Cystitis is the medical term for bladder inflammation. In most cases, the inflammation is caused by a bacterial infection, and this condition is called a urinary tract infection (UTI). Bladder inflammation is often accompanied by severe pain and an itchy, burning sensation during or after urination, and this can become a serious problem if the infection spreads to the kidneys.
Less commonly, cystitis can occur as a reaction to certain medications, radiation therapy, or potential irritants such as hygiene sprays, spermicides, or prolonged 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 usually include:
- Strong and constant desire to urinate;
- Burning when urinating;
- Pain when urinating;
- Small amounts 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 experience frequent or painful urination that lasts for several hours or longer, or if you notice blood in your urine, contact your doctor right away. If you've been diagnosed with a UTI in the past and have symptoms that mimic a previous UTI, see your doctor as well.
It is also worth visiting a urologist if cystitis symptoms return after finishing 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 can be the result of a more formidable disease, for example, prostate adenoma, presence of bladder stones, urethral narrowing , 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), the which is in the form of a straight tube located anterior to the vagina and opening out into the vestibule of the vagina, and the female genital area contains bacteria that can cause cystitis.
non-infectious cystitis
Although bacterial infections are the most common cause of cystitis, several non-infectious factors can also cause bladder inflammation. Other forms of cystitis:
- Interstitial cystitis. The cause of this chronic bladder inflammation, 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 drug's components are excreted in the urine.
- radiation cystitisorRadiation cystitis.Ionizing radiation directed at the pelvic region can cause inflammatory changes in the bladder wall.
- Foreign body cystitis.The prolonged presence of a catheter in the bladder, inserted through the urethra or installed in the form of an epicystostomy, can lead to tissue damage, addition of bacterial infection and development of an inflammatory process.
- Chemical cystitis.Some people may be hypersensitive to chemicals found in certain products, such as bubble bath, feminine hygiene sprays, or spermicides, and their use can cause an allergic-type reaction 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 a spinal cord injury.
Risk factors for cystitis
Some people are more likely to develop bladder infections or recurrent urinary tract infections. Women are one of those groups. The main reason is anatomy. Women have a shorter urethra, which shortens the path of bacteria to the bladder.
Women at higher risk of UTIs include those who:
- They 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 a higher risk of developing a UTI. Diaphragms containing spermicides further increase the risk of cystitis.
- Pregnancy. Hormonal changes during pregnancy can increase your risk of a bladder infection.
- Menopause. Changes in hormone levels in postmenopausal women are often associated with the development of a bladder infection.
- Stress.
- Non-observance of personal hygiene.
Other risk factors in 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 in the context of diseases such as diabetes mellitus, HIV infection or use of chemotherapy drugs in the treatment of cancer. Immunosuppression increases the risk of bacterial and, in some cases, viral infections of the bladder.
- Prolonged use of bladder catheters. These "tubes" may be necessary for people with chronic illnesses or the elderly. Prolonged use can lead to increased vulnerability to bacterial infections as well as damage to bladder tissues.
In men without predisposing health conditions, 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 if left untreated, they can lead to serious consequences. Complications can include:
- Kidney infection. Cystitis not treated in time can lead to a kidney infection, also called pyelonephritis, a very 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 under a microscope (microscopic hematuria) and usually disappear after treatment. Blood in the urine that is visible to the naked eye (macroscopic hematuria) is rare and is a warning sign that should prompt you to seek medical attention.
- Transition to the chronic form of cystitis, bladder leukoplakia.
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 offer 100% protection against reinfection.
While these preventative measures are not well understood, doctors sometimes recommend the following to prevent recurrent bladder infections:
- Drink plenty of fluids, especially water. This reduces the concentration of bacteria in the bladder and can 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 bathtubs. If you're susceptible to infections, showering instead of showering can help prevent them.
- Empty your bladder as soon as possible after intercourse. Drink 250-300 ml of water to avoid 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 seen a doctor, in addition to discussing your symptoms and medical history, your doctor may recommend additional tests:
- Urine analysis.If a bladder infection is suspected, the 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, you will need to perform a bacterial culture of the urine on the flora and determine sensitivity to antibiotics.
- Rub on flora and Gnor microscopic examination of the discharge from Organs genitourinary organs reveals inflammation in the vagina and cervical canal, which in turn can be the cause of cystitis.
- cystoscopy.It is not carried out in any case in the middle of an acute process. Only after normalization of laboratory parameters, the doctor may recommend performing cystoscopy - a visual examination of the lining of the bladder to assess its condition. In cases of chronic cystitis or suspected interstitial cystitis, the physician will suggest performing a biopsy of the altered bladder mucosa to determine the depth and extent of the lesion.
- Bladder ultrasound.A test is usually not necessary, but in some cases, especially when no signs of bacterial infection are found, it can be helpful. For example, ultrasound can help detect other potential causes of bladder damage, such as a tumor or abnormal development.
treatment of cystitis
Cystitis caused by a bacterial infection is usually treated with antibiotics. Treatment for non-infectious 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 overall 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 initiation of a large amount of fluid intake 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 best to drink the entire course of antibiotics prescribed by your doctor, and to ensure that the infection has completely disappeared, a control urinalysis is required - a complete urinalysis and urine culture for flora. .
- repeat cystitisorchronic cystitis. If you have a recurrent UTI, your doctor may recommend longer treatment with 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.
Interstitial cystitis treatment
In interstitial cystitis, the cause of inflammation is unknown, therapies used to relieve the symptoms of interstitial cystitis include:
- Medicines taken by mouth or injected directly into the bladder by instillation or injection under the lining of the bladder.
- Procedures that aim to reduce symptoms, such as distention of the bladder with fluid (bladder hydrodistention) or surgery (augmentation cystoplasty, as a way of restoring the organ's 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 bladder capacity, which is done quite successfully by urologists using the latest achievements of science.
Treatment of other forms of non-infectious cystitis
If you are allergic and susceptible to certain chemicals, avoiding them can 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.