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). Inflammation of the bladder is usually accompanied by severe pain and a feeling of irritation, burning during or after urination, which 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 toilet sprays, spermicides, or long-term catheter use. Cystitis can also occur as a complication of another disease, such as diabetes mellitus, etc.

The usual treatment for bacterial cystitis is antibiotic therapy. Treatment for other types of cystitis depends on the underlying cause.

Symptoms of cystitis often include:

• Strong and constant desire to urinate;
• Burning while 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 consult a doctor

Seek immediate medical attention if you have any of the signs and symptoms listed above, especially if you have:

• Back ache,
• Fever above 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 immediately. If you have already been diagnosed with a UTI and have symptoms that mimic a previous UTI, see your doctor as well.

It is also worth consulting a urologist if the symptoms of cystitis reappear after completing a course of antibiotics. You may need another 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 consequence of a more serious disease, for example, prostate adenoma, presence of stones in thebladder, urethral stricture, 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 following 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 urethra (the length of the female urethrais 3-5 cm), which is in the form of a straight tube located in front of the vagina and opening outwards at the vestibule of the vagina, and the female genital area contains bacteria that can causea cystitis.

Non-infectious cystitis

Although bacterial infections are the most common cause of cystitis, a number of non-infectious factors can also cause inflammation of the bladder. Other forms of cystitis:

• Interstitial cystitis.The cause of this chronic bladder inflammation, also called painful bladder syndrome, is unclear. Most cases are diagnosed in women. The condition is difficult to diagnose and treat.
• drug 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 cystitisWhereRadiation cystitis.Ionizing radiation directed at the pelvic region can cause inflammatory changes in the bladder wall.
• Foreign body cystitis.Long-term presence of a catheter in the bladder, inserted into 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 in certain products, such as bath foam, feminine hygiene sprays, or spermicides, and using them may cause an allergic-like reaction 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 such a group. The main reason is anatomy. Women have a shorter urethra, which shortens the path of bacteria to the bladder.

Women most at risk for UTIs include those who:

• Are sexually active. Frequent and intense sexual contact can allow bacteria to enter the urethra and bladder.
• Promiscuous sex.
• Inflammatory processes in the vagina, uterus.
• Use of certain types of contraception. Women who use diaphragms are at an 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 both 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 infections of the bladder.
• Prolonged use of bladder catheters. These "tubes" may be needed by people with chronic illnesses or the elderly. Prolonged use can lead to increased susceptibility to bacterial infections as well as damage to bladder tissue.

In men without a predisposing health condition, cystitis is extremely rare.

Complications of acute cystitis

With prompt 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. Cystitis not treated in time can lead to kidney infection, also called pyelonephritis, a rather dreadful 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 may appear in the urine which can only be seen under a microscope (microscopic haematuria) and usually disappear after treatment. The presence of blood in the urine visible to the naked eye (macroscopic haematuria) is rare and constitutes a warning sign which should encourage you to consult a doctor.
• 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 offer 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 only with lukewarm water, from 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, taking a shower instead of a bath can help prevent them.
• Empty your bladder as soon as possible after sex. 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 seen a doctor, in addition to discussing 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 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 sensitivity to antibiotics.
• Smears on flora and Gnor microscopic examination of discharge from the genitourinary organs reveals inflammation of the vagina and cervical canal, which in turn may be the cause of cystitis.
• Cystoscopy.In no case does it take place in the middle of an acute process. Only after the normalization of laboratory parameters can the doctor recommend performing a cystoscopy - a visual examination of the bladder mucosa in order to assess its condition. In 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.Usually a test is not necessary, but in some cases, especially when no signs of bacterial infection are detected, it may be useful. 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 medications are 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 the intake of a large amount of fluids and thermal procedures, but this condition is deceptive and threatens a new episode of the disease with even greater forcebig. Therefore, 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 urine analysis- a complete urinalysis and urine culture for flora.

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

Postmenopausal women may be particularly susceptible to cystitis. As an adjunct to treatment, your doctor may recommend an estrogen-based vaginal cream.

Treatment of interstitial cystitis

In interstitial cystitis, the cause of the inflammation is unknown, therapies used to relieve symptoms of interstitial cystitis include:

• Medicines taken by mouth or injected directly into the bladder by instillation or injection under the lining of the bladder.
• Procedures to reduce symptoms, such as distension of the bladder with fluid (hydrodistension of the bladder) or surgery (enhancement cystoplasty, as a means of restoring 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 the elimination of pain and the return of bladder capacity, which is successfully done by urologists using the latest scientific advances.

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 if you have chronic cystitis or interstitial cystitis, doctors will be able to help you.