Acute cystitis must be treated quickly and correctly, because with an advanced infection, therapy will be difficult, lengthy and not always successful.
Our expert – urologist of the highest category of the Department of Urology and Andrology of the National Medical Research Center for Obstetrics, Gynecology and Perinatology named after N.I. Academician V. I. Kulakov of the Ministry of Health of the Russian Federation Doctor of Medical Sciences, Professor Ruslan Safiullin.
Doctors treat patients with chronic cystitis not only with sympathy, but also with caution: exhausted by pain from constant exacerbations, regularly not getting enough sleep due to endless running to the toilet, they are often extremely nervous.
Old and young
With rare exceptions, the weaker sex suffers from cystitis. Most often, the problem first occurs at 17-23 years old, when girls usually begin to have sex. The urethra is located close to the vagina, so the route of infection is obvious. Postcoital cystitis, also called honeymoon cystitis, is the most common cause of bladder inflammation in young women.
The second peak of the disease occurs at the age of over 55 years. After menopause, the level of estrogen decreases, dryness of the vaginal mucosa develops, due to which the protective properties of the bladder deteriorate. In addition, in menopause, the tone of the pelvic floor muscles weakens, and against this background, prolapse or prolapse of the internal and external genital organs can occur, which also often provokes cystitis.
Settle in the toilet
The bladder consists of 4 layers. The infection progressively destroys them one by one. When the first two are affected and the muscle layer, where there are pain receptors, is exposed, the contact of the organ walls with urine begins to cause pain and false urge to urinate. Cystitis has certain symptoms.
Dysuric disorders. It can be frequent painful urination, pain in the abdomen, cloudy urine and blood in it, a feeling of incomplete emptying of the bladder. Patients constantly run to the toilet, but they cannot squeeze out more than three drops. And that will drive anyone crazy.
High fever, chills. If such symptoms appear, it means that the infection has risen higher and began to affect the kidneys. You need to see a doctor as soon as possible.
There is no discharge from the vagina with cystitis, and if they are, it is necessary to take PCR and look for sexual infections (ureaplasma, mycoplasma, gonococci, Trichomonas).
To identify acute cystitis and determine the treatment, two tests are enough.
Urinalysis (general and / or according to Nechiporenko). A general analysis will reveal inflammation, and the second will allow you to more accurately calculate leukocytes-erythrocytes. Previously, it was believed that the urine of a healthy person is sterile, today it is known that it has its own flora. The analysis will accurately show whether there is inflammation or not.
A bacterial culture of urine will help to find out which microbe caused the inflammation and which antibiotic it is sensitive to.
Some patients go further – for example, they do cystoscopy (endoscopic examination of the bladder) or cystography (X-ray of an organ with the introduction of a contrast agent). Thus, they do themselves a disservice – invasive studies carried out in the acute period of the disease will only increase the infection.
In 90% of cases, the main causative agent of cystitis is an opportunistic microbe that lives in the rectum, in other words, E. coli. Therefore, it is not necessary to wait a week until the sowing is ready, you can immediately start taking an antibiotic (fosfomycin). If it is confirmed that E. coli is to blame, fine. And if there is another pathogen (for example, the human papillomavirus, which accounts for 7% of cystitis), the doctor will change the therapy.
But you can’t just take a magic pill without taking tests. It is this “treatment” that most often leads to the fact that the infection subsides only for a while, and acute cystitis turns into chronic, in which any provocation will lead to a relapse 3-4 times a year, or even more often.
After treatment, it is necessary to retake tests to make sure that the infection is no more. The fact is that the bladder is not able to absorb drugs, and it is not always possible to achieve the required concentration of the drug in the urine in order to destroy the entire colony of microbes. Because of this, the most tenacious bacteria can hide in the submucosal layer of the bladder, and in the future the infection will recur every now and then. So a control analysis is necessary even when everything has passed and nothing else worries.
The root cause of inflammation of the bladder is a bacterial infection that gets there from the vagina or rectum. Since the urethra in women is wider and shorter than in men, it is easier for infections to get through. In Russia, 26-36 million cases of cystitis are registered annually. In the acute form, every fourth woman suffers the disease, a third has a relapse within a year, and 10% develop a chronic form, fraught with pyelonephritis.
Reminder for young ladies
Due to the abundance of provoking factors, the prevention of cystitis should be comprehensive, and it should be started from childhood. Mothers should teach their daughters:
- Change underwear daily. It is advisable to wear cotton underpants rather than thongs.
- Rinse properly. Movements from front to back to prevent the entry of E. coli.
- Avoid factors that reduce immunity. Hypothermia, stress, lack of sleep, overwork, SARS, alcohol intake reduce immunity and stress resistance. A healthy lifestyle, yoga, swimming, any sport will help strengthen the body’s defenses.
- Eliminate a sedentary lifestyle. Hypodynamia leads to venous congestion in the small pelvis, which in men is fraught with prostatitis, and in women with ischemic bladder disease and cystitis. When sedentary work / study, you need to do physical exercises every hour, squats are especially useful.
- Do not get carried away with tight clothing. Tight jeans disrupt blood circulation, lead to stagnation in the pelvic organs, and this reduces local immunity.
- “Keep honor from a young age.” Changing sexual partners, among other things, leads to a violation of the intimate microflora, which also threatens with cystitis.
- Eat properly. It is necessary to limit fast food, spicy, salty – they alkalize the urine. To prevent bacteria from multiplying, urine must be slightly acidic.
- Drink more liquid. So that urine does not stagnate, it would be good to drink 200 ml of a diuretic collection once a quarter for 10 days in the morning: horsetail, lingonberry leaf, bearberry, chamomile. An acidifying drink, such as cranberry juice, is also suitable. But the lemon, on the contrary, alkalizes the urine.