What is cystitis and how is it treated?

Cystitis is an inflammation of the bladder that can result from a bacterial or fungal infection. Although in some cases, the disease is also non-infectious. Acute cystitis is one of the most common urological diseases especially in women, which without treatment can transform into a chronic form, characterized by a periodic exacerbation of symptoms.

Short information about urinary tract infections

Cystitis in women is diagnosed a little more often than in men. This is because women have a shorter urethra and its close location to the anus which makes it easier for bacteria to reach the bladder. That is why the disease is considered predominantly female, so the special attention is paid to the treatment of cystitis in women.

Symptoms and signs of cystitis

Signs of cystitis directly depend on the prevalence of inflammation, the type of pathogen and the age of the patient. First, there are general symptoms of infection and signs of a malfunctioning bladder. The most typical symptoms of cystitis:

- Feeling of incomplete emptying of the bladder;
- Increased body temperature;
- Urinary incontinence;
- Burning sensation in the urethra;
- Nagging pain in the lower abdomen;
- Weakness and dizziness;
- Frequent urination;
- False urge to urinate.

Cystitis pain spreads to the lower abdomen and other areas of the pelvis. Soreness is often felt in the lumbar region. With cystitis, urine becomes brown or reddish. It is also characterized by the appearance of an unpleasant odor.

Chronic cystitis is accompanied by the same symptoms, only they are less pronounced. They are more pronounced during the period of exacerbation of the disease. Symptoms of cystitis in men are similar to those in women.

Development reasons

The main cause of cystitis is bacteria: chlamydia, Escherichia coli, staphylococcus, Trichomonas, mycoplasma, etc. They can penetrate into the bladder under certain favorable factors. How the cystitis is treated will depend on the type of bacteria. Different microorganisms require the use of certain drugs.

The main causes of cystitis in women:

- Use of untested hygiene products;
- Long-term catheterization of the bladder;
- Sexually transmitted infections (STIs);
- Diabetes mellitus, obesity and foci of chronic infections in the body;
- Insufficient or improper intimate hygiene;
- Hypothermia (overcooling) of the body;
- Situations when you have to endure too long before the act of urination;
- Abrupt climate change affecting immunity;
- Older age;
- Pregnancy.

Cystitis after intimacy develops due to prolonged friction of the opening of the urethra, which occurred during intercourse. In this case, the disease occurs, as a rule, within 12 hours after intimacy.

Cystitis during pregnancy occurs due to some displacement of internal organs due to the uterus, which puts pressure on them. The situation is aggravated by hormonal changes. All this leads to incomplete emptying of the bladder, and the remains of urine act as a favorable breeding ground for bacteria.

Cystitis in men most often appears against the background of infectious processes in the pelvic area:

- Prostatitis;
- Urethritis;
- Orchitis;
- Epididymitis;
- Vesiculitis.

Infection routes

If a patient develops cystitis after sex, this indicates a sexual route of infection, in particular bacteria.

There are other ways of infection:

- Ascending. Bacteria enter the bladder through the urethra. This transmission route is the most common;
- Descending. The infection descends into the bladder from the kidneys, for example, with pyelonephritis;
-  Lymphogenous. Infection is transmitted through the lymph. In women, this happens, as a rule, with inflammation of the appendages;
- Straight. The infection enters the bladder during surgery, catheter placement, or when abscesses break out in the tissues surrounding the organ.

Depending on the cause and route of infection, the doctor will choose a specific remedy for cystitis.

Risk factors

In addition to the specific reasons for the development of the disease, doctors note the presence of risk factors that increase the likelihood of its occurrence. So, cystitis can form against the background of:

- Circulatory disorders in the small pelvis;
- Injuries of the mucous membrane of the bladder;
- Stress and overwork;
- Decreased immunity;
- Incomplete emptying of the bladder;
- Hormonal changes.

Complications

If left untreated, cystitis can lead to serious complications. The most dangerous consequences of the disease include:

- Vesicoureteral reflux (urine is thrown from the bladder back into the ureters);
- Pyelonephritis (kidney infection);
- Fistulas and inflammation of the peri-vesicular tissue;
- Acute urinary retention and intoxication.

When to see a doctor?

Many patients are interested in the question of which doctor to contact with cystitis. Women in such a situation need the help of a therapist (family doctor), gynecologist or urologist; men need to make an appointment with a urologist. If the disease develops against the background of sexually transmitted infections, a venereologist's consultation will be required.

Preparing to visit a doctor

Before visiting a specialist, you must take a hygienic shower without using intimate hygiene products and other care cosmetics. It is equally important to consider what you will tell the specialist at the appointment. It is necessary to accurately describe all the symptoms and the time of their occurrence.
Also urologists and gynecologists advise to refrain from intercourse 2 days before the planned consultation. This is necessary for taking swabs and scrapings from the mucous membrane of the genital and excretory organs.

Diagnosis of cystitis

Before curing cystitis, it is necessary to confirm the preliminary diagnosis. For this, the patient is appointed several laboratory and instrumental studies.

The following methods of diagnosing cystitis are most practiced:

- General analysis of blood and urine;
- Urine culture;
- Ultrasound of the bladder;
- Cytoscopy (with frequently recurring cystitis);
- Ultrasound of the pelvic organs;
- Pelvic organs x-ray.

Treatment of cystitis

Because bacteria are the most common cause of cystitis, antibiotics must be used. The first-line medications include: Nitrofurantoin, Fosfomycin Trometamol, Cotrimoxazole, Trimethoprim, and others. Mainly used are cephalosporins and fluoroquinolones.

Certain tablets for cystitis are prescribed by a doctor based on the results of the analysis and the type of pathogen identified. Not all drugs are effective against specific bacteria. In addition, microorganisms develop resistance to some agents.

Treatment of cystitis in men is also carried out with antibacterial drugs. Additionally, antispasmodics and anti-inflammatory drugs are included in the therapy regimen.

Women may also be prescribed suppositories for cystitis. With this disease, suppositories of anti-inflammatory, analgesic and antibacterial action are used.

Whatever medicine the doctor prescribes for cystitis, the patient must drink as much water as possible - up to 3 liters per day. As for the diet, it prohibits everything that is fried, fatty and salty. Herbal teas based on lingonberry leaf, horsetail or bearberry, are useful for both women and men.

Home remedies

Treatment of cystitis at home must be agreed with a doctor. To relieve pain, you can place a slightly warm heating pad on the area between your legs. To get rid of the burning sensation, it is necessary to lower the acidity of the urine. To do this, you can drink a glass of water with a teaspoon of salt dissolved in it every 3 hours.

Myths and dangerous misconceptions in treatment

Many people are faced with the opinion that cystitis is forever. In fact, the acute form of the disease can be cured. On average, the course of antibiotic therapy takes about 10 days, but another couple of weeks are required to restore the microflora of the vagina and intestines.
Another myth is that hot baths help with cystitis. Doctors do not recommend them. With such a disease, it is necessary to take a shower and a bath with water only at a warm temperature.

Prevention of cystitis

As preventive measures against cystitis, the following tips can be followed:

- Timely emptying of the bladder;
- Strict adherence to intimate hygiene;
- Wearing cotton underwear;
- Rejection of too tight trousers;
- Exclusion of hypothermia;
- Use of neutral cleansing products for hygiene procedures;
 -Avoid using vaginal spermicides;
- For postmenopausal women, estrogen-based topical products can be useful against vaginal dryness and micro wounds;
- Always use toilet paper from your clitoris to the anus and not vice versa (the intestines are the main source of bacteria that cause cystitis);
- Urinate before bedtime and after intercourse;
- Drink sufficient for your body weight amount of clean water per day;
- Work on improving your immunity, i.e. eat healthy, exercise, quit bad habits, treat any diseases timely, etc.
- Do not use other people’s hygienic products, items, for instance, towels.

Post by: Kylie Richardson, General Practitioner, Rotterdam, Netherlands