Cystitis: symptoms, prevention, treatment
Mar 24, 2018
Acute or chronic inflammation of the mucous membrane of the bladder - such a complex proposal can be deciphered the name of one of the most famous and unpleasant diseases of the urinary tract - cystitis.Statistics show that every second woman suffers from this ailment during her life.Among men, the disease is much less common, although they are not immune from the appearance of its symptoms.Table of contents: Types of cystitis in men and women Cystitis causes in men and women Symptoms of cystitis Features of the course of chronic cystitis Diagnosis of cystitis Treatment of cystitis
About the features of the course of cystitis in women you will learn by watching this video review:
Types of cystitis inMen and women
The current classification covers all types of cystitis, from its course to the nature and depth of the bladder wall.From a practical point of view, all aspects of the disease are important, but first there is a differentiation between acute and chronic forms.
In addition, cystitis is distinguished by:
- is infectious;
- is a medicament;
- is a neurogenic;
- is an involution;
- Localization peculiarities:
- is diffuse( inflammation is spread over large areas of the bladder wall);
- focal( a small area of the wall is affected, for example, only the organ neck or the Lieto triangle).
- primary( the disease begins in the bladder);
- secondary( cystitis develops as a complication of other infectious diseases).
Causes of cystitis in men and women
The main cause of the disease is an infection.In 70-80% of cases, the microbe causing cystitis becomes the E. coli - a conditionally pathogenic bacterium that is constantly present in the intestine.Less often it is caused by staphylococci, proteas, klebsiely, enterococci, and even less often - viruses and fungi.
The higher frequency of cystitis in women is associated with the anatomical features of the female reproductive system.The exit of the urethra is very close to the entrance to the vagina.Relatively close to the anus, from which, if the rules of hygiene of the sexual organs are not observed, intestinal sticks and enter the urinary tract.
Possible development of aseptic cystitis.It usually occurs after the introduction of chemicals in the bladder, as well as radiation and chemotherapy, with trauma of its stone or instrument, which is used by doctors during endoscopy.However, aseptic disease does not last long, as the infectious process develops rapidly on the damaged mucosa.
One penetration of microbes is usually not enough for the onset of the disease.The inner surface of the bladder is equipped with powerful protective mechanisms that prevent the introduction of microorganisms into the wall of the organ. However, local immunity decreases and the pathogenicity of the microbes increases, causing the disease, when the provoking factors of :
- become hypothermia;
- of hypovitaminosis;
- of the associated comorbidities;
- hormonal disorders;
- of the transferred operations;
Another factor contributing to the development of pathology, is the outflow of urine.It can be caused by:
- by prostatic hyperplasia,
- by constriction of the urethra( usually after venereal diseases);
- disorders of the nervous regulation of the act of urination;
- weakness of the muscular layer of the bladder.
As a result, urine stagnation occurs, which under such conditions becomes a favorable environment for the growth and development of bacteria.
Symptoms of cystitis
Disease debuts always acutely, within a matter of hours.The first symptom is usually pain.It arises suddenly in a person who until this moment considered himself healthy.Localized pain in the abdomen, sometimes in the perineum.Urination becomes severely painful, frequent.Pain can occur only at the beginning of urination, at the end of it or be present throughout the process.
As the disease progresses, the intensity of pain sensation only increases, sometimes becoming unbearable.Partly because of this, some patients lose the ability to hold urine.The latter is promoted by the urge to urinate, which can not be resisted( imperative).
The next symptom is called pollakiuria.It looks like the frequency of urination sometimes up to 20-30 times a day.At the same time, an exceptionally small amount of urine can be released - up to a few drops.Often patients note a feeling that the bladder has not completely emptied.
The third symptom of cystitis is pyuria.Urine becomes turbid due to the presence in it of dead leukocytes, red blood cells, necrotic cells of the mucous membrane, bacteria.This sign indicates the height of the disease.
Terminal hematuria is a symptom that speaks of the localization of the inflammatory process in the neck of the bladder.It consists in the appearance of an admixture of blood in the last portion of urine.Hematuria can also indicate the neglect of the inflammatory process, when the blood vessels in the wall of the bladder are affected.
With cystitis, the general condition suffers poorly.The temperature rises slightly, not reaching high figures.A fever above 38 ° indicates that the infection has spread beyond the bladder, causing pyelonephritis.Other symptoms of intoxication - weakness, headaches, fatigue, malaise - with cystitis does not happen.This is due to the fact that the wall of the bladder is practically impenetrable for microbial poisons, which because of this are not absorbed into the blood.
For more details about the symptoms of cystitis, see the video review:
Features of the course of chronic cystitis
Incomplete, poor-quality treatment of acute cystitis, as well as its complete absence in half the cases leads to the transition of the disease to a chronic form.The intensity of the inflammatory process here is estimated by the number of exacerbations during the year.
During the remission period, signs of the disease are either not available at all, or they are assessed by patients as mild discomfort in the lower abdomen and with urination.
The exacerbation of chronic cystitis manifests itself in the same way as in an acute process - with blisters during urination, which becomes very frequent, pain, blurred urine, hematuria, mild fever.
Diagnosis of cystitis
Usually the diagnosis of acute cystitis does not cause difficulties.Expose it on the basis of the characteristic complaints of the patient.
In case of chronic inflammation, the information on the frequency of exacerbations, their nature, accompanying gynecological and urological diseases, as well as infections with sexual transmission( chlamydia, ureaplasmosis, gonorrhea, etc.) is also taken into account.
The diagnosis of both forms of cystitis takes into account the data of laboratory and instrumental research methods:
- general analysis of urine( appearance of leukocytes, epithelial cells, erythrocytes);
- urine culture on nutrient media to isolate the causative agent and determine its susceptibility to antimicrobial agents;
- ultrasound of the pelvic organs( limited informative);
- gynecological examination;
- smear from the vagina and cervical canal for the detection of sexually transmitted infections;
- Cystoscopy of the bladder with the sampling of tissues and its microscopy.
Treatment of cystitis
While the diagnosis of any form of cystitis rarely causes difficulties, in terms of treatment, this pathology presents a serious problem.It is a matter of a mistake often committed when antimicrobial agents are prescribed.It is especially bad when the illness is treated not under the guidance of an experienced urologist, but on the advice of a pharmacist or even incompetent people.
The standard of cystitis treatment, whether acute or it is an exacerbation of chronic, is rational antibiotic therapy.Drugs from the groups of nitrofurans( furadonin), fluoroquinolones( levofloxacin, norfloxacin, ofloxacin, pefloxacin), macrolides( monural), cephalosporins( cefixime) are used.
The use of the once-very effective 5-NOC preparation is now recognized as useless due to the total resistance of most microbes.The same applies to Biseptol, which was treated literally by everyone 20 years ago.
Given that cystitis is almost always caused by infection, antibiotic therapy is the main method of fighting the disease.However, the use of antimicrobial agents is not limited to treatment.In parallel with taking antibiotics, the doctor can prescribe copious drinking and taking painkillers and antispasmodics - ibuprofen, diclofenac, paracetamol, baralgin, drotaverine.
You can also find out about some popular methods of cystitis treatment by watching this video:
Treatment of chronic cystitis
The same methods are used to treat the chronic form of the disease.However, operational interventions are also becoming relevant.Often the chronicities of the outflow of urine due to strictures, prostatic hyperplasia, the inversion of the mucous membrane of the urethral mouth, etc., often contribute to the chronic process. Remodeling plastic surgery is used to eliminate these phenomena.
How to prevent the development of cystitis
Since cystitis is a predominantly infectious disease, preventive measures should also aim to prevent the infection from entering the bladder and to preserve the ability of defense mechanisms to suppress inflammation.
Prevent infection of the urinary tract as follows:
- Genital hygiene:
- wash after each act of defecation;With a stream of warm running water should be directed from the front to back, to prevent the introduction of germs from the anus into the genital organs;
- rejection of vaginal tampons in favor of sanitary napkins;
- rejection of funds for intimate hygiene;
- use of a condom when intercourse with an unfamiliar partner;
- use of underwear made from natural materials( the effect of synthetic underwear on the chance of developing cystitis in women has been proved).
- Treatment of concomitant infectious and inflammatory gynecological, venereal and urological diseases.
- Thoroughly sanitize any foci of chronic infection.
- Compliance with certain dietary rules:
- rational, protein, fat, carbohydrate and vitamin balanced nutrition;
- rejection of irritating, spicy, spicy food;
- elimination of alcohol( especially relevant for chronic cystitis);
- compliance with the drinking regime - at least 1.5 liters of fluid per day.
- Elimination of situations that may reduce local or general immunity:
- malnutrition( including hungry "slimming" diets).
Prevention and treatment of cystitis at home
Drug prevention of cystitis is carried out using a variety of phytopreparations and dietary supplements based on plant extracts.Very popular are such products as:
- Monorail( not to be confused with Monural - a powerful antibiotic used to treat the disease) has a cranberry extract that helps strengthen local defenses in the bladder.
- Phytolysin is a paste containing a number of herbal extracts.Has anti-inflammatory, diuretic and antispasmodic effect.
- Kanefron, which has the same effect as phytolysin.
It should be noted that such preventive measures are not recommended by doctors and patients use them independently.Phytolysin and Kanefron are intended only for the treatment of diseases, and the effectiveness of dietary supplements is not proven by clinical studies.Therefore, the practitioner does not have the right to recommend these drugs for the prevention of cystitis.
This disease is relatively rare.Interstitial cystitis is manifested with pains in the small pelvis, rapid, painful urination( up to 100 times a day!), Insuperable urges and nicture( repeated urination at night).
The causes of this disease, as well as the mechanisms of its development, have not been studied enough.That is why it is difficult to treat.Nevertheless, we must fight the disease, and for this we use:
- antihistamines - according to the National Urology Guidelines, 2009 ed.Lopatkina NA in the treatment of interstitial cystitis apply cimetidine( blocker of histamine H2 receptors of the 1st generation) and hydroxyzine( histamine H1 receptor blocker, piperazine derivative);
- antidepressants - amitriptyline;
- preparations correcting the protective mechanisms of the bladder - pentosan sodium polysulphate.
Despite the fact that cystitis does not belong to serious illnesses, it is quite capable of seriously worsening the patient's quality of life.Therefore, at the first signs of the disease, you should immediately go to the urologist, and if it is not available, then to the therapist.An experienced specialist will be able to prescribe such treatment in acute cystitis, which will prevent the transition of the process to the chronic phase.In chronic, the same quality treatment will suppress the disease for a very long time.
Volkov Gennady Gennadievich, medical reviewer, an ambulance doctor.