By itself, cystitis is not dangerous and does not cause difficulties in treatment, but it poses a threat of serious complications.
This disease can occur at any age. Due to the peculiarities of the structure of the genitourinary system, women are more prone to cystitis. According to statistics, about 80% of women experience this pathology at least once in their life. For men, the possibility of getting cystitis increases after overcoming the milestone of 40-50 years.
Types of diseases
Cystitis can be of several types. The causes of disease development divide it into infectious and non-infectious.
Infectious cystitis
Primary and secondary.In the first case, this is an independent disease: a healthy bladder is affected by the infection. In the second, it is a complication of another disease: the mucous membrane becomes inflamed based on the pathology of the urinary system, kidney or already developed prostate.
Acute and chronic.In the acute form, symptoms are usually severe. With improper treatment or its absence, the disease becomes chronic, characterized by periods of aggravation and decline. There are cases when acute cystitis ends in recovery after a few days, even without treatment.
Depending on the location of the focus of inflammation:
- cervix - damage to the neck of the bladder;
- trigonal - inflammation of the triangle of the bladder (the area between the mouth of the ureter and the internal opening of the urethra);
- total - affects the entire organ. In this case, the course of cystitis is very severe.
Postcoital.It develops within 1-2 days after sexual intercourse or vaginal manipulation. Its occurrence is caused by the entry of pathogenic microflora into the female urethra. During intercourse, under the pressure arising from the movement of the penis, vaginal mucus is expelled into the urethra. From that, the infection freely enters the bladder. Also, prerequisites for the development of this type of disease are frequent changes of sexual partners, abuse of contraceptive spermicides, violation of intimate hygiene rules, use of tampons, wearing synthetic underwear, etc.
"Honeymoon Cystitis".It develops after the loss of virginity against the background of violations of the existing vaginal microflora (candidiasis, etc. ). This happens for the same reason: during intercourse, vaginal microflora is thrown into the urethra and bladder, which until then are not exposed to infection.
Viruses, tuberculosis and parasites.Such forms of cystitis are very rare.
Cystitis is not contagious
Non-infectious cystitis is not associated with the entry of pathogenic microflora into the bladder. Depending on the cause of the incident, it can take the form of:
- radiation;
- chemistry;
- heat;
- traumatic;
- after surgery;
- allergic
Separately, there is a classification of cystitis according to the degree of involvement of the bladder mucosa:
- hemorrhagic - accompanied by the presence of blood impurities in the urine (hematuria);
- no blood - blood in the urine is not visible.
Cause
Inflammation of the bladder in most cases (up to 85%) is caused by an infection that enters the organ. Basically, the "provocateurs" of cystitis are Escherichia coli (about 90%), streptococci, staphylococci and other conditionally pathogenic microorganisms. Rarely, the causative agent of this disease is a fungus of the genus Candida or a sexual infection (chlamydia, mycoplasma, ureaplasma, etc. ).
There are two main routes of infection to the bladder:
- ascending - through the urethra. This is facilitated by improper genital care, poor intimate hygiene, sexual life, etc. Pathogenic microorganisms can enter the body during surgery or manipulation of the bladder and urethra, during catheterization, if sterility is not observed;
- descending - from the diseased kidney through the ureter, as well as with blood and lymph from the rectal canal and genital organs. The large intestine serves as the habitat of the main pathogen - Escherichia coli. The causative agents of genital infections in women are located in the uterus and vagina, in men - in the urethra and prostate duct.
Non-infectious cystitis occurs for the following reasons:
- pelvic organ irradiation. During radiation therapy, radiation affects not only the organs affected by cancer (uterus, ovaries, prostate, intestines, etc. ), but also nearby, in particular, the bladder. A high dose of radiation can cause burning of the mucous membrane of the organ, after which ulcers and fistulas form on its walls in the future;
- chemical burns due to the entry of drugs into the bladder cavity;
- organ injury with gallstones;
- exposure to the bladder mucosa with hot liquids;
- allergic reaction. Against its background, not only sneezing, nasal congestion, etc. , but also cystitis can occur.
In the case of non-infectious cystitis, secondary infection usually occurs due to weakness of the bladder mucosa.
Risk factors
There are many factors that contribute to the development of cystitis:
- hypothermia;
- decreased immunity;
- hypovitaminosis;
- improper nutrition. Spicy, salty, fried, fatty and alcoholic drinks irritate the bladder wall and dry out the body;
- violation of vaginal microflora;
- frequent and prolonged constipation;
- bladder mucosa injury;
- sedentary lifestyle (impaired blood circulation);
- synthetic tights and underwear;
- the presence of chronic gynecological, urological or venereal diseases;
- previous urinary tract infection;
- non-compliance with personal hygiene rules;
- improper use of pads and tampons;
- constant lack of sleep, too much work, stress;
- promiscuity and unprotected sex;
- diabetes;
- hormonal disorders;
- operations are transferred;
- bladder catheterization;
- taking certain medications, such as sulfonamides;
- genetic predisposition;
- pregnancy and childbirth;
- anatomical abnormalities, such as phimosis in boys.
cystitis in women
Cystitis is considered by some to be a "women's" disease due to the fact that women usually suffer from it. Several factors contribute to this:
- anatomical features of the structure of the genitourinary system. Due to the wide and short urethra, it is easier for pathogenic microflora to penetrate the bladder. The entrance to the urethra is located near the anus and vagina, so infection can occur during intercourse;
- tone of the lower urinary tract. It is caused by the influence of female sex hormones. This is especially noticeable during pregnancy, when the body produces progesterone. It relaxes the uterus and nearby organs for the safety of the child;
- give birth naturally. In this case, the pelvic muscles lose their elasticity, the bladder sphincter's ability to contract weakens, the vagina expands. The penetration of infection is facilitated in such conditions;
- hormonal changes, especially during menopause.
Every tenth woman during pregnancy is at high risk of cystitis. This happens for several reasons. First, during childbirth, a woman's immunity decreases. The body becomes more vulnerable to any type of infection. Second, changes in the general hormonal background, which is a signal for the development of inflammatory diseases of the genitourinary system. Third, the increase in the uterus leads to the squeezing of the bladder. This causes a deterioration in its blood supply and, as a result, leads to an increase in the possibility of damage by pathogens. Do not forget about the increased synthesis of progesterone, which reduces the tone of the bladder. In the future, congestion and a sharp development of infection occur.
cystitis in men
The presence of a long and curved urethra in men significantly reduces the risk of bladder infection. Chances of developing cystitis in men under 40-50, who follow the rules of personal hygiene, are very small. After overcoming this age limit, in the presence of concomitant diseases, cystitis is diagnosed more often.
Provocative diseases include prostatitis, prostate adenoma, vesiculitis, urethritis, prostate cancer, etc. Usually they are accompanied by a narrowing of the urethra. As a result, the bladder is not completely empty. Stagnant urine is formed, which serves as a good environment for the development of pathogens - cystitis pathogens.
The disease in men occurs in a more severe form and is accompanied by fever and general intoxication of the body, because cystitis in men develops as a complication of other diseases. The chronic form of this disease in men continues without symptoms.
Cystitis in children
Children of any age are also susceptible to cystitis. Especially often it develops in girls of preschool and school age. Many factors contribute to this. Among them are the weak protective properties of the mucous membrane of the bladder, a wide and short urethra, and a lack of estrogen synthesis by the ovaries.
The risk of developing the disease increases if the child has other diseases. This weakens the immune defense and creates favorable conditions for the reproduction of pathogenic microflora.
symptoms
Depending on the form of the disease, various symptoms may appear. If acute cystitis is characterized by a clear clinical picture with painful and frequent urination, then chronic cystitis during remission can be generally asymptomatic.
Symptoms of acute cystitis are:
- high temperature;
- shivering;
- general weakness;
- difficult and painful urination. Urine comes out in small portions. In the process, there is a burning sensation in the urethra, and after that - pain in the lower abdomen;
- a feeling of incomplete emptying of the bladder;
- pain in the suprapubic area before and after urination;
- sharp pain in the bladder area on palpation;
- pain in the external genitalia (scrotum, penis, etc. ).
In some cases, cystitis develops urinary incontinence, provoked by a strong urge to urinate.
Urine may become cloudy or reddish, which indicates the presence in it of a large number of bacteria, desquamated epithelium, red blood cells and white blood cells.
In the case of acute cystitis, the picture of general intoxication of the body is possible: body temperature rises up to 38-40 degrees, sweating, thirst and dry mouth. As a rule, this indicates the spread of infection to the kidneys and renal pelvis, which leads to the development of pyelonephritis. Under these circumstances, emergency medical treatment is required.
In patients, the manifestation of clinical signs in acute cystitis occurs in different ways. In a milder form of the disease, the patient may only experience heaviness in the lower abdomen, a slight pain at the end of urination. In some cases, the course of acute cystitis becomes significant, a severe inflammatory process develops. Often, experts diagnose phlegmonous or gangrenous cystitis, which is characterized by fever, hangover, a sudden decrease in the amount of urine released, turbidity of urine and the appearance of a foul smell in it.
In chronic cystitis, the clinical signs of the disease are in many ways similar to acute cystitis, but less pronounced. Symptoms are permanent, only their intensity changes during treatment.
Diagnostics
The correct diagnosis of cystitis directly affects the success of the treatment of the disease. It is important to determine the nature and factors of inflammation before prescribing therapy. If allergic cystitis occurs and contact with the allergen is not eliminated before taking antibiotics, the condition will only worsen.
In the case of infectious cystitis, it is necessary to determine the causative agent and determine the antimicrobial or antifungal drug that is sensitive to it. The results of the study will determine the course of further therapy. If cystitis is not infectious, it is necessary to carry out an examination to determine the causes that triggered the onset of the disease. Maybe the cause is urolithiasis or neoplasm.
Diagnosis of the disease includes the following steps:
- collection of anamnesis;
- determination of clinical manifestations;
- appointment of laboratory tests;
- examination using instrumental methods.
Laboratory examination for cystitis
- General blood analysis. It is carried out to identify signs of non-specific inflammation, increase the level of leukocytes and immature forms of neutrophils, increase the level of ESR;
- General urine analysis. It detects the presence of protein in the urine, an increase in the number of white blood cells, red blood cells and bacteria. When leukocytosis is detected, an analysis is prescribed that determines the number of blood cells in the urine sediment, and three cup samples.
Modern express methods can also be used to diagnose diseases:
- quick test with indicator strip. If there is an infection in the urine, then a reaction appears on the strip;
- rapid test with a strip to obtain data on leukocyte and protein content in urine. The importance of the method is doubtful, because a general urine test can also cope with this task;
- leukocyte esterase reaction. This method allows you to identify the esterase enzyme. It accumulates if pus is present in the urine.
After completing the laboratory tests, the urine is cultured, i. e. a culture study is carried out. The meaning is as follows: the pathogenic microflora that provokes the development of cystitis is studied, and the sensitivity of microbes to antibiotics is determined. Such an examination allows you to prescribe the most effective medicine.
Reliability of studies is often compromised due to improper sampling of materials and non-compliance with hygiene rules by patients.
Instrumental research methods
Among the instrumental methods to diagnose the disease, the most common is cystoscopy, which consists of visualization of the urethra and bladder using a cystoscope. In the case of acute cystitis, the introduction of instruments into the bladder is contraindicated, because the process is very painful and contributes to the spread of infection in the organs of the genitourinary system.
Such a procedure is only allowed in the case of chronic cystitis, the presence of a foreign body in the bladder, or with a protracted course of the disease (10-12 days).
In addition to the above procedures, women with cystitis are advised to undergo an examination by a gynecologist, diagnose a genital infection, undergo an ultrasound examination of the small pelvis, biopsy, uroflowmetry and other studies.
In special cases, cystography is prescribed. This study allows you to see any violations and neoplasms on the wall of the bladder. During the procedure, X-rays are used. To get more accurate results, a contrast agent is injected through the catheter, which straightens the organ to expand the field of view. The results can be seen on x-rays.
Treatment
Drug therapy is the main treatment for cystitis. There is no universal treatment regimen: doctors approach each patient individually based on the nature of the disease, its stage of development, etc. If the pathogenic microflora is bacteria, antibiotics are prescribed, fungi - fungicides, for allergies - antihistamines, etc. Acute cystitis involves taking antispasmodics, analgesics and non-steroidal anti-inflammatory drugs. Additional measures are being taken to boost the patient's immunity.
In acute cystitis, it is important not to stop the course of antibiotic therapy at the time of disappearance of signs of the disease. Such untreated diseases often become chronic, threatening a person's overall health.
In chronic cystitis, drugs based on medical herbs show high efficiency. It is useful to take herbal decoctions that have anti-inflammatory and antibacterial effects. Physiotherapy methods may also be involved: magnetophoresis, electrophoresis, inducto- and hyperthermia, EHF therapy, ultrasound treatment and laser therapy.
Complex therapy of cystitis includes the appointment of a special diet for the patient. It is necessary to eliminate from the diet foods that irritate the mucous membrane of the bladder. Spicy, salty, fried, smoked and pickled foods and dishes are prohibited. Food should be as light as possible and deliver a large amount of plant fiber to the body, which is necessary for the normal functioning of the intestinal microflora to ensure a high level of immunity. Many warm drinks are prescribed.
In some cases, surgery is the only treatment for this disease. Usually used with postcoital cystitis or with a very low location of the external opening of the urethra. In this case, the surgeon moves the urethra slightly above the entrance to the vagina to prevent infection during intercourse or hygiene procedures.
Surgical methods for the treatment of cystitis in men are prescribed for the occurrence of cicatricial sclerosis, deformation of the bladder neck, or persistent narrowing of the urethra.
More complex operations are performed for cervical cystitis, tuberculosis and parasites (with drug ineffectiveness). In the case of an advanced form of the disease - gangrene - the damaged area of the bladder is removed, and if the gangrene is total, then the entire organ.
Complications
Vesicoureteral reflux is the most dangerous complication. It is expressed in the fact that urine is thrown into the ureter. If the process is not interrupted, then the inflammation spreads further to the kidneys, inflammation of the uterus and appendages is possible. It also reduces the elasticity of the bladder wall, which may be scarred or ulcerated. Spread of the infection higher into the kidney leads to pyelonephritis. In the case of this disease, the amount of urine decreases. Urine accumulates in the kidneys and causes peritonitis, because the kidneys do not fully perform their functions. This requires immediate surgical intervention.
A complication of cystitis is also paracystitis, which is characterized by an infection of the small pelvic tissue, which is responsible for the preservation of the organ. Lesions cause scarring, abscesses. In this case, saving the patient's life is possible only with surgical intervention. Complications in the form of cystalgia appear after the treatment of cystitis. It consists of maintaining painful urination, which is associated with disruption of receptors, but usually it passes quickly.
Among other complications of diseases with cystitis, one can distinguish a decrease in reproductive capacity, urinary incontinence. For pregnant women, untreated cystitis can cause miscarriage, as the inflammation can spread to the fetus.
In men, the complications of cystitis differ slightly from women and are only related to the structural peculiarities of the genitourinary system. In both sexes, the gangrenous form of cystitis becomes a complication. It is one of the most complex conditions, it affects the mucous membrane of the bladder wall. The purulent process can cause necrosis of the bladder tissue and its death, penetration of the bladder wall or paracystitis is possible. At the same time, urination does not bring relief to the patient.
Also a dangerous complication of pathology is the occurrence of diffuse ulcerative cystitis and empyema. They develop with insufficient therapy for inflammation of the bladder. At the time when the infection affects the entire mucous membrane of the organ, an abscess forms on it, and then a bleeding ulcer. For this reason, scars are formed, tissue elasticity is lost. All this leads to a decrease in the volume of the bladder.
Urgent surgical intervention is required for empyema, when pus accumulates in the bladder due to decreased outflow. Sphincter dysfunction may also occur due to infectious lesions on the mucous membrane of the organ. In this case, urinary incontinence is observed.
Prevention
Cystitis, like any other disease, is better to prevent than to treat. For this it is recommended:
- avoid hypothermia. You cannot sit in the cold, swim in cold water, or dress lightly in winter;
- eat right. Spicy, spicy, sour, salty, fried, fatty, pickled foods, it is desirable to exclude or consume in limited quantities, drink plenty of water;
- get rid of bad habits - smoking and drinking alcohol;
- drink more fluids (at least 2 liters) - still water, juice. This allows you to quickly remove pathogenic microorganisms from the bladder, preventing their reproduction;
- do not drink coffee, orange, pineapple and grape juice, because they increase the acidity of urine;
- cure gynecological, urological and genital diseases;
- normalizes the work of the digestive tract;
- comply with personal hygiene rules;
- change pads and tampons in time during menstruation, while the use of pads is better;
- wear comfortable underwear made of natural fabrics;
- refuse tight clothing, because it interferes with the blood circulation of the pelvic organs;
- avoid overfilling the bladder;
- when leading a sedentary lifestyle, get up, stretch every hour for at least 5-15 minutes;
- conduct regular preventive visits to urologists and gynecologists.
It is also useful to use herbal decoctions with antiseptic and anti-inflammatory properties (from calendula, chamomile, parsley, etc. ).