Among the inflammatory processes in the organs of the urinary tract in the first place come changes in the tissues of the bladder – cystitis.
The symptoms of cystitis in women can occur at any age, the disease is diagnosed, even among girls of preschool age, and in women during menopause. To identify the disease can be characterized dysuric disorders (violation of urination, pain while emptying bladder, etc.), and on the changes of the urinary sediment, which are detected during laboratory diagnostics.
The diagnosis of cystitis requires the doctor for comprehensive treatment, and the patient adherence to therapy, because only then will you achieve the effect.
Acute cystitis in women, the first signs of the disease appear suddenly, a vivid picture of the process is evident already in the first days after exposure to a provoking factor (severe hypothermia, the introduction of a catheter or cystoscope into the lumen of the bladder, sexual intimacy, etc.).
Acute cystitis usually has a characteristic clinical picture that allows the doctor in the early stages of the correct diagnosis
Among the main symptoms of the disease include
- the constant desire for emptying of the bladder, which can not be controlled, often urge to urinate appear every 5-10 minutes;
- “about” the desire for a trip to the toilet, in which the patient does not have time to run to the bathroom;
- when going to the bathroom can feel pain, cramps or discomfort that brings the patient a lot of inconvenience (they can occur in any period of urination in the beginning, throughout emptying of the bladder or at the end);
- increasing the number of night urge to urinate, it suffers from the sleep and psycho-emotional background of the patient;
- often, in order to urinate, you need to make some effort (“to push”), however, from the lumen of the bladder secreted only a few drops of urine;
- increased body temperature, as a protective reaction to harmful infectious agents;
- a typical symptom of acute cystitis is expressed leukocyturia (a surplus of leukocyte cells in the urinary sediment), since in its absence the diagnosis of cystitis is excluded;
- the appearance of erythrocytes in urine (microhematuria, gross hematuria rarely), due to involvement in the pathological process of the cervical part of the bladder, or the patient has a hemorrhagic form of the disease.
Causes of frequent urination associated with increased excitability of nerve fibers located in the walls of the bladder and inflammatory components (there is compression)
In the chronic form of cystitis in women, the symptoms of the process vary (from minor discomfort to severe and difficult kupiruetsya pain) that often causes difficulties in diagnosis. Pain during urination, as a rule, is mild in nature, and symptoms of dysuria well to care. Patients can control the urge to urinate, which allows them to lead a normal lifestyle.
Manifestations of the disease are associated not only with the constant presence of an infectious agent, but also with the development of degenerative and irreversible changes in the tissues of the bladder.
Depending on which symptoms bother the patient, and the degree of severity, there are two groups of patients:
- patients with undulating course of the process (the periods of exacerbation followed by remission, which is totally free of any manifestations of the disease);
- patients who have persistent clinical signs of active process, and laboratory manifestations of cystitis.
The transition of the acute form of chronic disease associated with prolonged exposure to pathogenic organisms or the absence of timely treatment
Often recurrent cystitis
There is a category of women whose cystitis has a tendency to a relapsing course and long-term periods of exacerbation.
This condition is due to the existence of the following factors:
- a genetic predisposition to inflammatory processes, including in the tissues of the bladder;
- increased aggression own conditionally pathogenic microflora of the organism (gram-negative);
- the presence in the female body chronic inflammatory processes in the genitals;
- congenital or acquired defects of the urethra;
- the individual characteristics of sexuality (early initiation, frequent change of sexual partners, lack of contraception, etc.);
- injury to the lumbar spine or lower back;
- the failure to observe the necessary rules of regular hygiene of the genital organs;
- uncontrolled intake of antibiotics;
- the lack of adherence to prescribed therapy, early end of treatment.
Failure to comply with medical prescriptions and uncontrolled reception of antibiotics, there is a risk of development of resistance of infectious agents to antimicrobial drugs
Signs of cystitis in women with frequent recurrence of the process are observed almost constantly. In addition to the specific dysuric manifestations of the disease, changing the emotional background of patients, they become very irritable, apathetic, lost interest in life.
Very often the cause of relapse becomes a sexual act, so women begin to avoid intimacy with your sexual partner. Against this background, there are problems in the family, crumbling marriages.
Differential diagnosis of
If the patient has symptoms and signs resembling the clinical picture of cystitis, however, conducted antibacterial treatment does not bring the desired effect, it is necessary to exclude her from one of the following diseases:
- tuberculosis of the bladder (the crucial point for diagnosis is the detection of tuberculosis bacteria in urine);
- cancer processes in the wall of the bladder (requires histological examination of affected areas of the body);
- urethritis (characterized by unpleasant secretions from the lumen of the urethra, and identifying such pathogens as chlamydia, gonococci, Mycoplasma or Ureaplasma);
- vulvovaginitis (woman suffers from strong selection from the lumen of the vagina and itching throughout the day, based on the diagnosis present data microscopic examination of the vaginal smear).
Diagnosis of disease
In order to establish a correct diagnosis, the physician needs to collect a thorough medical history, as manifested cystitis in women, what the complaint concerned, what was the reason of their occurrence, etc.
An objective examination of the patient, it is possible to determine local tenderness in the suprapubic region, as well as extreme discomfort when vaginal or rectal examination. Diagnosis of cystitis in women is also based on data obtained during laboratory and instrumental examination.
The General analysis of urine. Urine of patients changes its natural color, becomes cloudy due to the large content of white blood cells, epithelial cells sladenkogo, protein, as well as bacteria and red blood cells. Often purulent component in the urine visible to the naked eye, it quickly settles in the sediment. If the urine changes its smell to smelly, this indicates a far advanced process, or gangrenous form of the disease.
Urine analysis according to Nechyporenko. For research use average portion of urine. In 1 ml of urine, the specialist determines the content of leukocytes, erythrocytes, and cylinders, which is of great diagnostic value. A urine culture on nutrient media. This study must be done in order to identify the exact nature of the disease (to determine the infectious agent).
This method of diagnosis has the greatest sensitivity allows the identification of the pathogen and also helps the physician to determine antibacterial sensitivity of the pathogen.
However therapy patients start until, as a difficult to diagnose infectious agent, since the growth of the bacterial colony takes time (5-7 days). Test strips. To begin treatment of the patient, as early as possible and not to delay the process of diagnosis, doctors use special test strips.
Thanks to the test strips, you can suspect the presence of infectious agents in the test urine, and you can define it different impurities and pathological components
There are different types of strips (for the determination of nitrite, protein, leucocytes, etc.). The basic principle of their action consists in biochemical reaction that takes place during the interaction of reagents with a specific component in the urine, thus changing the color of the indicator.
Order laboratory studies have not given a false result, it is necessary to adhere to the recommendations.
The basic requirements for the ongoing preparation and collection of urine the following:
- careful toilet of outside sexual organs (the washing away immediately before urine collection);
- to use for taking samples is only a sterile container;
- do not store urine for more than an hour and not freeze it.
Cystocoele. The method allows to estimate the active work of the bladder and the pressure gradient in it. The cystoscopy. The procedure to women in the acute period of the disease is considered to be unfounded, as after the patient’s condition is only getting worse.
To cystoscopy is resorted to only in the presence of a foreign object in the lumen of the bladder or the existing long-term cystitis
Ultrasound of the bladder. Through research you can identify foreign objects in the lumen of the bladder, calculi, and tumors.
The principles of treatment of cystitis in women
The treatment of inflammation in the bladder requires a holistic approach that implies a purpose of drugs from different pharmacological groups. Therapy should have the following areas.
It is based on the effects on the infectious agent that caused the inflammation.
First and foremost we are talking about the preparations with antibacterial and antimicrobial activity. Their choice depends on the type of pathogen and their sensitivity to drugs. If it is viral or fungal cystitis, therapy use of appropriate pharmacological group.
Antibiotics are prescribed rates for one, three or seven days. Used means from the group of fluoroquinolones, cephalosporins, macrolides or penicillins.
In addition to effects on infectious agents, it is very important to block or remove the main links of pathogenesis. Treat cystitis need in complex with immune stimulating drugs, which activate the protective properties of the organism and accelerate the healing process.
You also need to adjust all anatomical defects in urethra with the help of surgical intervention.
To eliminate the unpleasant symptoms of the disease is possible by assigning analgesic, antispasmodic and anti-inflammatory drugs.
Widely used drugs based on herbal components, as they are able to provide pronounced anti-inflammatory, analgesic and antimicrobial effects.
It is important to follow preventive measures to avoid recurrence of the disease
Such diseases as cystitis, is often the cause of social desadaptation woman and her depressed state, especially if we are talking about is often a recurrent version of the process.
Modern methods of treatment help in dealing with such an unpleasant illness, but only if a timely appeal for help, and upon further compliance with all medical recommendations.