Cystitis is one of the most common urological diseases. Over a lifetime, every fourth woman develops the disease, 30% of them may experience a recurrence of the disease within a year, and 10% may have a form that often gets worse.
The disease is common in many girls and women, significantly reducing the quality of life. Often, during the first episode of cystitis, patients experience severe pain and fear, and do not know what to do. Our article aims to help prevent the occurrence of cystitis and, in case of symptoms, to direct further action.
Cystitisis an inflammation of the lining of the bladder.
The reasons
Infection is the leading cause of cystitis, non -infectious causes are less common. The fact that women are ill with cystitis is associated with anatomical and physiological features of the body, which include short and wide urethra, proximity of the external opening of the urethra to the vagina and rectum, and hormonal features. Men do not suffer from cystitis, because their urethra is long and the prostate gland is a kind of anatomical barrier to the entry of microorganisms upwards into the bladder. Frequent urination in men, pain in the perineum, pain at the end of urination are signs of prostatitis.
It is important to note that cystitis in most cases is not caused by microorganisms that enter the body from the external environment or during sexual intercourse, but by their own bacteria, which usually inhabit the intestines and genital tract of women. Any factor that leads to a decrease in immunity (hypothermia, stress, etc. ) causes an increase in the reproduction of endogenous (internal) microorganisms, which leads to inflammation of the bladder mucosa. The presence of special fimbria in these bacteria (hooks to attach to the wall of the bladder), their large number and a decrease in the protective ability of the mucopolysaccharide layer of the bladder lead to the development of inflammation.
If cystitis is not treated, or antibiotic therapy is not chosen properly, the infection can infect the urinary tract, causing inflammation of the kidneys, the characteristic symptoms are:
- increased body temperature;
- pain in the lumbar region;
- signs of intoxication (general weakness, headache, drowsiness, chills).
The main bacteria that cause cystitis are:
- Escherichia coli (E. coli) accounts for 75% of cases;
- In 10% - Klebsiella spp. ;
- Staphylococcus saprophyticus is the cause in 5-10% of cases;
- Other enterobacteria are less common.
Risk Factors for Cystitis
- sexual activity;
- inadequate hygiene;
- Use of intravaginal contraceptives;
- Foot hypothermia or general hypothermia;
- Pregnancy;
- After menopause;
- Decreased immune response of the body (with diabetes, HIV infection, chemotherapy, etc. );
- The presence of obstruction to the outflow of urine (e. g. , bladder stones, inactive bladder due to neuropathy due to diabetes mellitus).
Symptoms of acute cystitis
- Pain at the end of urination (when the lower part of the bladder touches the neck;
- Frequent (more than 8 times a day) urination;
- The presence of an increase in the number of leukocytes in the general analysis of urine;
- An important urge to urinate;
- Feeling of pressure or cramping in the genital area;
- The appearance of a mixture of blood in the urine, especially at the end of urination;
- Absence of vaginal itching and discharge;
- Absence of hyperthermia (body temperature less than 37. 5 degrees).
The first three symptoms above are always present in acute cystitis.
Clinical forms of cystitis
Cystitis without acute complications
In most cases, the diagnosis is clear from the presence of characteristic symptoms (frequent urination, pain at the end of urination). As a rule, with this variant of cystitis, additional diagnostics are not required, but you can immediately begin the empirical administration (proven in practice) of the recommended antibacterial drugs. At this time, as a rule, one dose is enough. Only in case of treatment failure, additional examination is indicated. Control of general analysis of urine with signs of complete recovery is also not required.
In acute cystitis in the general analysis of urine, an increase in the number of leukocytes is always detected.
If this is not the case, the diagnosis is doubtful and other causes of frequent and painful urination should be sought.Acute cystitis maskmaybe:
- overactive bladder;
- urethral inflammation caused by obvious sexually transmitted infections (chlamydia, mycoplasma genitalium, gonorrhea, trichomonas);
- vaginitis (inflammation of the vagina);
- bladder disease (stones and tumors);
- urinary tuberculosis.
Frequent recurrent cystitis
Frequent recurrent cystitis is the presence of 2 or more episodes in six months or 3 or more episodes in a year.
Why in some women cystitis is an episode in life, while in others it leads to frequent relapses, science is not known exactly.
Possible causes of recurrent cystitis:
- genetic predisposition (decrease in the barrier function of the mucopolysaccharide layer of the bladder mucosa);
- anomalies in the development of the urinary system;
- prolapse (prolapse) of the internal genital organs;
- estrogen deficiency;
- vitamin D deficiency;
- iron deficiency anemia, including latent (ferritin deficiency);
- hypothyroidism (decreased production of thyroid hormones);
- diabetes;
- vaginal dysbiosis;
- intestinal dysbiosis;
- use of diaphragms and spermicides;
To diagnose the cause of recurrent cystitis, use:
- general urine analysis;
- analysis of urine bacteria with determination of sensitivity to antibiotics;
- Ultrasound of the kidneys, bladder with determination of residual urine;
- consultation with a gynecologist (detection of vaginal dysbiosis);
- FSH, estradiol (detection of estrogen deficiency);
- blood glucose, glycated hemoglobin, insulin, C-peptides (diagnosis of diabetes mellitus);
- TSH, T4 -free, T3 -free (diagnosis of hypothyroidism);
- general blood analysis;
- blood ferritin (detection of latent anemia);
- uroflowmetry (determination of urinary speed).
If the cause of this form of cystitis cannot be found, the use of special immune preparations is considered the "gold" standard in the first line of therapy. Their mechanism of action is the uptake of weak Escherichia coli strains and the development of protective antibodies in them, which in turn prevents microbes from multiplying.
Antibacterial drugs are also used in small doses at night, for a long time, herbal medicines and diuretics, the introduction of hyaluronic acid into the bladder (increases the protective capacity of the bladder).
Postcoital cystitis
This is cystitis that occurs up to 36 hours after sexual intercourse. Often, women face it when a new sexual partner emerges or with the beginning of family life. At the same time, obvious pathogens that require treatment are not always detected in men.
Important differentiating factorscause of postcoital cystitisiscondom test:
- there is no relapse when using condoms - male factors (look for genital infections in the urethra, on the head of the penis, prostate, testicles);
- persistent recurrence when using condoms. The possible cause is an allergy to latex. The use of spermicides is recommended;
- condom use does not lead to recovery; when using lubricant, there is no recurrence. Sexual factors, possibly local trauma of dry mucosa during intercourse. The use of lubricants is recommended;
- using condoms does not lead to recovery, using lubricants does not lead to recovery. The female factor. Examination by a gynecologist to exclude low locations of the external opening of the urethra (intravaginal dystopia), symptoms of vaginitis.
In the treatment of postcoital cystitis, antibacterial drugs are also used in small doses after sexual intercourse.
Prevention of postcoital cystitis includes:
- Hygiene procedures for all couples before and after sexual intercourse;
- Women are advised to urinate immediately after intercourse;
- Avoid vaginal dryness by using water -based lubricants and those containing estrogen;
- Do not use deodorants, aerosols and cosmetics on the perineum area;
- Do not wear synthetic underwear.
Chronic cystitis
This variant of cystitis is caused by the presence of mandatory pathology in the wall or cavity of the bladder:
- stone;
- tumor;
- foreign bodies;
- cystokel;
- diverticulum (protrusion of the wall outwards);
- ulcers;
- leukoplakia
Cystoscopy (examination of the inner surface of the bladder) plays a major role in making a diagnosis or confirming it.
In the treatment of chronic cystitis, first of all, measures aimed at eliminating the underlying cause, usually through surgery, are essential.
cystitis during menopause
It occurs due to insufficient estrogen levels, like other menopausal disorders in the body. The hormone -dependent bladder mucosa becomes thinner and more sensitive. The woman noted a frequent urge to urinate. At the same time, there were no significant deviations from the norm in the general analysis of urine.
Treatment includes long -term use of topical estrogen in the form of creams and suppositories. In addition, it is recommended to reduce or completely eliminate the consumption of caffeinated beverages and maintain optimal weight.
How to collect urine for analysis
- On the night before the test, it is recommended not to drink mineral water and exclude the use of foods (e. g. , carrots, beets) and drugs (riboflavin, rifampin, aspirin, triamterene, phenolphthalein, etc. ) that can change color. urine;
- On the night before the test, it is recommended not to drink mineral water and exclude the use of foods (e. g. , carrots, beets) and drugs (riboflavin, rifampin, aspirin, triamterene, phenolphthalein, etc. ) that can change color. urine;
- If possible, do not take diuretics;
- It is not recommended to take a urine test during menstruation;
- Before collecting urine, it is recommended to do an external genital toilet, but without using antiseptics;
- The outer labia are separated laterally with the index and middle fingers to avoid contact with the urine stream;
- For analysis, the morning portion of urine was collected: the first third of the urine was lowered, the second third of the urine was collected in a container for analysis, the third was lowered again;
- The walls of the container and genitals should not be touched;
- It is recommended to use special containers to collect urine;
- It is necessary to send urine in a tightly closed container to the laboratory no later than 2 hours after collection;
- Don’t forget to bring your references for analysis with you.
How to relieve the pain of cystitis
- A heating pad in the lower abdomen will relieve pain and heaviness in the pelvic area;
- Take a hot bath for 15-20 minutes;
- Drink plenty of fluids so that about 2. 5 liters of urine stand out: urine mechanically removes bacteria;
- Avoid foods that irritate the bladder: caffeinated beverages, alcohol, citrus juices, spicy foods.
Prevention of recurrent cystitis
- Frequent urination;
- Drinking regime - 1. 5 liters or more per day. Helps remove bacteria from the bladder.
- Proper daily hygiene of the perineum area without the use of irritants;
- Clean bath for all couples before and after sex. Women are advised to urinate immediately after intercourse;
- Avoid hypothermia of the legs and body as a whole;
- The reception of cranberry juice or fruit drinks, however, according to the latest data, this method is not very effective.
- Do not use deodorants, aerosols and cosmetics on the perineum area, as they can irritate the urethra;
- Do not use toilet paper to dry the external genitalia.
In case of symptoms of cystitis, we recommend that you consult a doctor to choose the right treatment, which will minimize the risk of recurrence. Be healthy!
Frequently asked questions
In what cases is it necessary to see a doctor immediately?
We recommend that you immediately see a doctor at the first symptoms of cystitis, during pregnancy, or the return of symptoms after the end of the course of treatment, the appearance of gross hematuria (visible blood in the urine). The doctor will talk to you, examine you and decide on the need to prescribe other research methods and treatments, as well as tell you about preventive measures.
How to prepare for a doctor's appointment?
Write down all your symptoms, even if you don’t think they are related to cystitis. Write down any medical conditions you have and any medications and supplements you take. Think about things that could signal the onset of symptoms (hypothermia, sexual intercourse, etc. ). Make sure you write all the questions to the doctor, so as not to forget to ask them and discuss all the things that bother you.
In what cases is hospitalization indicated?
Emergency hospital admissions in emergency hospitals are indicated:
- when signs of inflammation of the kidneys (acute pyelonephritis) appear, namely: pain in the back or sides, fever above 38 ° C and chills, nausea and vomiting;
- if blood appears in the urine (gross hematuria), but no symptoms of cystitis;
- exacerbate the condition against the background of continuous therapy (severe pain syndrome, persistent persistent hyperthermia).