Cystitis is the medical term 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). Bladder inflammation is usually accompanied by severe pain and irritation, burning during or after urination, and this can become a serious problem if the infection spreads to the kidneys.
Less commonly, cystitis may occur in response to certain medications, radiation therapy, or potential irritants such as sanitary sprays, spermicides, or long-term use of catheters. Cystitis can also occur as a complication of other diseases, such as diabetes mellitus, etc.
The usual treatment for bacterial cystitis is antibiotics. Treatment for other types of cystitis depends on the underlying cause.
Cystitis symptoms often include:
- A strong and persistent desire to urinate;
- Burning when urinating;
- Pain when urinating;
- Small portion of urine;
- blood in the urine (hematuria);
- Appearance of cloudy or strong-smelling urine;
- Discomfort in the lower abdomen;
- Feeling of pressure in the lower abdomen;
- Increase in body temperature to 37. 0 - 37. 5 °C.
When do you want to see a doctor?
Get immediate medical attention if you have any of the signs and symptoms listed above, especially if you have:
- Backache,
- Fever over 37. 5 C and chills,
- Dizziness and vomiting.
If you have frequent or painful urination that lasts several hours or longer, or if you see blood in your urine, call your doctor right away. If you have been diagnosed with a UTI in the past and have symptoms that resemble a previous UTI, see your doctor as well.
It is also worth visiting a urologist if cystitis symptoms return after you finish 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 reported, in this case it may be the result of a more serious disease, for example, prostate adenoma, the presence of stones in the bladder, narrowing of the urethra. , and others.
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 although girls and women who are not sexually active are prone to lower urinary tract infections, because the female urethra is hidden in the pelvic cavity, it is wider and shorter than that of men (the length of the female urethra is 3-5 cm), which is presented in the form of a straight tube located in front of the vagina and opens outwards in the vaginal vestibule, and the female genital area contains bacteria that can cause cystitis.
Cystitis is not contagious
Although bacterial infection is the most common cause of cystitis, several non-infectious factors can also cause inflammation of the bladder. Other forms of cystitis:
- Interstitial cystitis.The cause of this chronic inflammation of the bladder, also called painful bladder syndrome, is unclear. Most cases are diagnosed in women. This condition is difficult to diagnose and treat.
- medical cystitis.Some drugs, especially chemotherapy drugs, can cause inflammation of the bladder, because some of the damaged components of the drug are excreted in the urine.
- Radiation cystitisorRadiation cystitis.Ionizing radiation directed at the pelvic area can cause inflammatory changes in the bladder wall.
- Foreign body cystitis.The long-term presence of a catheter in the bladder, inserted through the urethra or installed in the form of an epicystostomy, can cause tissue damage, the addition of bacterial infections and the development of the inflammatory process.
- Chemical cystitis.Some people may be hypersensitive to chemicals found in certain products, such as shower gels, feminine hygiene sprays or spermicides, and their use can cause an allergic-type reaction to develop in the bladder, causing inflammation.
- Cystitis is associated with other conditions.Cystitis can sometimes occur as a complication of other disorders such as diabetes, kidney stones, prostate enlargement, or spinal cord injury.
Risk Factors for Cystitis
Some people are more likely to get recurrent bladder or 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 high risk for UTIs include those who:
- Sexually active. Frequent and intense sexual intercourse can allow bacteria to enter the urethra and bladder.
- Free sex.
- Inflammatory process in the vagina, uterus.
- Use of certain types of contraception. Women who use a diaphragm are at increased risk of getting a UTI. Diaphragms containing spermicide further increase the risk of cystitis.
- Pregnancy. Hormonal changes during pregnancy can increase the risk of bladder infections.
- Menopause. Changes in hormone levels in menopausal women are often associated with the development of bladder infections.
- Pressure.
- Not complying with personal hygiene.
- Urine residue. This can happen when there are bladder stones or when men have an enlarged prostate.
- Changes in the immune system. Reduced immunity can occur against the background of diseases such as diabetes mellitus, 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.
- Prolonged use of bladder catheters. This "tube" may be needed by people with chronic diseases or the elderly. Prolonged use can cause increased susceptibility to bacterial infections as well as damage to bladder tissue.
In men without any underlying health problems, cystitis is very rare.
Complications of acute cystitis
With timely access to a urologist or urogynecologist and proper treatment, bladder infections rarely lead to complications. But if not treated, they can lead to serious consequences. Complications may include:
- Kidney infection. Cystitis that is not treated in time can lead to a kidney infection, also called pyelonephritis, a rather formidable disease that requires hospital treatment. 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 with a microscope (microscopic hematuria) and usually disappear after treatment. Blood in the urine that can be seen with the eye (gross hematuria) is rare and is a warning sign that should prompt you to seek medical attention.
- Transition to the chronic form of cystitis, leukoplakia of the bladder.
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 provide 100% protection against reinfection.
Although 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 a shower, not a bath. If you are prone to infection, taking a shower rather than a shower can help prevent it.
- 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 consulted a doctor, in addition to discussing your symptoms and your 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 whether 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, then you need to do a urine bacterial culture on the flora and determine the sensitivity to antibiotics.
- Smudge on flora and Gnor microscopic examination of genitourinary discharge reveals inflammation in the vagina and cervical canal, which in turn can be the cause of cystitis.
- Cystoscopy.It is not done in any case in the middle of an acute process. Only after the normalization of laboratory parameters, the doctor can recommend performing a cystoscopy - a visual examination of the bladder mucosa to assess its condition. In cases of chronic cystitis or suspected interstitial cystitis, the doctor will suggest performing a biopsy of the altered bladder mucosa to determine the depth and extent of the lesion.
- Bladder ultrasound.Usually testing is not necessary, but in some cases, especially when no signs of bacterial infection are found, it may be useful. For example, ultrasound can help detect other potential causes of bladder damage, such as tumors or abnormal growths.
Treatment of cystitis
Cystitis caused by a bacterial infection is usually treated with antibiotics. Treatment for noninfectious cystitis depends on the underlying cause.
Treatment of bacterial cystitis
Antibiotics are the first line of treatment for cystitis caused by bacteria. Which medication is used and for how long depends on your general health and the type and concentration of bacteria in your urine.
- Acute cystitis.A characteristic sign of acute cystitis is an improvement in the condition after the start of drinking a large amount of liquid and heat procedures, but this condition is deceptive and threatens a new episode of the disease with greater strength. Therefore, it is necessary to contact a urologist or a urogynecologist for the appointment of antibiotic therapy. You may 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 entire antibiotic prescribed by your doctor, then to make sure that the infection has completely disappeared, it is necessary to perform urinalysis control - complete urinalysis and urine culture for flora.
- Recurrent cystitisorChronic cystitis. If you have recurrent UTIs, your doctor may recommend longer treatment with both systemic and topical bladder injections.
Postmenopausal women may be particularly prone to cystitis. In addition to treatment, your doctor may recommend an estrogen vaginal cream.
Treatment of interstitial cystitis
In interstitial cystitis, the cause of the inflammation is unknown, therapies used to relieve the symptoms of interstitial cystitis include:
- Medicines taken orally or injected directly into the bladder through injections or injections under the lining of the bladder.
- Procedures aimed at reducing symptoms, such as distending the bladder with fluid (bladder hydrodistension) or surgery (enlargement cystoplasty, as a way to restore organ capacity).
- Tibial neuromodulation, or electrical stimulation, which uses electrical impulses to stimulate 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 restoration of capacity to the bladder, which is performed quite successfully by urologists using the latest scientific achievements.
Treatment of other forms of non-infectious cystitis
If you are allergic and exposed 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, a doctor knows how to help you.