Cystitis is the medical name for inflammation of the bladder. In most cases, the inflammation is caused by a bacterial infection, and this condition is called a urinary tract infection (UTI). Cystitis is usually accompanied by severe pain and irritation, a burning sensation during or after urination, and it 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 long-term use of a catheter. Cystitis can also occur as a complication of another disease, such as diabetes, 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 urge to urinate;
- Burning sensation during urination;
- Pain during urination;
- small amount 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
See your doctor immediately if you experience any of the signs and symptoms listed above, especially if:
- backache,
- Fever over 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, see your doctor right away. If you have been diagnosed with a UTI in the past and have symptoms that mimic a previous UTI, you should also see your doctor.
It is also worth visiting a urologist if the symptoms of cystitis return after the end of the 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 be warned, in this case it may be the result of a more serious disease, for example, prostate adenoma, the presence of stones in the bladder, urethral stricture, 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 bacterium called Escherichia coli (E. coli).
Bladder infections in women can occur as a result of sexual contact. But even sexually inactive girls and women are prone to lower urinary tract infections, since the female urethra is hidden in the pelvic cavity, wider and shorter than that of men (the length of the female urethra is 3-5 cm). it appears in the form of a straight tube located in front of the vagina, opening outwards in the vestibule of the vagina, and bacteria that cause cystitis are found in the area of the female genital organs.
Non-infectious cystitis
Although the most common cause of cystitis is a bacterial infection, many non-infectious factors can also cause cystitis. Other forms of cystitis:
- Interstitial cystitis.The cause of this chronic cystitis, also known as 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 cystitis, as some of the broken down drug components are excreted in the urine.
- Radiation cystitisobsessionRadiation cystitis.Ionizing radiation directed to the pelvic area can cause inflammatory changes in the bladder wall.
- Foreign body cystitis.The long-term presence of a catheter introduced through the urethra or inserted in the form of an epicystostomy in the bladder can lead to tissue damage, bacterial infection and the development of an inflammatory process.
- Chemical cystitis.Some people may be hypersensitive to chemicals in certain products, such as bath foams, 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 diseases, such as diabetes, kidney stones, prostate enlargement, 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's urethras are shorter, which shortens the path of bacteria to the bladder.
Women at greatest risk for UTIs include those who:
- They are sexually active. Frequent and intense sexual contact allows bacteria to enter the urethra and bladder.
- Promiscuous sexual relations.
- Inflammatory processes in the vagina, uterus.
- Using certain types of contraception. Women who use diaphragms have an increased risk of developing a urinary tract infection. Diaphragm containing spermicides further increases the risk of cystitis.
- Pregnancy. Hormonal changes during pregnancy can increase the risk of a bladder infection.
- Age of change. Changes in hormone levels in postmenopausal women are often associated with the development of bladder infections.
- Tension.
- Non-observance of personal hygiene.
- Residual urine. This can happen if you have gallstones or if men have an enlarged prostate.
- Changes in the immune system. Reduced immunity can occur in the background of diseases such as diabetes, 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.
- Long-term use of bladder catheters. People suffering from chronic diseases or the elderly may need these "tubes". Prolonged use can lead to increased vulnerability to bacterial infections and damage to bladder tissue.
In men who do not have 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 if left untreated, they can lead to serious consequences. Complications may include:
- Kidney infection. If cystitis is not treated in time, it can lead to a kidney infection, also known as pyelonephritis, which is a rather scary disease that requires hospitalization. Children and the elderly are most at risk.
- Blood in the urine. In cystitis, red blood cells can appear in the urine, which can only be seen under a microscope (microscopic hematuria) and usually disappear after treatment. Visible blood in the urine (gross hematuria) is rare and is a warning sign that prompts you to seek medical attention.
- Transition to the chronic form of cystitis, leukoplakia of the bladder.
Disease prevention
Cranberry juice or tablets containing proanthocyanidins are often recommended in women to reduce the risk of recurrent bladder infections. However, recent studies show that these drugs do not provide 100% protection against reinfection.
Although these preventive measures are not fully 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 can prevent infection.
- Rinse with warm water only, from front to back. This prevents bacteria from spreading from the anal area to the vagina and urethra.
- Use a shower, not a bath. If you are prone to infections, showering instead of 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 seen a doctor, in addition to discussing your symptoms and medical history, your doctor may recommend additional tests:
- Analysis of urine.If a bladder infection is suspected, the doctor may recommend a urine sample to see if there are bacteria, red blood cells, and white blood cells in the urine—lab indicators of inflammation. If there is inflammation in the bladder, you should do a bacterial urine culture for the flora and determine the sensitivity to antibiotics.
- Apply the flora and Gnor during the microscopic examination of the secretions of the urogenital organs, inflammation is revealed in the vagina and cervical canal, which in turn can be the cause of cystitis.
- Cystoscopy.In no case do we perform it in the midst of an acute process. Only after the normalization of laboratory parameters, the doctor can recommend performing a cystoscopy - a visual examination of the mucous membrane of the bladder in order to assess its condition. If chronic cystitis or interstitial cystitis is suspected, the doctor will recommend 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 if no signs of a bacterial infection are found, it may be helpful. For example, ultrasound can help detect other possible 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 of non-infectious cystitis depends on the underlying cause.
Treatment of bacterial cystitis
Antibiotics are the first line of treatment for bacterial cystitis. What medications you use and for how long depend on your overall health and the type and concentration of bacteria in your urine.
- Acute cystitis.A characteristic sign of acute cystitis is the improvement of the condition after the initiation of 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, a urologist or urogynecologist should be contacted to prescribe 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 full course of antibiotics prescribed by the doctor, and then to check the complete elimination of the infection, a control urinalysis should be performed - a complete urinalysis and a urine culture for flora.
- Recurrent cystitisobsessionChronic cystitis. If you have recurrent urinary tract infections, your doctor may recommend longer treatment with both systemic and topical bladder drops.
Postmenopausal women may be particularly susceptible to cystitis. As a supplement to the treatment, your doctor may recommend an estrogen vaginal cream.
Treatment of interstitial cystitis
The cause of the inflammation in interstitial cystitis is unknown, the therapies used to alleviate the symptoms of interstitial cystitis are as follows:
- Taken orally or injected directly into the bladder as a drip or injected under the lining of the bladder.
- Procedures aimed at reducing 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, uses electrical impulses to irritate nerve endings to relieve pelvic pain and, in some cases, reduce the frequency of urination.
The main task of treating interstitial cystitis is to eliminate pain and restore the capacity of the bladder, which urologists do quite successfully using the latest results of science.
Treatment of other forms of non-infectious cystitis
If you have allergies and sensitivities 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 have acute cystitis or chronic cystitis or interstitial cystitis, doctors know how to help you.