Cystitis by itself is not dangerous and does not cause difficulties in treatment, but it poses a threat of serious complications.
The disease can occur at any age. Due to the characteristics of the structure of the genitourinary system, women are more prone to cystitis. According to statistics, about 80% of women have suffered from this pathology at least once in their life. For men, the probability of getting cystitis increases after passing the stage of 40-50 years.
Types of disease
Cystitis can be of several types. The reason for the development of the disease divides it into infectious and non-infectious.
Infectious cystitis
Primary and secondary.In the first case, it is an independent disease: a healthy bladder is affected by the infection. The second is a complication of other diseases: the mucous membrane is inflamed on the basis of already developed pathology of the urinary system, kidneys or prostate.
Acute and chronic.In the acute form, symptoms are usually severe. With incorrect treatment or its absence, the disease becomes chronic, characterized by periods of exacerbation and decline. There are cases when acute cystitis ends with recovery after a few days, even without treatment.
Depending on the location of the inflammation:
- cervical - bladder neck injury;
- trigonal - inflammation of the triangle of the bladder (the area between the mouths of the ureters and the internal opening of the urethra);
- total - affects the whole body. In this case, the course of cystitis is particularly severe.
Postcoital.It develops within 1-2 days after sexual intercourse or vaginal manipulations. Its occurrence is due to the entry of pathogenic microflora into the urethra of a woman. During intercourse, vaginal mucus is thrown into the urethra under the pressure caused by the movements of the penis. From it, the infection freely enters the bladder. Also, the prerequisites for the development of this type of disease are frequent changes of sexual partners, abuse of contraceptive spermicides, violation of intimate hygiene rules, use of tampons, wearing synthetic underwear, etc.
"Honeymoon Cystitis".It develops after deprivation of virginity against the background of existing disorders of the vaginal microflora (candidiasis, etc. ). This happens for a similar reason: during sexual intercourse, the vaginal microflora is thrown into the urethra and bladder, which were not infected until then.
Viral, tuberculosis and parasitic.Such forms of cystitis are very rare.
Non-infectious cystitis
Non-infectious cystitis is not associated with the entry of pathogenic microflora into the bladder. Depending on the cause of occurrence, there may be such forms:
- radiation;
- chemical;
- heat;
- traumatic;
- postoperative;
- allergic.
Separately, there is a classification of cystitis according to the degree of involvement of the vessels of the bladder mucosa:
- hemorrhagic - accompanied by the presence of blood impurities in the urine (hematuria);
- non-hemorrhagic - blood is not visible in the urine.
Reasons
Bladder inflammation in most cases (up to 85%) is caused by an infection entering the organ. Basically, the "provocateurs" of cystitis are Escherichia coli (about 90%), streptococci, staphylococci and other conditionally pathogenic microorganisms. In rare cases, the causative agent of the disease is Candida fungus or sexually transmitted infections (chlamydia, mycoplasma, ureaplasma, etc. ).
There are two main ways to get a bladder infection:
- ascending - through the urethra. This is due to improper care of the genitals, non-observance of intimate hygiene rules, sexual life, etc. Pathogenic microorganisms can enter the body during surgery or manipulation of the bladder and urethra, during catheterization, if sterility is not observed;
- descending - from diseased kidneys through the ureters, as well as blood and lymph from the veins of the rectum and genitals. The large intestine serves as the habitat of the main pathogen - Escherichia coli. In women, the causative agent of genital infections is located in the uterus and vagina, and in men, in the urethra and prostate ducts.
Non-infectious cystitis occurs for the following reasons:
- radiation of the pelvic organs. During radiation therapy, radiation affects not only the organ affected by cancer (uterus, ovaries, prostate gland, intestines, etc. ), but also nearby, especially the bladder. High doses of radiation can cause burning of the mucous membrane of the body, after which ulcers and fistulas form on its walls in the future;
- chemical burn due to drugs entering the bladder cavity;
- organ damage with kidney stones;
- exposure to the mucous membrane of the bladder with hot liquid;
- allergic reaction. In its background, not only sneezing, stuffy nose, etc. , cystitis can also occur.
In the case of non-infectious cystitis, secondary infection usually occurs due to weakness of the bladder mucosa.
Risk factors
There are many factors that contribute to the development of cystitis:
- hypothermia;
- decreased immunity;
- hypovitaminosis;
- improper nutrition. Spicy, salty, fried, fatty and alcoholic drinks irritate the walls of the bladder and dehydrate the body;
- violation of the microflora of the vagina;
- frequent and long-term constipation;
- damage to the mucous membrane of the bladder;
- sedentary lifestyle (impaired blood circulation);
- tight clothing and synthetic underwear;
- presence of chronic gynecological, urological or sexually transmitted diseases;
- previous urinary tract infections;
- non-observance of personal hygiene rules;
- improper use of pads and tampons;
- constant lack of sleep, overwork, stress;
- promiscuity and unprotected sex;
- diabetes;
- hormonal disorders;
- transferred transactions;
- bladder catheterization;
- taking certain medications such as sulfonamides;
- genetic predisposition;
- pregnancy and childbirth;
- anatomical anomalies, for example, phimosis in boys.
cystitis in women
Cystitis is considered by some to be a "female" disease because women usually suffer from it. Several factors contribute to this:
- anatomical features of the structure of the genitourinary system. Due to the wide and short urethra, it is easier for pathogenic microflora to penetrate into the bladder. The entrance to the urethra is located close to the anus and vagina, so infection can occur during sexual intercourse;
- low tone of the lower urinary tract. It is caused by the effect of female sex hormones. This is especially true during pregnancy, when the body produces progesterone. It relaxes the uterus and nearby organs for the safety of the child;
- natural childbirth. At this time, the pelvic muscles lose their flexibility, the capacity of the bladder sphincter to contract weakens, and the vagina expands. In such conditions, the penetration of infection is facilitated;
- hormonal changes, especially during menopause.
Every tenth woman is at risk of developing cystitis during pregnancy. This happens for several reasons. First, women's immunity decreases during the birth of a child. The body becomes more sensitive to all kinds of infections. Secondly, the general hormonal background changes, which is a signal for the development of inflammatory diseases of the genitourinary system. Thirdly, the growth of the uterus causes compression of the bladder. This causes its blood supply to deteriorate, making it more likely to be damaged by pathogens. Do not forget the increased synthesis of progesterone, which reduces the tone of the bladder. In the future, there is an acute development of congestion and infection.
cystitis in men
Having a long and curved urethra in men significantly reduces the risk of bladder infection. Men younger than 40-50 years who follow the rules of personal hygiene are extremely unlikely to develop cystitis. After exceeding this age limit, in the presence of concomitant diseases, cystitis is diagnosed more often.
Provocative diseases include prostatitis, prostate adenoma, vesiculitis, urethritis, prostate cancer, etc. Usually they are accompanied by a narrowing of the urethra. As a result, the bladder does not empty completely. Stagnant urine is formed, which serves as a favorable environment for the development of pathogens - cystitis pathogens.
In men, the disease occurs in a more severe form and is accompanied by fever and general intoxication of the body, because cystitis in men develops as a complication of other diseases. In men, the chronic form of the disease continues almost without any symptoms.
Cystitis in children
Children of all ages are also susceptible to cystitis. It develops especially often in preschool and school-aged girls. Many factors contribute to this. Among them are weak protective properties of the bladder mucosa, wide and short urethra, lack of estrogen synthesis by the ovaries.
If the child is sick with other diseases, the risk of developing the disease increases. This weakens the immune defense and creates favorable conditions for the reproduction of pathogenic microflora.
Symptoms
Depending on the form of the disease, different symptoms may appear. If acute cystitis is characterized by a clear clinical picture with painful and frequent urination, chronic cystitis during remission can generally be asymptomatic.
Symptoms of an acute form of cystitis are as follows:
- high temperature;
- trembling;
- general weakness;
- difficult and painful urination. Urine comes out in small portions. In the process, there is a burning sensation in the urethra, and after that - pain in the lower abdomen;
- a feeling of incomplete emptying of the bladder;
- pain in the suprapubic region before and after urination;
- sharp pain in the bladder area during palpation;
- pain in the external genitalia (scrotum, penis, etc. ).
In some cases, cystitis develops urinary incontinence, which is provoked by the urge to urinate.
Urine can become cloudy or red, which indicates that it contains a large number of bacteria, desquamated epithelium, red blood cells and white blood cells.
In the case of acute cystitis, a general intoxication picture of the body is likely: an increase in body temperature to 38-40 degrees, sweating, thirst and dry mouth. As a rule, this indicates the spread of infection to the kidneys and renal pelvis, which leads to the development of pyelonephritis. In these conditions, emergency medical assistance is needed.
Manifestation of clinical symptoms in patients with acute cystitis occurs in different ways. In milder forms of the disease, patients can only feel heaviness in the lower abdomen and slight pain at the end of urination. In some cases, the course of acute cystitis becomes clear, a severe inflammatory process develops. Often, specialists diagnose phlegmonous or gangrenous cystitis, which is characterized by fever, intoxication, a sharp decrease in the volume of excreted urine, turbidity of urine and the appearance of a rotten smell in it.
In chronic cystitis, the clinical signs of the disease are similar to acute cystitis in many ways, but less pronounced. Symptoms are permanent, their intensity changes only during treatment.
Diagnostics
The correct diagnosis of cystitis directly affects the success of the treatment of the disease. Before prescribing therapy, it is important to determine the nature and factors of inflammation. If allergic cystitis occurs and contact with the allergen is not eliminated before taking antibiotics, the condition will only worsen.
In the case of infectious cystitis, it is necessary to determine its causative agent and determine which antimicrobial or antifungal drugs it is sensitive to. The result of the study will determine the next course of therapy. If cystitis is non-infectious, it is necessary to conduct an examination to determine the causes that led to the onset of the disease. Perhaps the cause is urolithiasis or neoplasm.
Diagnosis of the disease includes the following steps:
- anamnesis collection;
- determination of clinical manifestations;
- prescribing laboratory tests;
- examination by instrumental methods.
Laboratory examination for cystitis
- General blood analysis. It is carried out to identify signs of non-specific inflammation, increase the level of leukocytes and immature forms of neutrophils, increase the level of ESR;
- General urinalysis. It determines the presence of protein in the urine, an increase in the number of white blood cells, red blood cells and bacteria. When leukocytosis is detected, an analysis is prescribed that determines the number of blood cells in the urine sediment and three glass samples.
Modern express methods can also be used to diagnose the disease:
- quick test with an indicator strip. If there is an infection in the urine, then a reaction appears on the strip;
- rapid test with strips to obtain information about the content of leukocytes and proteins in urine. The importance of the method is doubtful, because a common urine test can also cope with this task;
- leukocyte esterase reaction. This method allows to determine the esterase enzyme. If there is pus in the urine, it collects.
After the laboratory tests are completed, the urine is cultured, that is, a cultural study is carried out. Its meaning is as follows: the pathogenic microflora that causes the development of cystitis is studied and the sensitivity of microbes to antibiotics is determined. Such an examination allows prescribing the most effective drugs.
The reliability of studies often suffers due to improper sampling of the material and poor hygiene by the patient.
Instrumental research methods
Among the instrumental methods for diagnosing the disease, the most common is cystoscopy, which consists in viewing the urethra and bladder using a cystoscope. In the course of acute cystitis, inserting instruments into the bladder is contraindicated, as the process is extremely painful and contributes to the spread of infection in the organs of the genitourinary system.
Such a procedure is allowed only during chronic cystitis, the presence of a foreign body in the bladder, or a prolonged course of the disease (10-12 days).
In addition to the above procedures, women with cystitis are recommended to undergo an examination by a gynecologist, to diagnose genital infections, undergo ultrasound examination of the small pelvis, biopsy, uroflowmetry and other studies.
Cystography is prescribed in special cases. This study allows you to see any irregularities and neoplasms in the walls of the bladder. X-rays are used during the procedure. To obtain more accurate results, a contrast agent is injected through the catheter, which straightens the body to expand the field of vision. The results are visible on the X-ray.
Treatment
Drug therapy is the main treatment for cystitis. There is no universal treatment regimen: the doctor depends on the nature of the disease, the degree of development, etc. for each patient. If the pathogenic microflora is bacteria, antibiotics are prescribed, fungi - fungicides, for allergies - antihistamines, etc. Acute cystitis involves taking antispasmodics, analgesics and non-steroidal anti-inflammatory drugs. Additional measures are taken to improve the patient's immunity.
In acute cystitis, it is important not to stop the course of antibiotic therapy when the symptoms of the disease disappear. Such an untreated disease often becomes chronic, threatening the general health of a person.
Medicines based on medicinal plants show high efficiency in chronic cystitis. It is useful to take herbal decoctions that have anti-inflammatory and antibacterial effects. Physiotherapy methods can also be involved: magnetophoresis, electrophoresis, inducto- and hyperthermia, EHF-therapy, ultrasound treatment and laser therapy.
Complex treatment of cystitis involves prescribing a special diet for the patient. Foods that irritate the mucous membrane of the bladder should be excluded from the diet. Spicy, salty, fried, smoked and sour foods and foods are prohibited. The food should be as light as possible and should provide the body with a large amount of plant fiber, which is necessary for the normal functioning of the intestinal microflora, to ensure a high level of immunity. Plenty of hot drinks are prescribed.
In some cases, the only treatment for the disease is surgery. They usually refer to him with postcoital cystitis or a very low location of the external opening of the urethra. In this case, the surgeon raises the urethra slightly above the vaginal opening to prevent infection during sexual intercourse or hygiene procedures.
The operative method for the treatment of cystitis in men is prescribed for cicatricial sclerosis, deformation of the bladder neck or persistent narrowing of the urethra.
More complex operations are performed for cervical, tuberculosis and parasitic cystitis (with ineffectiveness of drugs). In an advanced form of the disease - gangrene, the damaged areas of the bladder are removed, and if the gangrene is general, the entire organ is removed.
Complications
Vesicoureteral reflux is the most dangerous complication. It is expressed by throwing urine into the ureters. If the process is not stopped, then the inflammation spreads further to the kidneys, inflammation of the uterus and appendages is possible. It also reduces the elasticity of the bladder walls, which can cause scarring or ulcers. A higher spread of infection to the kidneys leads to pyelonephritis. In this disease, the amount of urine decreases. Since the kidneys do not fully perform their functions, urine accumulates in the kidneys and causes peritonitis. This requires immediate surgical intervention.
A complication of cystitis is paracystitis, which is characterized by infection of the small pelvic tissues responsible for the innervation of organs. The lesion causes scars, abscesses. At this time, it is possible to save the patient's life only with surgical intervention. A complication in the form of cystalgia appears after the treatment of cystitis. It consists of painful retention of urine, which is associated with disruption of the receptors, but usually passes quickly enough.
Among cystitis and other complications of the disease, a decrease in reproductive capacity and urinary incontinence can be distinguished. For pregnant women, untreated cystitis can lead to abortion, as the inflammation can spread to the fetus.
Complications of cystitis in men are slightly different from women and are only related to the characteristics of the structure of the genitourinary system. In both sexes, the gangrenous form of cystitis becomes a complication. This is one of the most complex conditions, affecting the lining of the bladder walls. Purulent processes can cause necrosis of bladder tissues and their death, perforation of the bladder walls or paracystitis is possible. At the same time, urination does not bring comfort to the patient.
Also, a dangerous complication of the pathology is the formation of diffuse ulcerative cystitis and empyema. They develop with insufficient therapy for inflammation of the bladder. At a time when the infection affects the entire mucous membrane of the body, abscesses are formed on it, and then bleeding wounds. Because of this, scars are formed, the tissue loses its elasticity. All this leads to a decrease in the volume of the bladder.
Urgent surgical intervention requires empyema, pus accumulates in the bladder due to decreased discharge. Sphincter dysfunction can also occur due to infectious damage to the mucous membrane of the body. At this time, urinary incontinence is observed.
Prevention
Cystitis, like any other disease, is better to prevent than to cure. It is recommended for:
- avoid hypothermia. You should not sit in the cold, swim in cold water, and wear light clothes in winter;
- eat right. spicy, spicy, sour, salty, fried, fatty foods, acid, it is desirable to exclude or consume in limited quantities, drink plenty of water;
- get rid of bad habits - smoking and drinking alcohol;
- drink more fluids (at least 2 liters) - still water, juices. This allows to quickly remove pathogenic microorganisms from the bladder, preventing their reproduction;
- do not drink coffee, orange, pineapple and grape juices, because they increase the acidity of urine;
- treatment of gynecological, urological and venereal diseases;
- normalize the work of the digestive system;
- observe the rules of personal hygiene;
- during menstruation, change pads and tampons in time, it is preferable to use pads;
- wear comfortable underwear made of natural fabrics;
- avoid tight clothes, as they disrupt the blood circulation of the pelvic organs;
- prevent overfilling of the bladder;
- when leading a sedentary lifestyle, get up, stretch at least 5-15 minutes every hour;
- make regular preventive visits to the urologist and gynecologist.
It will also be useful to use herbal decoctions (calendula, chamomile, parsley, etc. ) with antiseptic and anti-inflammatory properties.