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 urine sediment.

Symptoms of cystitis appear acutely:

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

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

According to statistical analysis, women aged 14-60 have had cystitis at least once in their life, especially sexually active women aged 20-50 with diabetes and reduced immune system functions.

Modern children, as experience shows, often suffer from cystitis, even babies and toddlers. Unfortunately, many parents cannot predict the development of this disease in a child.

Depending on the nature of the process, cystitis occurs:

• acute: appears suddenly, accompanied by local (frequent and painful urination) and general symptoms (fever, general weakness);
• chronic: symptoms detected in laboratory tests are slow or absent, but during an exacerbation, they take an acute form.

Depending 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 showed that the main cause of cystitis is infection with representatives of the conventional pathogenic environment of the human body - staphylococci, streptococci, Escherichia coli, as well as 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.

A complex of factors that cause cystitis:

1. Promiscuous sex: the proximity of the urethra to the vagina leads to easy infection during contact with both female and male flora.
2. Non-observance of intimate hygiene rules, such as daily washing of the external genitalia, frequent changing of sanitary pads and underwear during menstruation, washing of the genitals after intercourse, keeping underwear clean, and daily use of pads.
3. Chronic dysbacteriosis or vaginal candidiasis: disturbed intestinal and / or vaginal microflora sometimes contributes to the increase of the population of conventional pathogenic microflora, then the microflora unusual for the genital and urinary system causes an inflammatory process that damages the whole body.
4. Dysfunctions of the immune system: decreased immune defense or local allergic 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 can accumulate inside a woman's bladder, and its regular, timely emptying causes structural changes in the bladder, sphincter, and the creation of greenhouse conditions for the infection and reproduction of pathogenic microorganisms.
6. The decrease in protective forces causes the infection to freely penetrate upwards into the bladder cavity and excite the inflammatory process there.
7. The presence of Escherichia coli E. coli (in 70-95% of patients).
8. The presence of golden staphylococcus (Staphylococcus saprophyticus) in 5-20% of patients.
9. The presence 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 women and women during childbirth, especially in the postoperative period, when the tone of the urinary tract is reduced and gram-negative bacteria have shown activity.
11. The content of various fungi (Candida and others), chlamydia, trichomonas, mycoplasma and viruses in the body.

In the acute form of cystitis, a woman can get sick several times, and the disease is often chronic.

In men, cystitis rarely develops, as a rule, after inflammation of the urethra, prostate gland, epididymis and seminal vesicles. Men suffering from adenoma of the prostate gland are more likely to develop cystitis during bladder catheterization, one of its symptoms is constant urinary retention.

Symptoms of cystitis

Cystitis is a very unpleasant, painful disease, it gives the sick person a lot of uncomfortable and painful feelings, which they often bravely endure, not knowing the dangers that may cause complications of untreated cystitis later. As a rule, acute cystitis appears suddenly, and cystitis manifests itself after 8-10 hours after intercourse.

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

• cutting pains during urination;
• burning and cutting at the end of urination;
• painful 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 with slight chills.

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

It is known that women and girls suffer from cystitis more than men and boys. It is strange, but the probability of getting cystitis increases significantly during pregnancy, although any disease during this period is very undesirable. Often, cystitis develops in the early stages of pregnancy, sometimes even without the woman knowing about it. And in addition to everything, cystitis is often referred to as a non-specific or relative symptom of pregnancy.

Cystitis in early pregnancy manifests itself with 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 urination with small amounts of urine;
• urine may have a strong smell, dark color;
• constant pain in the lower back;
• mild hematuria (not always);
• fever (optional)
• menstrual disorders in women of reproductive age.

Symptoms of cystitis in the elderly and children are often not so 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.

Spread of cystitis

Acute cystitis is one of the most common diseases in urology. 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 conducted in urological practice, the prevalence of cystitis among women is 500-700 episodes per 1000 patients, and only 6-8 cases per 1000 people from 21 to 50 years of age, and an acute form of cystitis is observed in men. it is observed very rarely.

The greater prevalence of cystitis in women is explained by the following factors:

• the female urethra (urethra) is shorter and the lumen is wider than the male urethra;
• the external opening of the female urethra goes directly to the perineum, which facilitates 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 cystitis in 80% of cases due to infection with intestinal bacteria (E. Coli) entering the bladder from the intestinal lumen.

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

cystitis in summer

Ironically, during the hot summer season, especially during the holiday season, when most women go on vacation to other climate zones, cases of cystitis are more frequent due to the following reasons:

• accommodation on vacation with the impossibility of high-quality hygienic care for intimate places;
• hypothermia of the body after taking an excessively long bath in a cold reservoir;
• failures in the usual urinary routine (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;
• increased sexual activity on frequent vacations, etc.

If you suddenly could not avoid cystitis while relaxing at a resort, you should urgently contact a urologist. Clarifying the diagnosis, conducting a urine test and undergoing an ultrasound examination.

The latest antibacterial drugs and antibiotics will effectively speed up your recovery and prevent complications (transition of acute cystitis into a chronic state). The fact is that they concentrate as much as possible in the urine and in the diseased mucous membrane of the bladder, almost without affecting the rest of the organs and systems of the body, and only affect the inflammatory process in the bladder. The toxicological effect on the body is minimal.

He takes a drug from the fosfomycin group, which is particularly successful in the treatment of cystitis in the summer, as other drugs of the same series do not have phototoxicity. The drug, which does not contain components with photosensitizing and photoreactive properties, does not increase the sensitivity of the skin to ultraviolet radiation, even at low intensity, so it does not cause redness and burns of the skin, i. e. must be taken without breaking the beach regime.

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

Heading into the long-awaited summer vacation, stocking your first aid kit with a broad-spectrum antibiotic just in case won't do.

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 only under the supervision of an inpatient physician.

The main causes of cystitis during pregnancy:

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

All these reasons can make it difficult to empty the bladder, lead to chronic urinary retention and infection in the bladder. 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.

Child cystitis

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

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

The complex of these factors helps to create 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 lead to the development of cystitis. A reliable diagnosis will help to prescribe adequate therapy and provide medical recommendations to prevent recurrence of the disease in the future and to prevent cystitis from turning into a chronic form.

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

• doctor's inquiry 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 urine;
• Ultrasound of the bladder;
• determining the presence of concomitant diseases.

If necessary, other methods of urological examination are used.

Treatment of cystitis

How to treat cystitis? The speed and quality of the treatment of cystitis, the restoration of the mucous membrane of the bladder always depends on the timely diagnosis and the correctly selected tactics of the complex treatment of the disease.

The choice 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, rate of elimination from the body, etc.

The effectiveness of a drug for the treatment of cystitis depends on the strength of its effect on these or other microorganisms. It should be noted that pathogenic bacteria mutate and become sensitive to antibiotics. Decades ago, cystitis was treated very successfully 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 drug against the pathogens of cystitis, it is necessary to take into account the cost of treatment, which will be expressed not in the price 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 concentrate in the bladder and selectively affect pathogens, thereby increasing their effectiveness. The use of the latest generation of antibiotics reduces the duration of treatment of cystitis, reduces the risk of side effects, which is less harmful to the health of patients. A broad-spectrum antibiotic from the fosfomycin group is used in the treatment of cystitis in both pregnant women and children as an effective and safe drug.

How to treat 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 foods;
• increased drinking habits;
• fear of hypothermia;
• a warm heating pad under 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 preventing 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. Follow your sexual partner for simple genital hygiene.
3. Be sure to wash with soap before and after each intercourse, and so should your sexual partner.
4. In case of stomatitis, tonsillitis, candidiasis and other infections of the oral cavity, exclude oral sex in order to avoid infection of the oral cavity with the external genitalia and urethra through saliva.
5. Dress for the weather, not the fashion. The return for a miniskirt in cold weather can be cystitis, and not only cystitis, but inflammation of the appendages, which is chronically recurring and even threatens 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 its condition.
7. Try not to hold in urine when you want to urinate, otherwise holding in will lead to a bladder infection.
8. Follow the normal drinking regime - 2 liters of water per day, and 1-1. 5 liters more in the heat.
9. Women are advised to use pads rather than tampons, which can compress the urethra and become a source of infection and eventually the bladder.
10. Men are advised to change their underwear daily, which will prevent the occurrence of non-specific urethritis as much as possible.
11. When using the toilet, it is recommended to wipe from front to back, not the other way around, to avoid entering the external genitalia, where intestinal bacteria can enter the urethra and bladder.

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