Effective treatment for cystitis

Cystitis is the medical term for inflammation of the bladder. In most cases, inflammation is caused by a bacterial infection, and this condition is called a urinary tract infection (UTI). Inflammation of the bladder 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 may occur as a reaction to certain medications, radiation therapy, or potential irritants such as hygiene sprays, spermicides, or long-term use of a catheter. Cystitis can also occur 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, constant desire to urinate;
• Burning when urinating;
• Pain when urinating;
• 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;
• An 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:

• Back pain,
• Fever above 37. 5 C and chills,
• Nausea and vomiting.

If you have frequent or painful urination that lasts several hours or longer, 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 too.

It is also worth visiting a urologist if the symptoms of cystitis return after you have 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 alert, in this case it may be the result of a more formidable 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 even sexually inactive girls and women are 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), which is presented in the form of a straight tube locatedanterior to the vagina and opening outward at the vestibule of the vagina, and the female genital area contains bacteria that can cause cystitis.

Noninfectious cystitis

Although bacterial infections are the most common cause of cystitis, a number of non-infectious factors can also cause inflammation of the bladder. 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 drug components are excreted in the urine.
• Radiation cystitisorRadiation cystitis.Ionizing radiation directed at the pelvic area can cause inflammatory changes in the wall of the bladder.
• Foreign body cystitis.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 can 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 to the bladder.

Women at highest risk for UTIs include those who:

• 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 certain types of contraception. Women who use diaphragms are at an increased risk of developing a UTI. Diaphragms containing spermicides 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 an infection in the bladder.
• Stress.
• Non-observance of personal hygiene.

Other risk factors in both men and women include:

• Residual urine. This can occur when there is a bladder stone 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 diseases or the elderly. Prolonged use may lead to increased vulnerability to bacterial infections as well as damage to bladder tissues.

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 left untreated, they can lead to serious consequences. Complications may include:

• Kidney infection. Untreated cystitis in time can lead to a kidney infection, also called pyelonephritis, a rather formidable disease that requires treatment in a hospital setting. Children and the elderly are most at risk.
• Blood in the urine. In cystitis, red blood cells may appear in the urine that can only be seen with 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.
• 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 preventive measures are not well understood, doctors sometimes recommend the following to prevent recurring bladder infections:

• Drink plenty of fluids, especially water. This reduces the concentration of bacteria in the bladder and may prevent infection.
• Rinse only with warm water, 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 susceptible to infections, showering rather than bathing 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 your medical history, your doctor may recommend additional testing:

• Analysis of urine.If a bladder infection is suspected, a 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 urine on the flora and determine 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 can be the cause of cystitis.
• Cystoscopy.It is not performed in any case in the midst of an acute process. Only after the normalization of laboratory parameters, the doctor can recommend performing cystoscopy - a visual examination of the bladder mucosa in order to assess its condition. In cases of chronic cystitis or suspected interstitial cystitis, the doctor will suggest performing a biopsy of the altered bladder mucosa to determine the depth and extent of the lesion.
• Bladder ultrasound.Usually a test is not required, but in some cases, especially when no signs of bacterial infection are found, it may be useful. For example, ultrasound can help detect other potential 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 your urine.

• Acute cystitis.A characteristic sign of acute cystitis is an improvement in the condition after the start of drinking a large amount of fluid 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 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 perform control urinalysis - a complete urinalysis and urine culture for flora.

• Repeated cystitisorChronic cystitis. If you have a recurrent UTI, your doctor may recommend longer treatment with both systemic and topical bladder instillations.

Postmenopausal women may be especially susceptible to cystitis. As an adjunct to treatment, your doctor may recommend an estrogen vaginal cream.

Treatment of interstitial cystitis

In interstitial cystitis, the cause of the inflammation is unknown, therapies used to relieve the symptoms of interstitial cystitis include:

• Medicines taken orally or injected directly into the bladder by instillation or injection under the lining of the bladder.
• Procedures that aim to reduce symptoms, such as distending the bladder with fluid (bladder hydrodistension) or surgery (augmentation cystoplasty, as a way to restore organ capacity).
• Tibial neuromodulation, or electrical stimulation, which uses electrical impulses to irritate 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 the elimination of pain and the return of capacity to the bladder, which is done quite successfully by urologists using the latest achievements of science.

Treatment of other forms of noninfectious cystitis

If you are allergic and susceptible to certain chemicals, avoiding them may help relieve symptoms and prevent further episodes of cystitis.

Treatment of cystitis that develops as a complication of chemotherapy or radiation therapy focuses on pain relief, usually with systemic or topical medications.

If you suffer from acute cystitis or have chronic cystitis or interstitial cystitis, doctors know how to help you.