Cystitis

Cystitis is an inflammation of the bladder walls. In practical urological terminology, the word "cystitis" is generally used to denote a symptomatic urinary tract infection, with manifestations of inflammation of the bladder mucosa, impaired function, and changes in urine 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 right away, cystitis can become chronic or the infection will travel through the kidneys (kidney disease) or through the urethra (urethral disease).

Based on statistical experience, women aged 14 to 60 years had cystitis at least once in their lives, especially sexually active women aged 20 to 50 years who had diabetes mellitus and a history of decreased immune system functions.

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

Cystitis, depending 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, the symptoms are slow or absent, but during an exacerbation it takes the form of an acute one.

Depending on the causative factor, cystitis also occurs:

• nonspecific - 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 with 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 a single factor.

The complex of factors leading to the appearance of cystitis:

1. Promiscuous sexual intercourse: The proximity of the opening of the urethra to the vagina contributes to easy infection during sexual intercourse with both the female and male flora.
2. Non-compliance with intimate hygiene rules such as daily washing of the external genital organs, frequent change of sanitary napkins and underwear during menstruation, washing of the genitals after sexual contact, keeping underwear clean, use of daily sanitary pads.
3. Chronic dysbacteriosis or vaginal candidiasis - disturbed intestinal and / or vaginal microflora contributes to the growth of the population of conditionally pathogenic microflora at times, and then unusual microflora for the genital and urinary system provokes an inflammatory process that damages the whole body.
4. Immune system dysfunctions: a decrease in immune defenses or local allergic pathologies significantly reduce the body's resistance to disease, giving pathogenic bacteria carte blanche to easily enter the bladder cavity.
5. Infrequent urination: a woman's bladder can accumulate 250-500 ml of urine inside, and regular untimely emptying leads to structural changes in the bladder, sphincter, and the creation of hothouse conditions for infection and reproduction of pathogenic microorganisms .
6. The decrease in protective forces leads to the fact that the infection freely penetrates upwards into the bladder cavity 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. Existence of Klebsiella spp and Proteusmirabilis (Proteus) in other patients.
10. Bladder catheterization in men and women: sometimes leads to infection of the urethra. This procedure is especially dangerous for pregnant and laboring women, 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, mycoplasmas 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, epididymis and seminal vesicles. The possibility of developing cystitis increases during bladder catheterization in men suffering from prostate adenoma, one of the symptoms of which is constant urinary retention.

Symptoms of cystitis

Cystitis is a very unpleasant and painful disease that gives a sick person a lot of uncomfortable and painful sensations, which they often bravely endure, not realizing 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.

Symptoms of cystitis are very painful, the most characteristic of them:

• cutting pains when urinating;
• burning and cutting at the end of the act of urination;
• stabbing, stabbing pains in the lower abdomen, sometimes unbearable;
• sensation 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 chill.

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

Women and girls are known to suffer from cystitis much more often than men and boys. Oddly enough, but the probability of getting cystitis during pregnancy increases significantly, although during this period any disease is highly undesirable. Most often, cystitis develops in the early stages of pregnancy, sometimes even before the woman knows it. And for everything else, cystitis is often referred to as a non-specific or relative sign of pregnancy.

Cystitis in early pregnancy is manifested by the following symptoms:

• diverse pain that can range 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 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 usually not so obvious. Fever, abdominal pain, and nausea may be the only symptoms of cystitis.

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

Cystitis prevalence

Acute cystitis is one of the most frequent diseases in urology. Most of the time, uncomplicated cystitis is seen when the 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 per 1000, and the acute form of cystitis in men is observed extremely rarely.

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

• the urethra (urethra) of a woman is shorter and the lumen of it is wider than that of the male urethra;
• the external opening of the female urinary canal goes directly to the perineum, which contributes to the easy penetration of the 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 due to infection with intestinal bacteria (E. Coli) that have entered the bladder from the intestinal lumen.

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

cystitis in summer

Interestingly, however, in the hot 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 for intimate places;
• hypothermia of the body after an excessively long bath in a cold reservoir;
• failures in the usual way of urinating (flight, moving, new place), when you have to hold out for a long time;
• a sharp change in the climatic zone, which causes a decrease in the functions of the immune system;
• it often increases sexual activity on vacation and so on.

You should urgently contact a urologist if you suddenly cannot avoid cystitis while relaxing at a resort. To clarify the diagnosis, take a urine test and undergo an ultrasound scan.

The latest antibacterial drugs and antibiotics will effectively speed up your recovery 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 on the urine and the diseased mucosa of the bladder. The toxicological effect on the body is minimal.

Particularly successful in the treatment of cystitis in the summer is taking a drug from the Fosfomycin group, which does not have 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, therefore it does not cause redness and skin burns, which means that it can be taken without violating the regime of the beach.

The phosphonic acid derivative also has an almost complete absence of side effects, which makes it possible to effectively and safely treat cystitis in children and pregnant women, taking it once for acute cystitis without complications. 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 it's time to embark on a long-awaited summer vacation, it won't hurt 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 therapy should be carried out exclusively under hospital medical supervision.

The main causes of cystitis during pregnancy:

• hemodynamic alterations;
• 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 urinary retention in the bladder and infection. At the first suspicion of cystitis, a pregnant woman should immediately contact a specialist in charge of her pregnancy, who will refer her to a urologist if necessary.

infantile cystitis

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

• the lack of ability of the ovaries of girls to produce estrogen;
• low barrier capacity 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 hygienic care of the genitals;
• concomitant diseases that contribute to a decrease in 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 reveal all the factors that led to the development of cystitis. Reliable diagnoses will help prescribe the appropriate therapy and provide medical recommendations to prevent future recurrences of the disease and prevent the transition of cystitis into a chronic form.

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

• questioning and examination of a doctor;
• obvious symptoms;
• laboratory analysis of urine and blood;
• bacteriological studies of urine and smears 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 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:

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

The effectiveness of a drug for the treatment of cystitis consists in the strength of its suggestion to one or another microorganism. It should be noted that pathogenic bacteria mutate and become insensitive to antibiotics. Decades ago, cystitis was very 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. Also, the previous generation of antibiotics had a very high level of toxicity and many negative side effects.

When choosing a drug against the pathogens of cystitis, the cost of treatment should also be taken into account, 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 for the patient's health

Modern drugs for the treatment of cystitis act selectively on pathogens, concentrating in the bladder, thereby increasing their effectiveness. The use of antibiotics of the latest generation reduces the time of treatment of cystitis, reduces the risk of side effects, which causes less harm to the health of patients. A broad-spectrum antibiotic from the group of fosfomycin, 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 drinking 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 thermal procedures.

Useful tips to prevent cystitis

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

1. Observe 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. Supervise your sexual partner for simple genital hygiene.
3. Before and after each sexual contact, be sure to wash with soap, and your sexual partner should 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 the weather, not fashion. The reward for a miniskirt in cold weather can be cystitis, and not just cystitis, but chronic recurring and even swollen appendages, threatening many years of medical procedures, infertility, and hopes of recovery.
6. Keep in mind 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 your condition.
7. Try not to hold urine when you want to urinate, otherwise holding urine will lead to bladder infection.
8. Follow a normal drinking regimen: 2 liters of water per 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 consequently the bladder.
10. Men are advised to change their underwear daily, which will protect as much as possible against the occurrence of nonspecific urethritis.
11. When using the bathroom, it is recommended to wipe from front to back, and not the other way around, to avoid introducing intestinal bacteria to the external genitalia, from where they can enter the urethra and bladder.

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