Cystitis

Cystitis is an inflammation of the walls of the bladder. 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 urine sediment.

Signs of cystitis appear sharply:

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

If not treated immediately, the cystitis may become chronic, or the infection will travel up 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 20-50 who had diabetes mellitus and a history of decreased immune system function.

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

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

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

Based on the causative factor, cystitis also happens:

• non-specific: against 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 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 infection with genital ureaplasma and mycoplasma infections.

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

The complex of factors leading to the occurrence 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 the female and male flora.
2. Non-observance of 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, keeping underwear clean, use of daily 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 the microflora unusual for the genital and urinary system causes an inflammatory process, harming the entire body.
4. Dysfunctions of the immune system: a decrease in immune defense or allergic local pathologies significantly reduce the body's resistance to disease, which gives carte blanche to pathogenic bacteria 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 of it leads to structural changes in the bladder, sphincter and the creation of greenhouse conditions for infection and reproduction of pathogenic microorganisms.
6. The decrease in protective forces leads to the fact that the infection freely penetrates upward into the cavity of the bladder 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 infection of the urethra. 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, mycoplasmas and viruses.

Cystitis in 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 gland, epididymis and seminal vesicles. The possibility of developing cystitis is increased during catheterization of the bladder in men suffering from prostate adenoma, one of the symptoms of which is constant urinary retention.

Symptoms of cystitis

Cystitis is a very unpleasant, painful disease that delivers a lot of uncomfortable and painful sensations to a sick person, which they often bravely endure, unaware of the dangers that can subsequently cause complications of uncured 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 of them:

• cutting pains at the time of urination;
• burning and cutting at the end of the act of urination;
• aching-drawing 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 somewhere else, so immediately contacting a specialist would be a very reasonable act.

It is known that women and girls suffer from cystitis much more often than men and boys. Oddly enough, but the likelihood of getting 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 a woman knows about it. And to 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 vary from moderate pain in the lower abdomen with mild soreness 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;
• slight hematuria (not always);
• fever (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 such as cystitis, the symptoms and treatment are always completely dependent on the patient's sense of responsibility for their 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 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 to 50 years, only 6-8 cases per 1000, and the acute form of cystitis in men is observed extremelyrarely.

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

• the urethra (urethra) of a woman is shorter, and its lumen is wider than that of the male urethra;
• the external opening of the urinary canal of 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 have entered the bladder from the intestinal lumen.

Cases of cystitis 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, more often the disease is detected at the age of 1 to 3 years and in adolescence (13-15 years), but most often they are ill in children from 4 to 12 years.

cystitis in summer

Oddly enough, 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 reasons:

• accommodation on vacation with the impossibility of high-quality hygienic care for intimate places;
• hypothermia of the body after excessively long bathing in a cold reservoir;
• failures in the usual mode of urination (flight, 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 urgently contact a urologist if suddenly you could not avoid cystitis while relaxing at a resort. Clarifying 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 of acute cystitis to chronic). 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 the diseased mucous membrane 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 of 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 of 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 regimen.

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 uncomplicated acute cystitis. Chronic and other, more serious forms of cystitis will also be successfully treated with this drug, however, the remedy will be taken according to a certain scheme.

When going 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 therapy should be carried out exclusively under inpatient medical supervision.

The main causes of cystitis during pregnancy:

• hemodynamic disturbances;
• 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.

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 underlying reasons for this are:

• the lack of the ability of girls' ovaries to produce estrogens;
• low barrier abilities of 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 diagnostics will help prescribe adequate therapy and give 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 the correct diagnosis:

• questioning and examination of a doctor;
• obvious symptoms;
• laboratory tests of urine and blood;
• bacteriological studies of urine and smear from the urethra;
• conducting 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 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 course 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 consists of the strength of its suggestiveness to one or another microorganism. It should be noted that pathogenic bacteria mutate and become insensitive to antibiotics. Dozens of years 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. In addition, the previous generation of antibiotics had a very high level of toxicity and many negative side effects.

When choosing a medicine against pathogens of cystitis, 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 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 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 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, one should not forget about other methods of treatment:

• 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;
• warm 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.

Helpful Tips for Preventing 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, using baby soap (without harmful additives) and running water.
2. Monitor your sexual partner for simple genital hygiene.
3. Before and after each sexual contact, be sure to wash yourself with soap, and your sexual partner must also do this.
4. Exclude oral sex in the presence of stomatitis, tonsillitis, candidiasis and other infections of the oral cavity in order to avoid infection of the external genitalia and urethra through saliva.
5. Wear clothes based on the weather, not fashion. The payback for a miniskirt in cold weather can be cystitis, and not just cystitis, but chronic recurrent, and even inflammation of the appendages, which threatens with many years of medical procedures, infertility and hopes 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 measures should be taken to improve its condition.
7. Try not to hold on to urination when you want to urinate, otherwise holding on to 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 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 daily, which will protect against the occurrence of non-specific urethritis as much as possible.
11. When using the toilet, it is recommended to wipe from front to back, and not vice versa, 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 get rid of cystitis 100%, but it will help to minimize the risk of getting sick with it.