Effective treatment for 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 often accompanied by severe pain and a sore, 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 catheter use. 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 often include:

• strong and constant desire 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;
• Sensation 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 greater than 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, contact your doctor right away. If you have been diagnosed with a UTI in the past and have symptoms that mimic a previous UTI, see your doctor as well.

It's also worth visiting a urologist if cystitis symptoms return after you've finished a course of antibiotics. She 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 may be the result of a more formidable disease, for example, prostate adenoma, presence of bladder stones, 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 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 ), presenting as a straight tube located anterior to the vagina and opening 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, various noninfectious 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, as some of the broken down components of the drug are excreted in the urine.
• radiation cystitiseitherRadiation cystitis.Ionizing radiation directed at the pelvic area 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, the addition of a bacterial infection and the 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 to develop 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 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 for bacteria to the bladder.

Women at higher risk for UTIs include those who:

• They are sexually active. Frequent and intense sexual contact can allow bacteria to enter the urethra and bladder.
• Promiscuous sexual intercourse.
• Inflammatory processes in the vagina, uterus.
• Use of certain types of contraceptives. Women who use diaphragms are at increased risk of developing a UTI. Diaphragms containing spermicides further increase the risk of cystitis.
• The pregnancy. Hormonal changes during pregnancy can increase the 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-compliance with personal hygiene.

Other risk factors in both men and women include:

• Residual urine. This can happen 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 the use of chemotherapy drugs in cancer treatment. 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 illnesses or the elderly. Prolonged use can lead to increased vulnerability to bacterial infections as well as damage to bladder tissues.

In men without any 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 have serious consequences. Complications can include:

• kidney infectionUntreated cystitis in time can lead to a kidney infection, also called pyelonephritis - quite a formidable disease that requires treatment in a hospital. 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 naked 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 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 bacteria from spreading from the anal area to the vagina and urethra.
• Use showers, not baths. If you are susceptible 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 avoid a significant increase in the number of bacteria in the bladder.
• Avoid using spray deodorants 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 reviewing your symptoms and medical history, your doctor may recommend additional tests:

• Urine analysis.If a bladder infection is suspected, a doctor may recommend a urine sample to check for 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 conduct a bacterial culture of urine on the flora and determine the sensitivity to antibiotics.
• Spread in flora and Gno Microscopic examination of the discharge from the genitourinary organs reveals inflammation in the vagina and cervical canal, which in turn may be the cause of cystitis.
• Cystoscopy.It is not performed in any case in the middle of an acute process. Only after normalization of laboratory parameters, the doctor may recommend performing a cystoscopy - a visual examination of the mucosa of the bladder to assess its condition. In cases of chronic cystitis or suspected interstitial cystitis, the doctor will propose a biopsy of the altered bladder mucosa to determine the depth and extent of the lesion.
• Bladder ultrasound.A test is not usually 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 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 noninfectious cystitis depends on the underlying cause.

Treatment of bacterial cystitis

Antibiotics are the first line of treatment for cystitis caused by bacteria. The medications used and for how long depend 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 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 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 take 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 urinalysis and a urine culture for flora.

• repeated cystitiseitherchronic cystitis. If you have a recurring UTI, your doctor may recommend longer treatment with both systemic and topical bladder instillations.

Postmenopausal women may be especially 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 symptoms of interstitial cystitis include:

• Medications that are 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 (hydrodistention of the bladder) or surgery (augmentation cystoplasty, as a way to restore organ 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 to eliminate pain and return capacity to the bladder, which is quite successfully done 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.