Cystitis

Cystitis is an inflammation of the walls of the bladder. In practical urological terminology, the word "cystitis" is usually used to denote a symptomatic urinary tract infection, with manifestations of inflammation of the bladder mucosa, impaired functionality and changes in urinary sediment.

The signs of cystitis appear suddenly:

• frequent urination (every 15-20 minutes);
• sharp 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 (kidney disease) or urethra (urethral disease).

According to statistical expertise, women between the ages of 14 and 60 have had at least one cystitis in their life, especially sexually active women between the ages of 20 and 50 who suffered from diabetes mellitus and had a history of decreased functions of theimmune system.

Modern children, as practice shows, quite often suffer from cystitis, even babies and babies. 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: appears suddenly, accompanied by local symptoms (frequent and painful urination) and general symptoms (fever, general weakness);
• chronic: found in laboratory tests, the symptoms are slow or absent, but during an exacerbation, they take the form of an acute.

Based on the causative factor, cystitis also occurs:

• nonspecific: against the background of conditionally pathogenic microflora (enterobacteriaceae, candida, staphylococci, proteus, klebsiella);
• specific: due to sexually transmitted diseases (chlamydia, ureaplasmosis, syphilis) or renal tuberculosis.

Causes of cystitis

Most episodes of the disease have shown that the main cause of cystitis is infection with representatives of the conditionally pathogenic environment of the human body - staphylococci, streptococci, Escherichia coli, as well as infection with genital infections withureaplasma and mycoplasma.

Today it is known that cystitis, the causes of which are quite clear, cannot be caused by a single factor.

The complex of factors leading to the appearance of cystitis:

1. Promiscuous sex: The close proximity of the opening of the urethra to the vagina contributes to easy infection during sex with both female and male flora.
2. Non-compliance with the rules of intimate hygiene such as daily washing of the external genitalia, frequent changing of sanitary napkins and underwear during menstruation, washing of the genitals after sexual contact, maintaining the cleanliness of theunderwear, daily use of sanitary napkins.
3. Chronic dysbacteriosis or vaginal candidiasis: a disturbed intestinal and / or vaginal microflora sometimes contributes to the growth of the population of conditionally pathogenic microflora, then the unusual microflora for the genital and urinary system causes an inflammatory process, harming the whole body.
4. Dysfunctions of the immune system: a decrease in immune defenses or local allergic pathologies significantly reduce the body's resistance to disease, which gives carte blanche to pathogenic bacteria to easily penetrate the bladder cavity.
5. Infrequent urination: a woman's bladder can accumulate 250-500 ml of urine inside it, and its regular untimely emptying leads to structural changes in the bladder, sphincter and the creation of greenhouse conditions for infectionand reproduction of pathogenic microorganisms.
6. The decrease in protective forces leads to the fact that the infection freely penetrates upwards into the cavity of the bladder and provokes an inflammatory process there.
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 infection of the urethra. This procedure is especially dangerous for pregnant women and women in labor, especially in the postoperative period, when the tone of the urinary tract is reduced 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, epididymis and seminal vesicles. The possibility of developing cystitis is increased during bladder catheterization in men with prostate adenoma, one of the symptoms of which is constant urinary retention.

Symptoms of cystitis

Cystitis is a very unpleasant and painful disease that gives a sick person a lot of uncomfortable and painful sensations, which he often bravely endures, ignoring the dangers that can later lead to complications of uncured cystitis. As a rule, acute cystitis appears suddenly, and cystitis after sexual intercourse develops after 8-10 hours.

Symptoms of cystitis are very painful, the most characteristic of them:

• cutting pains when urinating;
• burning and cutting at the end of the act of urination;
• drawing pains in the lower abdomen, sometimes unbearable;
• feeling of incomplete emptying of the bladder;
• sometimes urinary incontinence with strong desire to urinate (more often in children);
• cloudy or bloody urine (hematuria);
• sometimes a slight increase in body temperature with a slight chill.

A rise in temperature during cystitis can also signal possible inflammation in the kidneys or elsewhere, so contacting a specialist immediately would be a very reasonable act.

It is known that women and girls suffer from cystitis much more often than men and boys. Oddly enough, but the likelihood of getting cystitis during pregnancy increases significantly, although during this period any disease is highly undesirable. Quite often, cystitis develops early in pregnancy, sometimes even before the woman knows about it. And for everything else, cystitis is often referred to as a nonspecific or relative sign of pregnancy.

Cystitis in early pregnancy is manifested by the following symptoms:

• various pains that can vary from moderate pain in the lower abdomen with mild pain at the end of urination to sharp, cutting pain with urinary incontinence;
• frequent urge to urinate with a small amount of urine;
• urine may have a pungent odor, dark color;
• constant pain in the lumbar region;
• slight hematuria (not always);
• fever (optional)
• menstrual disorders in women of childbearing age.

In older people and children, the symptoms of cystitis are often less obvious. Fever, abdominal pain, and nausea may be the only symptoms of cystitis.

With a disease such as cystitis, the symptoms and treatment always completely depend on the patient's sense of responsibility for his 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 mucous membrane of the bladder, 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 21-50 years, only 6-8 cases per 1000, and the formacute cystitis in men is observed extremely rarely.

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 urinary canal of women goes directly to the perineum, which contributes to the easy penetration of 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 due to infection by intestinal bacteria (E. Coli) that have entered the bladder from the lumenintestinal.

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

cystitis in summer

Surprisingly, however, during the hot summer season, especially during the holiday period, when most women go on vacation to other climatic zones, cases of cystitis become more frequent for reasons:

• accommodation on vacation with the impossibility of high-quality hygienic care for intimate places;
• hypothermia of the body after too long a bath in a cold tank;
• failures in the usual mode of urination (leakage, moving, new place), when you have to endure for a long time;
• a sharp change in the climatic zone, leading to a decrease in the functions of the immune system;
• often increased sexual activity on vacation and so on.

You need to urgently contact a urologist if suddenly you cannot avoid cystitis while relaxing in a complex. Clarify the diagnosis, take a urine test and undergo an ultrasound.

The latest antibacterial and antibiotic drugs will effectively speed up your recovery and prevent complications (transition from 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 in the urine and the diseased mucous membrane of the bladder. The toxicological effect on the body is minimal.

Especially successful in the treatment of cystitis in the summer takes 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 ultraviolet radiation from the sun even at low intensity, therefore it does not cause redness and burning of the skin, whichmeans that it can be taken without violating the beach regime.

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 acute uncomplicated cystitis. Chronic and other more severe forms of cystitis will also be successfully treated with this drug, however, the remedy will be taken according to a certain scheme.

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 treatment should be carried out exclusively under hospital medical supervision.

The main causes of cystitis during pregnancy:

• hemodynamic disorders;
• 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 urinary retention in the bladder and infection. At the first suspicion of cystitis, 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

Childhood cystitis affects the younger generation at any age, but girls of preschool and school age - five to six times more often, and the underlying reasons are:

• lack of ability of girls' ovaries to produce estrogen;
• weak barrier capacities 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;
• concomitant diseases that contribute to a decrease in the body's immune defense.

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 reveal all the factors that led to the development of cystitis. Reliable diagnostics will help prescribe adequate treatment and give medical recommendations to avoid future recurrences of the disease and prevent the transition of cystitis to a chronic form.

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

• questioning and examination of a doctor;
• obvious symptoms;
• urine and blood laboratory tests;
• bacteriological studies of urine and smears from the urethra;
• conduct special tests to detect the presence of nitrites and leukocytes in the urine;
• Bladder ultrasound;
• determine the presence of comorbidities.

If necessary, other methods of urological examination are used.

Treatment of cystitis

Cystitis how to treat? The timeliness and quality of treatment of cystitis, regeneration of the mucous membrane of the bladder always depends on the timeliness of diagnosis and well-chosen tactics of complex treatment of the disease.

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

• the duration of the disease;
• severity of symptoms;
• the presence of concomitant factors and pathologies;
• side effects of drugs, their absorption, method, rate of excretion from the body, etc.

The effectiveness of a drug for the treatment of cystitis consists of the strength of its suggestiveness for one or another of the microorganisms. It should be noted that pathogenic bacteria mutate and become insensitive to antibiotics. Decades ago, cystitis was very successfully treated with many bactericidal drugs. However, today one of the main causative agents of cystitis - E. coli - has become resistant to the effects of these drugs. Moreover, the previous generation of antibiotics had a very high level of toxicity and many negative side effects.

When choosing a drug for pathogens of cystitis, one should also take into account the cost of treatment, which will be expressed not so much in the cost of the drug itself, but in its effectiveness, long-term useterm and the existing risk to the patient's health.

Modern drugs for the treatment of cystitis act selectively on pathogens, concentrating in the bladder, thereby increasing their effectiveness. The use of the latest generation antibiotics reduces the time for treatment of cystitis, reduces the risk of side effects, which harms the health of patients less. A broad-spectrum antibiotic from the fosfomycin group, as an effective and safe drug, is used to treat cystitis in pregnant women and children.

How to treat cystitis? In addition to antibiotic treatment, one should not forget about other methods of treatment:

• anti-inflammatory and analgesic therapy with antispasmodics;
• stimulation and modulation of the immune system;
• a diet without fatty and spicy foods;
• increased drinking regimen;
• fear of hypothermia;
• warm heating pad on the lower abdomen;
• exclusion of anxiety, stressful situations;
• active lifestyle;
• phytotherapy;
• use of iontophoresis, UHF or inductothermy.

Remember that the presence of some gynecological diseases prohibits the use of physiotherapy and thermal procedures.

Useful tips to prevent cystitis

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

1. Respect the rules of personal intimate hygiene: wash your face at least once a day, and preferably 2 or more times, with baby soap (without harmful additives) and running water.
2. Monitor your sexual partner for simple genital hygiene.
3. Before and after each sexual encounter, be sure to wash yourself with soap, and your sexual partner should also do so.
4. Exclude oral sex in the presence of stomatitis, tonsillitis, candidiasis and other infections of the oral cavity in order to avoid infection of the external genitalia and urethra with saliva.
5. Dress according to the weather, not fashion. Reimbursing a cold weather miniskirt can be cystitis, and not just cystitis, but chronic recurring inflammation and even appendages, which threatens many years of medical procedures, infertility and hope for a cure.
6. Please note that frequent acute respiratory infections and acute respiratory viral 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 on to urination when you want to urinate, otherwise holding on to urine will lead to bladder infection.
8. Follow a normal drinking regime - 2 liters of water per day, and in hot weather - 1-1. 5 liters more.
9. Women are advised to use pads rather than tampons, which can compress the urethra and become a source of infection and therefore the bladder.
10. Men are advised to change their underwear daily, which will protect as much as possible against the occurrence of nonspecific urethritis.
11. When using the toilet, it is recommended to wipe from front to back, and not vice versa, to avoid introducing intestinal bacteria into the external genitalia, from where they can enter theurethra and bladder.

Compliance with these tips will not 100% get rid of cystitis, but it will help minimize the risk of becoming ill with it.