Cystitis

Cystitis is an inflammation of the bladder walls. In practical urological terminology, the word "cystitis" is usually used to indicate 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, cystitis can become chronic, or the infection will travel up the kidneys (renal 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 reduced immune system functions.

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

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

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

Based 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 kidney tuberculosis.

Causes of cystitis

Most episodes of the disease have shown 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 infection 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 that lead to the appearance of cystitis:

1. Promiscuous sex: the proximity of the urethral opening to the vagina contributes to easy infection during intercourse with both female and male flora.
2. Non-observance of such rules of intimate hygiene as daily washing of external genitals, frequent change of pads and underwear during menstruation, washing of genitals after sexual contact, keeping underwear clean, using daily pads.
3. Chronic dysbacteriosis or vaginal candidiasis: disturbed intestinal and / or vaginal microflora contributes to the growth of the population of pathogenic microflora on condition sometimes, and then unusual microflora for the genital and urinary system causes an inflammatory process, damaging the whole body.
4. Malfunctions of the immune system: a decrease in immune protection or local allergic pathologies significantly reduce the body's resistance to diseases, 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 its regular premature emptying leads to 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 leads to the fact that the infection freely penetrates up into the cavity of the bladder and triggers 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 urethral infection. This procedure is especially dangerous for pregnant women and women in labor, especially in the period after surgery, when the tone of the urinary tract has decreased, 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 gland, 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 retention of urine.

Symptoms of cystitis

Cystitis is a very unpleasant, painful disease that gives a sick person a lot of unpleasant and painful sensations, which they often bravely endure, without awareness of the dangers that complications of untreated cystitis can cause later. As a rule, acute cystitis appears suddenly, and cystitis after sexual intercourse is declared after 8-10 hours.

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

• cutting pain at the time of urination;
• burning and cutting at the end of the act of urination;
• painful pain in the lower abdomen, sometimes unbearable;
• the feeling 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 signal a possible inflammation in the kidneys or elsewhere, so immediate contact with a specialist would be a very reasonable action.

It is known that women and girls suffer from cystitis much more often than men and boys. Strangely enough, the chances of getting cystitis during pregnancy increase significantly, although during this period any disease is very undesirable. Very often, cystitis develops in the early stages of pregnancy, sometimes even before the woman knows about it. And for everything else, cystitis is often cited as a non-specific or relative sign of pregnancy.

Cystitis in early pregnancy is manifested by the following symptoms:

• various pains that can range from moderate pain in the lower abdomen with slight pain at the end of urination to sharp, cutting pain with urinary incontinence;
• frequent desire to urinate with a small amount of urine;
• urine may have a strong 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 often not so obvious. Fever, abdominal pain and nausea may be the only symptoms of cystitis.

With a disease such as cystitis, 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 bladder mucosa, leaving the submucosal layer intact.

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

The higher prevalence of cystitis in 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 female urinary tract 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 from infection with intestinal bacteria (E. Coli) that have entered the bladder from the intestinal lumen.

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

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 due to:

• holiday accommodation with the possibility of high-quality hygienic care for intimate places;
• hypothermia of the body after a too long bath in a cold tank;
• failures 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, causing a decrease in the functions of the immune system;
• often increased sexual activity on holidays, etc.

You should urgently contact a urologist if suddenly you cannot avoid cystitis while resting at a resort. Clarifying the diagnosis, take a urine test and do an ultrasound scan.

The latest antibacterial drugs and antibiotics will effectively speed up your recovery and prevent complications (transition of 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 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 the ultraviolet radiation of the sun even at low intensity, therefore it does not cause redness and burning of the skin, which means that it can be taken without violating the regimenof 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 uncomplicated acute cystitis. Chronic and other, more serious forms of cystitis will be successfully treated with this drug, however, the drug will be taken according to a certain schedule.

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 therapy should be carried out exclusively under the supervision of a medical hospital.

The main causes of cystitis during pregnancy:

• hemodynamic disorders;
• the 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 a cyst, 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 main reasons for this are:

• the lack of ability of the ovaries of girls to produce estrogen;
• 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;
• accompanying diseases that contribute to the reduction of the immune defense of the body.

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 diagnosis will help determine adequate therapy and give medical recommendations to avoid future recurrences of the disease and prevent cystitis from becoming chronic.

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

• questioning and examination of the doctor;
• visible symptoms;
• laboratory tests of urine and blood;
• bacteriological studies of urine and urethral smear;
• conducting 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 regeneration of the bladder mucosa always depends on the duration of the diagnosis and the well-chosen tactics of the complex treatment of the disease.

The selection of antibacterial drugs for the course of treatment of cystitis is determined by the following parameters:

• duration of illness;
• severity of symptoms;
• the presence of associated factors and pathologies;
• side effects of drugs, their absorption, the way, the rate of their 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 undergo mutations and become insensitive to antibiotics. Decades ago, cystitis was treated very successfully with many bactericidal drugs. However, today one of the main causes 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 cystitis pathogens, 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 to the patient's health.

Modern drugs for the treatment of cystitis act selectively on pathogens, concentrating on the bladder, thus increasing their effectiveness. The use of antibiotics of the latest generation reduces the time of cystitis treatment, 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, other treatment methods 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 regime;
• fear of hypothermia;
• warm heating pad on the lower abdomen;
• exclusion of anxiety, stressful situations;
• active lifestyle;
• phytotherapy;
• the use of iontophoresis, UHF or inductothermy.

Do not forget that the presence of some gynecological diseases prohibits the use of physiotherapy and thermal procedures.

Useful tips for preventing cystitis

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

1. Respect the rules of intimate personal 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 any sexual contact, make sure you wash with soap and so should your sexual partner.
4. Exclude oral sex in the presence of stomatitis, tonsillitis, candidiasis and other infections of the oral cavity to avoid infection of the external genital organs 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, 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 viral respiratory 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 your urine when you want to urinate, otherwise holding your urine will lead to a bladder infection.
8. Adhere to 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 more tampons, which can press the urethra and become a source of infection, and consequently the bladder.
10. Men are advised to change their underwear every day, which will protect as much as possible from the occurrence of non-specific urethritis.
11. When using the toilet, it is recommended to wipe from front to back, and not the other way around, to avoid the introduction of intestinal bacteria into 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.