Cystitis is the medical term for inflammation of the bladder. In most cases, the inflammation is caused by a bacterial infection, and this condition is called a urinary tract infection (UTI). Bladder inflammation is usually accompanied by severe pain and a feeling of irritation, burning during or after urination, and this can become a serious problem if the infection spreads to the kidneys.
Less commonly, cystitis can occur as a reaction to certain medications, radiation therapy, or potential irritants such as sanitary sprays, spermicides, or long-term use of a catheter. Cystitis can also appear as a complication of another disease, such as diabetes mellitus, etc.
The usual treatment for bacterial cystitis is antibiotics. Treatment for other types of cystitis depends on the underlying cause.
Symptoms of cystitis often include:
- Strong and constant urge to urinate;
- Burning during urination;
- Pain during urination;
- small portions of urine;
- blood in the urine (hematuria);
- The appearance of cloudy or strong-smelling urine;
- Discomfort in the lower abdomen;
- Feeling of pressure in the lower abdomen;
- Increase in body temperature to 37. 0 - 37. 5 ° C.
When to see a doctor
Seek immediate medical attention if you have any of the signs and symptoms listed above, especially if you have:
- Backache,
- Fever over 37. 5 C and chills,
- Nausea and vomiting.
If you have frequent or painful urination that lasts several hours or more, or if you notice blood in your urine, contact your doctor immediately. If you have been diagnosed with a UTI in the past and have symptoms that mimic a previous UTI, then see your doctor as well.
It's also worth seeing a urologist if cystitis symptoms return after you've finished a course of antibiotics. You may need a different type of treatment.
Cystitis most often affects women. In healthy men, cystitis is rare, but the appearance of signs of cystitis should alarm, in this case it may be the result of a more serious disease, for example, prostate adenoma, the presence of stones in the bladder, narrowing of the urethra. , etc.
Causes of exacerbation of cystitis
Bacterial cystitis
Acute cystitis usually occurs when bacteria enter the bladder through the urethra and begin to multiply. Most cases of cystitis are caused by a type of bacteria called Escherichia coli (E. coli).
Bladder infections can occur in women as a result of sexual intercourse. But sexually inactive girls and women are also susceptible to lower urinary tract infections, because the female urethra is hidden in the pelvic cavity, it is wider and shorter than the male one (the length of the female urethra is 3-5 cm). it appears in the form of a straight tube located in front of the vagina and opens externally into the vestibule of the vagina, and the female genital area contains bacteria that can cause cystitis.
Non-infectious cystitis
Although bacterial infections are the most common cause of cystitis, a variety of non-infectious factors can also cause bladder inflammation. Other forms of cystitis:
- Interstitial cystitis.The cause of this chronic inflammation of the bladder, also called painful bladder syndrome, is unclear. Most cases are diagnosed in women. The condition is difficult to diagnose and treat.
- medicinal cystitis.Some drugs, especially chemotherapy drugs, can cause inflammation of the bladder, as some of the broken down components of the drug are excreted in the urine.
- Radiation cystitisorRadiation cystitis.Ionizing radiation directed to the pelvic area can cause inflammatory changes in the bladder wall.
- Cystitis of foreign bodies.The long-term presence of a catheter in the bladder, inserted through the urethra or installed in the form of an epicystostomy, can lead to tissue damage, the addition of a bacterial infection and the development of an inflammatory process.
- Chemical cystitis.Some people may be hypersensitive to chemicals found in certain products, such as bath foam, feminine hygiene sprays or spermicides, and their use may cause an allergic-type reaction to develop in the bladder, causing inflammation.
- Cystitis associated with other conditions.Cystitis can sometimes occur as a complication of other disorders such as diabetes, kidney stones, an enlarged prostate, or spinal cord injury.
Risk factors for cystitis
Some people are more likely to develop bladder infections or recurrent urinary tract infections. Women are one such group. The main reason is anatomy. Women have a shorter urethra, which shortens the path of bacteria into the bladder.
Women at higher risk for UTIs include those who:
- They are sexually active. Frequent and intense sexual contact can allow bacteria to enter the urethra and bladder.
- Promiscuous sexual relations.
- Inflammatory processes in the vagina, uterus.
- Use of some types of contraception. Women who use diaphragms are at an increased risk of developing a UTI. Diaphragms containing spermicide further increase the risk of cystitis.
- Pregnancy. Hormonal changes during pregnancy can increase the risk of a bladder infection.
- Menopause. Changes in hormone levels in postmenopausal women are often associated with the development of a bladder infection.
- Stress.
- Failure to observe personal hygiene.
- Residual urine. This can happen when there is a stone in the bladder or when men have an enlarged prostate.
- Changes in the immune system. Reduced immunity can occur against the background of diseases such as diabetes mellitus, HIV infection or the use of chemotherapy drugs in the treatment of cancer. Immunosuppression increases the risk of bacterial and, in some cases, viral bladder infections.
- Prolonged use of bladder catheters. These "tubes" may be needed by people with chronic illnesses or the elderly. Prolonged use can lead to increased susceptibility to bacterial infections, as well as damage to bladder tissue.
In men without any predisposing health problems, cystitis is extremely rare.
Complications of acute cystitis
With timely access to a urologist or urogynecologist and proper treatment, bladder infections rarely lead to complications. But if they are not treated, they can lead to serious consequences. Complications may include:
- Kidney infection. Cystitis not treated in time can lead to a kidney infection, also called pyelonephritis, a rather scary disease that requires treatment in a hospital setting. The most vulnerable are children and the elderly.
- Blood in the urine. In cystitis, red blood cells may appear in the urine that can only be seen under a microscope (microscopic hematuria) and usually disappear after treatment. Blood in the urine that is visible to the eye (gross hematuria) is rare and is a warning sign that should prompt you to seek medical attention.
- The transition to the chronic form of cystitis, leukoplakia of the bladder.
Disease prevention
Cranberry juice or pills containing proanthocyanidins are often recommended to reduce the risk of recurrent bladder infections in women. However, recent studies show that these drugs do not provide 100% protection against reinfection.
Although these preventative measures are not well understood, doctors sometimes recommend the following to prevent recurrent bladder infections:
- Drink plenty of fluids, especially water. This reduces the concentration of bacteria in the bladder and can prevent infection.
- Rinse with warm water only, from front to back. This prevents bacteria from spreading from the anal area to the vagina and urethra.
- Use showers, not baths. If you are prone to infections, showering instead of taking a bath can help prevent them.
- Empty your bladder as soon as possible after intercourse. Drink 250-300 ml of water to prevent a significant increase in the number of bacteria in the bladder.
- Avoid using deodorant sprays or other hygiene products around the genital area. These foods can irritate the urethra and bladder.
Diagnosis of cystitis
If you have symptoms of cystitis and have consulted a doctor, in addition to discussing your symptoms and medical history, your doctor may recommend additional testing:
- Urine analysis.If a bladder infection is suspected, the doctor may recommend a urine sample to determine if there are bacteria, red blood cells and white blood cells in the urine - these are laboratory indicators of inflammation. If there is inflammation in the bladder, then you will need to perform a bacterial culture of the urine for flora and determine the sensitivity to antibiotics.
- Smear on flora and Gnor microscopic examination of the discharge of the genitourinary organs reveals inflammation in the vagina and cervical canal, which in turn may be the cause of cystitis.
- Cystoscopy.It is not performed in any case in the middle of an acute process. Only after the normalization of the laboratory parameters, the doctor can recommend performing a cystoscopy - a visual examination of the bladder mucosa to assess its condition. In cases of chronic cystitis or suspected interstitial cystitis, the doctor will suggest a biopsy of the altered bladder mucosa to determine the depth and extent of the lesion.
- Ultrasound of the bladder. A test is usually not required, but in some cases, especially when no signs of bacterial infection are found, it may be helpful. For example, ultrasound can help detect other possible causes of bladder damage, such as a tumor or an abnormal development.
Treatment of cystitis
Cystitis caused by a bacterial infection is usually treated with antibiotics. Treatment for noninfectious cystitis depends on the underlying cause.
Treatment of bacterial cystitis
Antibiotics are the first line of treatment for cystitis caused by bacteria. Which drugs are used and for how long depends on your general health and the type and concentration of bacteria found in the urine.
- Acute cystitis.A characteristic sign of acute cystitis is an improvement in the condition after starting to drink a large amount of fluids and thermal procedures, but this condition is deceptive and threatens a new episode of the disease with even greater force. Therefore, it is necessary to contact a urologist or urogynecologist for the appointment of antibiotic therapy. You will most likely need to take antibiotics for at least three days, depending on the severity of the infection.
Regardless of the duration of treatment, it is better to drink the entire course of antibiotics prescribed by your doctor, then to make sure that the infection has completely disappeared, it is necessary to carry out a control urinalysis - a complete urinalysis andurine culture for flora.
- Recurrent cystitisorChronic cystitis. If you have a recurrent UTI, your doctor may recommend longer treatment with systemic and local bladder instillations.
Postmenopausal women may be particularly susceptible to cystitis. As an adjunct to treatment, your doctor may recommend a vaginal estrogen cream.
Treatment of interstitial cystitis
In interstitial cystitis, the cause of the inflammation is unknown, therapies used to relieve symptoms of interstitial cystitis include:
- Medicines taken by mouth or injected directly into the bladder by insertion or injection under the lining of the bladder.
- Procedures aimed at reducing symptoms, such as distending the bladder with fluid (hydrodistension of the bladder) or surgery (augmentation cystoplasty, as a way to restore organ capacity).
- Tibial neuromodulation, or electrical stimulation, which uses electrical impulses to stimulate nerve endings to relieve pelvic pain and, in some cases, reduce the frequency of urination.
The main task in the treatment of interstitial cystitis is to eliminate pain and return the capacity to the urinary bladder, which is done quite successfully by urologists using the latest achievements of science.
Treatment of other forms of non-infectious cystitis
If you are allergic and sensitive to certain chemicals, avoiding them can help relieve symptoms and prevent further episodes of cystitis.
Treatment of cystitis that develops as a complication of chemotherapy or radiation therapy focuses on relieving pain, usually with systemic or local medications.
Whether you suffer from acute cystitis or have chronic cystitis or interstitial cystitis, doctors know how to help you.