Why cystitis occurs, how to cure it

In Russia, more than 20 million cases of the disease are registered annually, up to 60% of visits to urologists are associated with acute or recurrent cystitis. He, in fact, does not spare anyone, but women are mostly ill: during their lives, 20-25% of women suffer cystitis.

Cystitis – inflammation of the bladder – is one of the most common urological diseases. It is characterized by inflammatory changes in the mucous membrane and impaired bladder function, as well as certain changes in urine sediment.

Every third person has a relapse within a year, and in 10% the disease becomes chronic. Cystitis most often develops at the age of 25-30 years, as well as in women older than 55 years, that is, after menopause. In addition, every tenth pregnant woman suffers from cystitis. This is due to a change in the hormonal background, violation of microflora and reduced immunity.

In men, cystitis often develops after 40–45 years of age against the background of other diseases, such as stones and tumors of the bladder, adenoma and prostate cancer, urethral stricture, and inflammatory processes in the genitals. The atypicality of cystitis for men is explained by the characteristics of the male urethra: a long, narrow, curved urethra in most cases delays the infection and prevents its entry into the bladder.

Often cystitis occurs in children. Girls suffer from it about 5-6 times more often than boys. Infection enters the bladder primarily through the urethra.

Why does cystitis occur?

The main pathogen is uropathogenic enterobacteria Esherichia coli (E. coli). It is detected in 75-80% of patients. Less commonly (5-10%) occurs Staphylococcus saprophyticus. Other enterobacteria, for example Proteus mirabilis and Klebsiella spp.

Pathogens enter the bladder in three main ways: ascending (through the urethra), hematogenous (through the blood) and lymphogenous (with lymphatic flow). In women, the first path is most often encountered – the ascending one.

Cystitis is primary and secondary. Primary (or uncomplicated) occurs in people without risk factors and concomitant diseases. Secondary – complicated – occurs against the background of a violation of urodynamics as a complication of another disease. Inflammatory processes in the genitals, stones, or a bladder tumor can lead to it.

Cystitis is often associated with general hypothermia. It can really provoke a rapid development of infection.

In addition to hypothermia, the onset of the disease is facilitated by:

  • anatomical and physiological characteristics of the female body – short and wide urethra; its proximity to the natural reservoirs of infection (anus, vagina); developmental anomalies – dystopia, urethral hypermobility; favorable conditions for the development of infection during menstruation, pregnancy and the postpartum period;
  • frequent gynecological diseases – inflammatory processes in the vagina, hormonal disorders (including hypoestrogenism);
  • the presence of sexually transmitted infections, frequent changes in sexual partners and unprotected sex;
  • the development of a urinary tract infection at an early age or its presence in the mother;
  • mucosal atrophy in postmenopausal women, diabetes mellitus and urinary incontinence.
Does cystitis always occur due to infection?

No not always. In addition to bacterial (infectious) cystitis, the following non-infectious species are distinguished:

  • interstitial cystitis. The causes of this chronic inflammation of the bladder, also called “painful bladder syndrome,” are still unclear. Most commonly found in women. This disease can be difficult to detect and cure;
  • drug cystitis. Some medications (such as cyclophosphamide), chemotherapeutic drugs, and others can cause cystitis because they accumulate in the bladder and irritate its wall;
  • radiation cystitis. Radiation treatment of the pelvic area can cause inflammatory changes in the tissues of the bladder;
  • foreign body cystitis. Prolonged use of a urinary catheter can increase the risk of bacterial infections and tissue damage, both of which can cause cystitis;
  • chemical cystitis. Some people are hypersensitive to chemicals in hygienic sprays, intimate hygiene products, bath and shower products, spermicidal gels, sanitary pads and so on. Local chemical irritation or an allergic reaction can cause typical symptoms of cystitis;
  • cystitis caused by other factors. Sometimes a disease can occur as a complication of other conditions, such as diabetes, kidney stones, prostatic hyperplasia, or spinal cord injury.
What are the symptoms of cystitis and which doctor to run to

Acute cystitis is characterized by a sharp onset. Patients complain of frequent painful urination (in small portions). Desires are often imperative – a sudden feeling that urgently needs to go to the toilet. Sometimes these urges turn out to be false. With cystitis, pain in the projection of the bladder, muscle tension above the womb, the presence of an impurity of blood in the urine (especially in the last portion) are disturbing.

If exacerbations of cystitis occur twice within six months or three times a year, we can already talk about chronic recurrent cystitis. It is divided into a phase of exacerbation and a phase of remission.

Regardless of the patient’s gender, cystitis is treated by a urologist. Diagnosis of acute cystitis is based on the above symptoms and is confirmed by a urinalysis. Leukocyturia (an increased number of leukocytes) and bacteriuria (bacteria in the urine) are detected in it.

Sometimes an additional urine test (culture) is required to identify the pathogen and its sensitivity to antibiotics.

It is necessary in the following cases:

  • with suspected inflammation of the kidneys;
  • if the symptoms do not stop or recur within 2-4 weeks after completion of treatment;
  • with atypical symptoms;
  • during pregnancy;
  • with suspected urinary tract infection in men.

The diagnosis is confirmed if the analysis showed a concentration of uropathogens ≥ 10 3 CFU / ml. For complicated or recurrent cystitis, PCR diagnostics are recommended to prevent STDs.

It is important to note that in acute cystitis, cystoscopy (endoscopic examination of the inner surface of the bladder) is contraindicated. It is carried out with a prolonged course of cystitis in order to exclude other diseases. If there is a suspicion of a stone, tumor or other diseases, as well as if the treatment does not help, an ultrasound scan of the kidneys or pelvic organs, excretory urography, cystourethrography, CT or MRI are performed.

How to treat cystitis

Treatment of acute cystitis is aimed at the destruction of pathogens. This is to prevent relapse. The most commonly used antibiotic therapy. When choosing a drug, the doctor takes into account the sensitivity of the pathogen, possible side effects, the presence of clinical studies, the cost of the drug and its availability. Antibiotics should create a high concentration in the urine and at the same time minimize the effect on the intestinal and vaginal microflora.

It is very important to strictly follow the doctor’s recommendations and drink the prescribed course of antibiotics completely. Even if the symptoms disappeared in the middle of the course, the infection still remains in the body. If this is neglected, the development of chronic cystitis can be provoked.

Additionally, to relieve symptoms, it is recommended to drink plenty of water (2-2.5 liters per day) and analgesics (ibuprofen, diclofenac, paracetamol). Patients are advised to refuse salty, spicy and irritating esophagus food.

In the case of chronic cystitis, the main thing is to increase the period of remission and improve the quality of life of the patient. It is important in case of relapse not to self-medicate, but to consult a doctor. Women prone to frequent cystitis need to be tested for STDs. This is especially important when planning a pregnancy. In the early stages, cystitis is difficult to treat due to restrictions on the appointment of antibiotics.

To prevent relapse of cystitis, prolonged use of low doses of antibiotics is sometimes recommended. However, such courses have not justified themselves. Women feel good while taking drugs, but as soon as they stop, cystitis develops.

What is dangerous cystitis and how to prevent it

One of the particular complications is the transition of the disease to chronic forms and the spread of the process to the muscle layer. So there is an interstitial form of cystitis.

Pyelonephritis (an ascending infectious inflammatory disease of the kidneys) may become a more serious complication, which will be accompanied by pain, fever, corresponding changes in laboratory tests and an ultrasound picture. This disease is life threatening.

Here are some preventative measures that can help prevent relapse:
  • avoid hypothermia;
  • to drink a lot of water;
  • empty the bladder regularly;
  • go to the toilet after intercourse;
  • observe the rules of personal hygiene;
  • limit the use of alcohol and spicy foods;
  • monitor bowel function;
  • lead a healthy lifestyle;
  • adequately and timely treat gynecological diseases and STDs, and this applies to both sexual partners.

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