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 usually accompanied by severe pain and a feeling of irritation, burning 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 long-term use of catheters. Cystitis can also appear 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, constant urge to urinate;
• Burning when urinating;
• Pain during urination;
• Small portions of urine;
• blood in the urine (hematuria);
• Occurrence of cloudy or strong-smelling urine;
• Discomfort in the lower abdomen;
• Feeling of pressure in the lower abdomen;
• Increase in body temperature to 37. 0 - 37. 5 °C.

When to see a doctor

Get medical help right away if you have any of the above signs and symptoms, especially if you have:

• back pain,
• fever above 37. 5 C and chills,
• Nausea and vomiting.

If you have frequent or painful urination that lasts for several hours or longer, or if you notice blood in your urine, contact your doctor immediately. 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 seeing a urologist if cystitis symptoms return after you've finished a course of antibiotics. You 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 warn, in this case it may be the result of a more serious disease, for example, prostate adenoma, the presence of stones in the bladder, 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 infections of the lower urinary tract, because the female urethra is hidden in the pelvic cavity, it is wider and shorter than the male (the length of the female urethra is 3-5 cm), which is presented in the form of a straight tube thatit is located in front of the vagina and opens 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, a number of non-infectious factors can also cause cystitis. Other forms of cystitis:

• Interstitial cystitis.The cause of this chronic inflammation of the urinary bladder, also called painful bladder syndrome, is not clear. Most cases are diagnosed in women. The condition is difficult to diagnose and treat.
• medical cystitis.Some drugs, especially chemotherapy drugs, can cause inflammation of the bladder, because some of the broken down components of the drug are excreted in the urine.
• Radiation cystitisorRadiation cystitis.Ionizing radiation aimed at the pelvic area can cause inflammatory changes in the bladder wall.
• Foreign body cystitis.The long-term presence of a catheter in the bladder, inserted through the urethra or embedded 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 found in certain products, such as bath foam, 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 such group. The main reason is anatomy. Women have a shorter urethra, which shortens the path for bacteria to reach the bladder.

Women at greatest 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 relations.
• Inflammatory processes in the vagina, uterus.
• Use of certain types of contraception. Women who use diaphragms are at 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 bladder infections.
• 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. A decrease in immunity can occur in 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 bladder infections.
• Prolonged use of bladder catheters. These "tubes" may be needed by people with chronic diseases or the elderly. Long-term use can lead to increased susceptibility to bacterial infections, as well as damage to bladder tissue.

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 they are not treated, they can lead to serious consequences. Complications may include:

• Kidney infection. Untreated cystitis in time can lead to kidney infection, which is also called pyelonephritis, a rather serious 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 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 eye (gross hematuria) is rare and is a warning sign that should prompt you to seek medical attention.
• Transition to a chronic form of cystitis, leukoplakia of the bladder.

Disease prevention

Cranberry juice or tablets 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 only with warm water, from front to back. This prevents the spread of bacteria from the anal area to the vagina and urethra.
• Use showers, not bathtubs. If you are prone 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 prevent 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 consulted a doctor, in addition to discussing your symptoms and medical history, your doctor may recommend additional tests:

• Urinalysis.If a bladder infection is suspected, the 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 in the bladder, then you will need to do a bacterial culture of the urine for flora and determine sensitivity to antibiotics.
• Smear on the flora and Gnor a microscopic examination of the discharge from the genitourinary organs reveals inflammation in the vagina and cervical canal, which can again be the cause of cystitis.
• Cystoscopy.In no case is it performed in the middle of an acute process. Only after the normalization of laboratory parameters, the doctor can recommend performing a cystoscopy - a visual examination of the bladder mucosa in order to assess its condition. In cases of chronic cystitis or suspected interstitial cystitis, the doctor will suggest a biopsy of the altered bladder lining to determine the depth and extent of the lesion.
• Ultrasound of the bladder.Usually a test is not needed, but in some cases, especially when there are no signs of a bacterial infection, it may be useful. For example, an 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 of non-infectious cystitis depends on the underlying cause.

Treatment of bacterial cystitis

Antibiotics are the first line of treatment for cystitis caused by bacteria. Which drugs 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 the improvement of the condition after the start of drinking a large amount of liquid and thermal procedures, but this condition is deceptive and even more strongly threatens a new episode of the disease. Therefore, it is necessary to contact a urologist or urogynecologist for the appointment of antibiotic therapy. You will probably need to take antibiotics for at least three days, depending on the severity of the infection.

  Regardless of the length of treatment, it is better to drink the entire course of antibiotics prescribed by the doctor, and to make sure that the infection has completely disappeared, it is necessary to do a control urinalysis - complete urinalysis and urine culture for flora.

• Recurrent cystitisorChronic cystitis. If you have recurrent UTIs, your doctor may recommend longer treatment with both systemic and topical bladder instillations.

Postmenopausal women may be particularly susceptible to cystitis. As an adjunct to treatment, your doctor may recommend an estrogen 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 orally or injected directly into the bladder by drip or injection under the bladder lining.
• Procedures aimed at reducing symptoms, such as inflating the bladder with fluid (hydrodistention of the bladder) or surgery (augmenting cystoplasty, as a way 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 urinary frequency.

The main task in the treatment of interstitial cystitis is the elimination of pain and the restoration of capacity in the bladder, which is very successfully done by urologists using the latest achievements of science.

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 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.