Effective treatment of cystitis

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 a feeling of irritation, burning 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, for example, 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 often include:

• Strong, constant urge to urinate;
• Burning when urinating;
• Pain when urinating;
• Small portions of urine;
• blood in the urine (hematuria);
• The appearance of cloudy or strong-smelling urine;
• Discomfort in the lower abdomen;
• A feeling of pressure in the lower abdomen;
• Increase in body temperature to 37, 0-37, 5 °C.

When to see a doctor

Get medical help right away if you have any of the signs and symptoms listed above, especially if you have:

• back pain,
• Fever over 37. 5 C and chills,
• Nausea and vomiting.

If you have frequent or painful urination that lasts several hours or more, or if you notice blood in your urine, contact your doctor immediately. If you have been diagnosed with a UTI in the past and have symptoms that mimic a previous UTI, then see your doctor as well.

It is also worth visiting a urologist if the symptoms of cystitis resume after the course of antibiotics is completed. You may need a different type of treatment.

Cystitis affects women most often. In healthy men, cystitis is rare, but the appearance of signs of cystitis should warn, 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, 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 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 (the length of the female urethra is 3-5 cm), whichpresents as a straight tube located in front of the vagina and opens outward 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, a number of non-infectious factors can also cause bladder inflammation. Other forms of cystitis:

• Interstitial cystitis.The cause of this chronic inflammation of the bladder, also called painful bladder syndrome, is not clear. 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 because some of the broken down drug components are excreted in the urine.
• Radiation cystitisorRadiation cystitis.Ionizing radiation aimed 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, introduced through the urethra or installed in the form of an epicystostomy, can lead to tissue damage, the addition of bacterial infection and the development of an inflammatory process.
• Chemical cystitis.Some people may be hypersensitive to chemicals contained in certain products, such as bath foam, feminine hygiene sprays, or spermicides, and their use may cause an allergic-type reaction to develop 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, an enlarged prostate, 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 have a shorter urethra, which shortens the path of bacteria to the bladder.

Women at highest risk for UTIs include those who:

• are sexually active. Frequent and intense sexual contact can allow bacteria to enter the urethra and bladder.
• Indiscriminate sexual relations.
• Inflammatory processes in the vagina, uterus.
• Use of certain types of contraception. Women who use diaphragms are at increased risk of developing a UTI. Diaphragms containing spermicides further increase the risk of cystitis.
• Pregnancy Hormonal changes during pregnancy can increase the risk of bladder infection.
• Menopause. Changes in hormone levels in postmenopausal women are often associated with the development of a bladder infection.
• stress.
• Failure to observe personal hygiene.

Other risk factors in men and women include:

• Residual urine. This can happen when there is a stone in the bladder 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. These "tubes" may be necessary for people with chronic diseases 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 problems, cystitis occurs extremely rarely.

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. If not treated in time, cystitis can lead to a kidney infection, also called pyelonephritis, a rather dangerous 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 can 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 eye (gross hematuria) is rare and is a warning sign that should prompt you to seek medical attention.
• Transition to a 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 have shown that these drugs do not provide 100% protection against reinfection.

Although these preventive 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 with warm water only, front to back. This prevents the spread of bacteria from the anal area to the vagina and urethra.
• Use showers, not bathtubs. 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 consulted a doctor, in addition to discussing your symptoms and medical history, your doctor may recommend additional tests:

• Urinalysis.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 of the bladder, then you will need to perform a bacterial culture of urine on the flora and determine the sensitivity to antibiotics.
• Smear of flora and Gnor microscopic examination of urogenital discharge reveals inflammation in the vagina and cervical canal, which in turn may be the cause of cystitis.
• Cystoscopy.In no case is it carried out in the midst of an acute process. Only after the normalization of the laboratory indicators, the doctor can recommend carrying out a cystoscopy - a visual examination of the mucous membrane of the bladder to assess its condition. In the case 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.Testing is usually not required, but in some cases, especially when no signs of bacterial infection are found, it may 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 noninfectious 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 general 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 start of drinking a large amount of fluids and heat procedures, but this condition is deceptive and threatens a new episode of the disease with even greater force. That is why 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 better to drink the entire course of antibiotics prescribed by your doctor, then to make sure that the infection has completely disappeared, it is necessary to carry out a control urinalysis - a complete urinalysisand urine culture for flora.

• Recurrent cystitisorChronic cystitis. If you have a recurrent urinary tract infection, your doctor may recommend longer treatment with systemic and local bladder instillations.

Postmenopausal women may be particularly susceptible to cystitis. As an adjunct to treatment, your doctor may recommend a vaginal estrogen 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 by mouth or injected directly into the bladder by infusion or injection under the lining of the bladder.
• Procedures that aim to reduce symptoms, such as distending the bladder with fluid (hydrodistension of the bladder) or surgery (augmentation cystoplasty, as a way to restore the capacity of the organ).
• Tibial neuromodulation, or electrical stimulation, which uses electrical impulses to stimulate nerve endings to relieve pelvic pain and, in some cases, reduce urinary frequency.

The main task in the treatment of interstitial cystitis is the elimination of pain and the return of bladder capacity, which is carried out quite successfully by urologists using the latest advances in science.

Treatment of other forms of non-infectious cystitis

If you are allergic and sensitive to certain chemicals, avoiding them can help relieve symptoms and prevent further episodes of cystitis.

Treatment for 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.