Cystitis (Cyctitis) is a common disease of the urinary system associated with an inflammatory process in the mucosa of the bladder. It is noteworthy that every fourth woman faced the symptoms of cystitis at least once in her life, while every tenth suffers from a chronic form of this disease. It is also worth comparing the incidence in women and men: only 0. 5% of men suffer from cystitis, which is mainly due to the difference in the structure of the urinary canal and the difficulty of getting an infection into it.
Causes of the disease
Cystitis in women usually occurs due to an aggressive opportunistic pathogen entering the urethra, as well as ascending sexually transmitted infections: chlamydia, ureaplasma (Ureaplasma), fungal infections of the genus Candida, etc. The short and wide urinary tract is often vulnerable to such infections. The occurrence of cystitis in women can also occur due to the movement of pathogens through the bloodstream. This path of development of the disease is called hematogenous.
Another option for infection is the entry of bacteria into the bladder with pathologies of the kidneys and ureters. Usually such a development of events can be observed with pyelonephritis.
It should be noted a less common, but still occurring variant of the development of the disease, provoked by anomalies in the development of the urinary system. Also, a decrease in the contractility of the muscles of the bladder can lead to cystitis.
Signs of infection can appear especially actively in the presence of predisposing factors. These include:
- Sedentary work. Being in a sitting position for more than three hours in a row, urine stagnates, which leads to a possible infection of the bladder. Therefore, if your work involves a long sitting in one place, you need to get up every hour, and do a little warm-up every three hours.
- Constipation.
- The presence of sand and stones in the bladder.
- Tight underwear that can disrupt normal blood circulation in the pelvic organs.
- Frequent hypothermia of the body.
- Lower back injury, spinal cord injury.
- Early onset of sexual activity.
- Metabolic disorders, hormonal changes in the body (for example, menopause or pregnancy). During hormonal surges, the body's immune system can malfunction. Please note: when carrying a child, the expectant mother is at particular risk in case of infection and the development of cystitis. Therefore, during pregnancy, you must carefully monitor your own health and consult a doctor at the first sign of the disease.
- Diabetes mellitus (Diabetes mellitus).
- Therapy with immunosuppressive drugs.
- Oncological diseases.
- Unbalanced and irregular nutrition: abuse of spicy and fried foods, alcohol.
- Improper hygiene procedures (in particular, improper washing in the direction from the anus to the vagina).
- The chance of infection of the bladder is high with insufficient personal hygiene (long-term wearing of the same pad or tampon during menstruation, untimely change of underwear, constant use of daily pads).
- Stress, chronic lack of sleep, which has a serious impact on the state of immunity.
- A general decrease in immunity caused by the presence of a chronic focus of inflammation in the body (stomatitis (Stomatitis), caries (Caries), rhinitis (Rhinitis), tonsillitis (Tonsillitis). As a result, this can lead to a violation of the sterility of the urethra
Separately, it is worth highlighting such a form of inflammation of the bladder as interstitial cystitis, which is a consequence of serious disorders in the functioning of the immune system and is a severe chronic disease.
Symptoms and signs
Symptoms of cystitis are very characteristic and allow you to immediately make the correct diagnosis. First of all, these are frequent urination (the patient visits the toilet up to several times per hour) and the manifestation of pain at the end of the bladder emptying process. Also, the most striking symptoms include:
- feeling of fullness of the bladder even after urination;
- an admixture of blood or pus in the urine;
- urine with cystitis in women acquires a more pungent odor;
- cloudy urine and the presence of flakes in it;
- pain in the lower abdomen;
- when the infection spreads, including to the upper parts of the urinary system, pain in the kidneys and lower back is possible;
- quite rare, but still there is difficulty in holding urine
If you find these symptoms in yourself, you should consult a doctor for diagnosis and further treatment, since the advanced form of the disease is fraught with a number of complications.
Symptoms of cystitis give a woman not only physical, but also psychological discomfort, leaving an imprint on her personal and social life. Therefore, it is necessary to react as soon as possible to the appearance of the first signs of the disease and begin therapy.
If the inflammation caused by infection passes to the muscular layer of the bladder, the appearance of an interstitial form of cystitis, which has already been mentioned above, is possible. In this case, urine is introduced into the walls of the organ, as well as its reflux into the ureters.
If left untreated and if the infection spreads vertically, kidney disease, pyelonephritis, can develop.
Types of cystitis
It is necessary to distinguish between the types of the disease, differing in the method of occurrence, course, morphological changes and the nature of the spread.
All varieties of cystitis are divided according to the nature of the course into acute and chronic. We will consider both options for the course of the disease.
Acute cystitis
Against the background of the manifestation of the symptoms described above, acute cystitis gives low-grade fever, general malaise. The blood vessels of the bladder expand, which leads to swelling of the walls of the organ. In this case, point hemorrhages and hyperemia (Hyperaemia) are observed. In the acute phase of the disease, the mucous and submucosal membranes of the bladder usually suffer, and their epithelium is sometimes rejected, and an admixture of blood in the urine may appear. The color of urine in the hemorrhagic form of the disease can vary from light pink to cloudy brown.
Chronic cystitis
When the disease enters the chronic phase, the inflammation expands and moves from the mucosa and submucosa to the muscular layer of the bladder. In this case, the color of the mucosa acquires a whitish or grayish tint. If the disease is not treated for a long period of time, there is the appearance of sclerotic processes in the organ, due to which its volume may be reduced.
In the chronic form, all the previously mentioned signs can be "blurred" and dimly expressed, which makes diagnosis difficult. If chronic cystitis is suspected, it is necessary to focus on the data of anamnesis, macro- and microscopy of urine, cystoscopy, and bacteriological examination. Particularly important in the detection of chronic cystitis is a parallel gynecological examination, since it is often genital infections that cause the appearance of chronic forms of cystitis.
Acute and chronic cystitis: which doctor should I contact?
Standard tests for the diagnosis of cystitis in older women, mature women and girls are a general urinalysis, urine culture to detect pathological flora (bacteriuria), Nechiporenko analysis. As additional measures, modern clinics often offer to undergo ultrasound of the bladder and kidneys, cystoscopy, and examinations for STIs. In some cases, the doctor may prescribe a urine sample for analysis not by the standard method, but by using a catheter. This may be necessary to prevent vaginal discharge from entering the urine.
Treatment of acute cystitis is carried out on the basis of antibacterial drugs. Due to the fact that such drugs are excreted by the kidneys, it is very easy to achieve the desired concentration of the antibiotic in the bladder, so the effect of the treatment appears as quickly as possible. In doing so, two important factors must be taken into account:
The doctor should prescribe antibiotics after receiving the results of urine culture, which will determine the sensitivity of the pathogen to the selected drug.
Even after alleviating the condition, the prescribed course of antibiotics should be taken to the end, which will avoid relapse and the transition of the disease to a chronic form.
As ancillary measures for the treatment of cystitis, the following are used:
- drugs to relieve spasm of the bladder, general anti-inflammatory drugs;
- physiotherapy;
- ozone therapy;
- acupuncture.
For the treatment of the chronic form of cystitis, local administration of drugs that prevent the reproduction of pathogenic microorganisms can also be used. As an aid, tea tree essential oil gel can be used. The gel is recommended to eliminate vaginal discomfort, normalize the microflora and restore the vaginal mucosa after infectious and inflammatory diseases and in the period after antibiotic treatment.
Acute cystitis
It is worth noting that the treatment of acute cystitis is always bed rest. To treat the inflammatory process in the bladder "on the run" without issuing a sick leave, especially in the cold season, means to risk a possible transition of the disease into a chronic form. The disease is always accompanied by severe stress for the body, which requires rest and rest. At the same time, ignoring the disease and postponing a visit to the doctor can "result" in pyelonephritis, the treatment of which will require constant medical supervision.
Diet
In order to relieve inflammation as quickly as possible, it is recommended to drink plenty of fluids: the minimum amount of fluid you drink should be 1. 5 liters per day.
Nutrition for cystitis has a number of restrictions. The exclusion of spicy and spicy will contribute to recovery and avoid a recurrence of the situation. For the period of treatment, it is necessary to completely exclude alcohol. This applies to all alcoholic beverages.
If you find yourself with painful and frequent urination, impurities of blood, flakes or pus in your urine, do not rush to panic. Indeed, according to statistics, female cystitis is a very common occurrence.
The main thing is not to delay and consult a doctor in time.
As a rule, this disease is determined when there are frequent painful emissions of urine in small portions, with blood impurities. Such processes are often accompanied by an increase in body temperature. Cystitis is dangerous with a possible development into a chronic form or the development of inflammation in the kidneys. Most often, cystitis is of an infectious nature.
Cystitis is widespread in women and men, but still the fair sex is more likely to suffer from this disease due to the anatomical features of the female body. The female urethra is shorter and wider than the male urethra, making it easier for pathogens to enter the bladder. This explains the frequent cases of cystitis in women. Women of childbearing age are most susceptible to cystitis. There are many cases of recurrence of cystitis, which significantly worsens the health of a woman, affects her life.
Prevalence of cystitis
The so-called acute cystitis is one of the most common urological diseases. It is not uncommon to find uncomplicated cystitis, during which microbes affect only the mucous membrane and do not affect the submucosal layer.
Based on scientific research, it can be argued that in our country from 26 to 36 million people suffer from acute cystitis every year.
Girls suffer from cystitis almost three times more often than boys. The disease is sometimes diagnosed in newborns and children under the age of 1 year, and it is more common in children aged one to three, and especially in 13-15 years. As a rule, cystitis often occurs in patients aged 4 to 12 years.
Chronic cystitis is one of the most widespread urological diseases. Based on these studies, chronic cystitis can be observed in 11-21% of the population. A significant scatter of data is caused by a different approach regarding the definition of chronic cystitis. Some study authors write that the diagnosis of "chronic cystitis" should be considered when exacerbations occur 2 times a year or more.
cystitis in summer
There are very few women who did not feel the symptoms of cystitis on themselves, when the pleasure of wonderful, summer days was overshadowed by such an unpleasant illness. In addition, in the summer, especially when a woman travels a long distance from home and finds herself in an unusual environment, there are many reasons for the appearance of cystitis.
Most often, cystitis in the summer season occurs due to such factors:
- living in a new place during the holiday period, which causes problems with personal hygiene;
- hypothermia of the body, which occurs as a result of prolonged bathing in cold water;
- violation of the usual urination regimen, which is associated with moving, flights or being in a new place;
- drastic climate change, which adversely affects human immunity.
An additional factor in the threat of developing cystitis in some cases is an increase in the activity of sexual activity, against the background of the above conditions, which are unfavorable for the female body.
In the event that your weekend or vacation is nevertheless spoiled by the occurrence of such an unpleasant disease, it is necessary to make an appointment with a urologist as soon as possible. To clarify the diagnosis, you will need to undergo an ultrasound of the bladder, pass a urine test. Antibacterial drugs today effectively act directly on the causative agent of cystitis and can speed up the healing process, as well as prevent the development of acute cystitis into a chronic form.
Modern drugs, in contrast to the drugs of the past generation, which affected the entire body of the patient, affect only the inflamed areas of the bladder, minimally affect other human organs. The main concentration of drugs is maximally revealed exclusively in the urine and bladder mucosa, which is inflamed. This allows you to make the toxic effect on other organs minimal and focus the entire burden on the treatment of cystitis.
Among the drugs that are used to treat this disease, it is worth noting the drug with fosfomycin. He, given his high selectivity of actions with a minimum toxicological load on the body, has another useful quality - this drug subsequently does not cause phototoxicity. This is the name of a side effect that can be caused by many drugs used to treat cystitis. The manifestation of phototoxicity is an increase in sensitivity to sunlight, the occurrence of redness or burns under the influence of ultraviolet rays of even low intensity. Phototoxicity appears due to the presence in the preparations of substances that have the properties of photosensitizers or photoreagents. Such substances cause the appearance of a significant amount of free radicals in the skin, which cause the destruction of skin cells, inflammation and even burns.
Unlike other medicines for the treatment of cystitis, fosfomycin is not capable of causing phototoxicity, which means that it can be used without disturbing the planned beach holiday regimen. The advantage can also be called the maximum absence of side effects, and this makes it possible to safely and very effectively treat cystitis in children and pregnant women.
cystitis during pregnancy
The fair sex is very often interested in the question of how this disease affects pregnancy. In all patients, inflammation of the bladder causes discomfort, and for a woman in this position, who has a weak immune system, this disease may well become a serious test. Pregnant women who are faced with manifestations of symptoms of inflammation of the bladder, have to go through a lot of trouble. Cystitis during pregnancy is undoubtedly dangerous, but with timely access to a doctor, undesirable consequences can be prevented. Self-medication or ignoring the disease can provoke a very serious complication, such as kidney infection. Bacteria can seriously damage them. The mucous membrane of the bladder, which is inflamed, can also have a negative effect on the fetus. There is a chance to give birth to a child prematurely, with a lack of weight.
Children's cystitis
It is generally accepted that only adults are affected by cystitis, but this is not so. In addition, there are no age restrictions for this type of disease. Adults, children, and the elderly can also get sick. Both men and women and very young patients suffer from cystitis, but the treatment of cystitis in children has its own characteristics.
Very often, cystitis in children occurs due to hypothermia. Bacteria are the main causative agent, and fungal and viral infections are extremely rare.
Causes of cystitis
In 70–95% of patients who suffer from acute cystitis, it was caused by Escherichia coli (E. coli), 5–20% observed staphylococcus aureus (Staphylococcus saprophyticus), in the remaining patients, Proteus mirabilis acts as the causative agent of the disease. ) and Klebsiella (Klebsiella spp).
As a rule, cystitis is caused by organisms of opportunistic flora. Studies have confirmed that the causative agents of cystitis may not necessarily be bacteria, it is quite possible to get sick with cystitis, the cause of which will be the mycoplasma virus, chlamydia, Trichomonas and other fungi.
The high prevalence of cystitis among women is due not only to the small length of the urethra, but also to its wide lumen and physiological location relative to other organs. The urethra in women, unlike the urethra in men, is closer to the anus. Due to such anatomical features of the female body, the body is poorly protected from pathogenic microbes entering the urethra, then microbes can easily migrate to the bladder, which can cause cystitis.
In men, cystitis is less common. The causes of the manifestation of this disease in men are most often inflammation of the urethra, epididymis, seminal vesicles, prostate gland. It happens that the penetration of infection into the area of the urethra occurs due to catheterization. The risk of cystitis doubles after a bladder catheterization has been performed in men who suffer from BPH, where frequent urinary retention is one of the symptoms. The likelihood of developing cystitis also increases after the introduction of a catheter to a pregnant woman or a woman who has just given birth, this is based on a decrease in the tone of the urinary tract.
Symptoms of cystitis
In adults, cystitis usually causes frequent, painful urination. The nature of pain is described as a burning sensation. Urine changes, it can smell strongly, become cloudy and have blood impurities. At this time, the state of health may worsen and a constant pain in the lumbar region can be felt. In the elderly and children, the symptoms of cystitis are usually not so obvious. They may be characterized by symptoms such as fever, abdominal pain, and nausea.
Diagnosis of cystitis
When diagnosing a disease, the urologist examines the results of a urinalysis, as well as the results of an ultrasound of the bladder. To determine the etiology of cystitis, they resort to bacterial urine cultures, and also take a swab from the urethra. In most cases, bacteria of opportunistic flora, namely staphylococci, streptococci, E. coli, etc. , can be the causes of cystitis. Often, cystitis occurs due to infection with pathogens that can be sexually transmitted - ureaplasma and mycoplasma. Treatment of cystitis involves the effect of drugs on infectious agents that could provoke the development of the disease.
Treatment of cystitis
A quick cure for cystitis and even complete rehabilitation of the mucous membrane is possible if you do not postpone the start of treatment, but immediately use drugs of sufficient effectiveness. The chances of completely getting rid of cystitis will increase with timely correct diagnosis and the use of medications that affect the center of infection. Starting treatment in the later stages or prescribing treatment that only eliminates the symptoms of cystitis without affecting the pathogenic zone can turn acute cystitis into chronic.
The main task facing the doctor treating cystitis is the destruction of pathogenic microbes that have penetrated into the bladder area and provoked inflammation of the mucosa. The determination of drugs for the process of antibiotic therapy of the disease occurs according to the following parameters: the duration of the disease, the severity of symptoms. In addition, during the selection of medicines, possible side effects, the method and speed of their excretion, the absorption of the drug, the presence of additional diseases, and more are taken into account.
To date, there are relatively affordable medications for the treatment of cystitis, which selectively affect the causative agent of the disease, a qualified doctor will advise just such a treatment. When ingested, the drug is concentrated inside the bladder, which makes it possible to increase its effectiveness. In addition, the use of modern antibiotics reduces the duration of treatment of cystitis, protects against side effects as much as possible and reduces the risk to the entire patient's body.
Helpful Tips for Preventing Cystitis
- try to avoid hypothermia;
- despite the circumstances, carefully observe the rules of hygiene;
- when performing hygiene procedures, use neutral and gentle products;
- during menstruation, change the sanitary napkin in a timely manner;
- visit the toilet on time, do not delay if there is a need;
- drink more fluids;
- it is advisable to abandon tight clothing, tk. it can, squeezing, worsen blood circulation in the pelvic area;
- try to normalize bowel activity. If there is a tendency to constipation, it is advisable to increase the intake of fresh fruits and vegetables.
In this case, the symptoms and treatment of cystitis will not be a problem for you.