will help reduce the risk of getting it.