Cystitis in women - causes, symptoms and treatment

2024 Author: James Gerald | [email protected]. Last modified: 2023-12-17 14:00

Cystitis is a disease of the mucous (less often submucous) muscular layer of the bladder of an inflammatory nature. Most often, women are susceptible to it due to the structural features of the urinary tract. Some people can get sick only once in their life, while in others it becomes chronic. To protect yourself, you need to know why cystitis occurs in women, its symptoms and what treatments are used.

ICD 10

In the International Classification of Diseases (ICD 10), cystitis is under code number 30. The reference book lists all types of cystitis, their complete classification and symptoms.

Causes

Depending on the origin, cystitis can be either primary or secondary. Women, due to the structural features of the urinary tract, are more susceptible to primary. Men are secondary. But during pregnancy, especially in its first trimester, the expectant mother can be diagnosed with one or the other form of the disease.

Primary cystitis is an independent disease of the bladder and usually occurs in an acute form. The causes of its occurrence can be both basic non-observance of hygiene rules and infection.

Hypothermia and a reaction to chemicals contained in medicines or in intimate hygiene products can also lead to the development of cystitis. Sometimes, when diagnosing, the cause of the development of cystitis cannot be determined.

The urethra in women is wide and short and, moreover, is very close to the anus and vagina. Because of this, there is a high risk of infections in the bladder from other organs.

The pathogens of cystitis are:

• very rarely - Pseudomonas aeruginosa, Proteus, Klebsiella;
• more often (in 5-20% of cases) - staphylococci;
• very often (70-95%) - Escherichia coli;
• sometimes - a specific microflora.

Secondary cystitis appears as a complication of other diseases. Most often, the following health problems lead to it:

• malignant neoplasms;
• stones in the organs of the urinary system;
• radiation therapy of the pelvic organs;
• allergies;
• metabolic disorders (hypercalciuria, diabetes mellitus and others);
• pathology of the endocrine system (including menopause), in connection with the development of which changes in the mucous membranes occur due to a reduced hormonal background.

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Also, infectious diseases of the genitourinary system can become the cause of secondary cystitis in women. These include:

• genital tuberculosis;
• trichomoniasis;
• chlamydia;
• ureaplamosis;
• gonorrhea;
• mycoplasmosis;
• gardnerellosis;
• vulvitis and urethritis against the background of candidiasis;
• colpitis.

A primary disease with cystitis or its exacerbation can be triggered by:

• ARVI;
• wearing too tight underwear;
• alcohol abuse;
• spicy food;
• the onset of menstruation;
• change of sexual partner.

Cystitis in women can appear after the first intimacy. The reasons are the ingress of foreign microflora into the urethra.

No less frequent provoking factors for the development of cystitis in women include:

• constipation;
• too infrequent emptying of the bladder;
• narrowing of the internal lumen of the urethra;
• stagnation of urine with congenital or acquired saccular protrusion of the bladder wall;
• any foreign objects in the bladder, including stones;
• pyelonephritis.

The reasons for the development of cystitis in girls may be a neurogenic bladder or an incorrect approach to intimate hygiene.

During pregnancy, the disease can develop due to an imbalance in the microflora of the urogenital tract or endocrine gestational and hemodynamic changes.

Cystitis in a woman can also occur as a result of trauma to the mucous membrane of the bladder during surgery or after endoscopic procedures.

The cause of cystitis, which occurs in a chronic form, can be prolapse of the vagina or uterus, a sluggish infection.

Cystitis is often diagnosed in girls 4-12 years old and women 20-40 years old. In 11-21% of cases, the acute form of the disease flows into a chronic one, in which attacks can occur 2 times a year or more often.

Symptoms of cystitis in women

Cystitis is characterized by acute development with pronounced symptoms, so the diagnosis of the disease is usually not difficult. The main signs of the disease include:

• Violation of the process of urination, during which a woman feels pain, cramps and burning in the bladder and urethra. At the same time, with each visit to the toilet, the volume of urine is significantly reduced, and the urge appears every 5-15 minutes. Unpleasant sensations appear both at the beginning of urination and at the end of it.
• Urinary incontinence due to spasms of the muscular membrane of the bladder.
• Discoloration of urine. Also, purulent discharge can join it.
• As the disease worsens, blotches of blood are observed in the urine.

Also, cystitis in women is accompanied by the following symptoms:

• decreased activity;
• deterioration in general well-being;
• an increase in body temperature up to 38 °.

In childhood, with acute cystitis, urinary retention may occur.

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In chronic cystitis, the symptoms are the same as in the acute form, but not so pronounced. The frequency of urination is somewhat less frequent, the discomfort is almost imperceptible.

Diagnostics

If you suspect the development of cystitis, a woman should immediately seek help from a urologist. The preliminary diagnosis is made after examination, interviewing the patient and palpation of the suprapubic region.

To confirm it, you will need to undergo a series of medical studies. These include:

1. Ultrasound of the bladder. Helps to identify changes in the walls of the bladder, hyperechoic suspension.
2. Examination of the inner wall of the organ using cytoscopy. Allows you to identify the presence of ulcers, fistulas, blind protrusions of the walls of the organ, foreign bodies (including foreign stones), neoplasms, injuries of the inner walls. In addition, with the help of cytoscopy, material is taken for histology.
3. General urine analysis. With cystitis, the content of uric acid salts, proteins, erythrocytes, leukocytes is usually increased. With infections of a bacterial nature, a significant increase in pathogenic microflora is noted.
4. Examination of gynecological smears. The analysis for polymerase chain reaction helps to identify the causative agent of the disease, even with a small concentration.
5. Bacteriological and microscopic examination of the smear. It is carried out to exclude bacteriological infections and to identify the sensitivity of the pathogen to various types of antibiotics. Microscopic analysis allows you to assess the state of the microflora.

If you suspect the development of cystitis as a consequence of gynecological diseases, the attending physician may recommend a consultation with a gynecologist.

Complications and why cystitis is dangerous

Complications of cystitis most often occur due to the fact that a woman uses self-medication, including folk remedies. In this case, it can only drown out the symptoms, and the disease will turn into a chronic form. In addition, the lack of timely adequate treatment can lead to the development of serious complications.

These include:

• pyelonephritis - inflammation of the kidney tissue;
• interstitial cystitis - progressive inflammation of the tissues of the bladder of a chronic form of non-infectious origin;
• chronic cystitis with a recurrent nature;
• development of inflammatory processes in the uterus and appendages;
• a decrease in the elasticity of the walls of the bladder, due to which the process of urination is disrupted;
• the appearance on the inner walls of the organ and the urethra of ulcers, scars;
• paracystitis, in which inflammation spreads to other organs of the small pelvis;
• cystalgia - persistence of pain during urination even after healing;
• inflammation of the cystic triangle;
• decreased reproductive functions;
• urinary incontinence;
• spontaneous termination of pregnancy;
• partial or complete necrosis of the bladder tissue;
• accumulation of pus in the bladder cavity.

In some cases, urinary retention may develop, which negatively affects the kidneys and provokes peritonitis. In this case, emergency surgery is indicated.

Types of cystitis in women

By the type of inflammation, there are 2 main types of the disease - primary and secondary. According to the form, cystitis is divided into acute and chronic.

Moreover, both forms of pathology are classified according to the area of coverage:

• with a lesion of the bladder triangle of Lieto;
• focal;
• total.

By the type of changes in the tissues of the bladder and urethra, cystitis is divided into the following subspecies:

• gangrenous - with necrosis of organ tissues;
• catarrhal - with an inflammatory process only of the mucous membranes;
• cystic - with the formation of cysts in the submucosa of the bladder;
• phlegmonous - purulent inflammation of the submucosa;
• encrusted - ulcers of a chronic nature with the formation of salt deposits on them;
• granulomatous - with numerous rashes on the mucous membranes of the bladder;
• ulcerative - with damage to the internal walls of the organ;
• interstitial - with the development of inflammation of the muscle tissue of the bladder;
• hemorrhagic - characterized by the presence of blood in the urine.

Treatment of cystitis is prescribed taking into account all the signs and the presence of concomitant diseases.

Acute cystitis

In almost 80% of cases, the cause of acute cystitis is the bacterium Escherichia coli (Escherichia coli). In other cases, the disease appears due to other pathogenic microorganisms.

Acute cystitis is characterized by the rapid development of the inflammatory process and pronounced symptoms.

Chronic cystitis

The disease in this form is characterized by a latent course and blurred symptoms. Women may experience only moderately frequent urge to urinate and slight pain during it.

Chronic cystitis is characterized by frequent relapses (from 2 times a year) with exacerbation of symptoms.

According to research data, more than 60% of women with acute cystitis do not receive adequate treatment, and 2/3 of them do not seek medical help at all. This leads to a transition to a chronic form and the development of complications.

Treatment of cystitis in women

For the treatment of cystitis in women, complex therapy is used, which includes: taking medications, physiotherapy and herbal medicine. For patients of different age groups with chronic pathologies and pregnant women, different approaches to treatment are used.

Only a specialist should deal with the diagnosis and selection of treatment methods; self-medication for cystitis is unacceptable. Only a doctor can prescribe medications that eliminate not only the symptoms of the disease, but also the causes of its development.

In case of a disease of an infectious nature, antibiotics are necessarily prescribed. For the treatment of cystitis in women, drugs are prescribed that quickly eliminate the cause of the development of the disease. These include:

• Ceftatizim;
• Cefibuten;
• Nitrofurantoin;
• Fosfomycin.

If there is no therapeutic effect, Ertapenem or Imipinem may be prescribed.

To relieve painful sensations and lower fever, the following drugs are used:

• antispasmodics - Papaverine, Drotaverin, No-shpu, etc.
• non-steroidal anti-inflammatory drugs - Nimesulide, Diclofenac and others;
• antipyretic (only at temperatures from 38 °) - Nurofen, Paracetamol, etc.

To enhance the effect of drug therapy, doctors recommend drinking herbal teas and taking herbal medicine.

The following physiotherapy methods can be prescribed as an aid:

• magnetotherapy;
• UHF;
• iontophoresis;
• instillation of the bladder.

During the treatment of cystitis, you must follow a special diet. The following foods must be excluded from the diet:

• tomatoes;
• citrus;
• sugar;
• spices;
• alcoholic drinks;
• carbonated water, including mineral;
• tea;
• coffee.

The menu should contain:

• melons and vegetables (watermelon, zucchini, pumpkin, etc.);
• spinach;
• carrot;
• cucumbers;
• fresh berries (especially cranberries and lingonberries);
• fruit drinks;
• vegetable and fruit juices;
• herbal teas (kidney collection, corn silk, bearberry).

After the removal of acute symptoms, meat, fish, dairy products and milk can be introduced into the diet.

The first effect of the treatment of cystitis in women occurs already on the 2nd day from the start of therapy. The course directly depends on the cause of the development of the disease, the presence of complications and concomitant pathologies and ranges from 7 to 14 days.

How to treat cystitis during early pregnancy

In the first trimester of pregnancy, when the fetus is forming and there is a high risk of spontaneous miscarriages, sparing methods are used to treat cystitis. Strong drugs are strictly prohibited.

Cystitis therapy during early pregnancy consists of 3 stages:

1. Removal of inflammation. For this, drugs such as Ibuprofen, Diclofenac, Paracetamol, Ibuclin are used. Celecoxib and Meloxicam are prohibited.
2. Antifungal therapy. The appointment of the drug is carried out only after the attending physician assesses the likelihood of risk to the fetus.
3. Instillation. If the ingestion of an antibiotic at an early stage of pregnancy is for some reason excluded, then its direct introduction into the bladder through the urethra may be indicated. In this case, the desired therapeutic effect is achieved without the risk of negative impact on the child.

After 2 days from the start of treatment, urine is examined for the presence of the causative agent of the disease. If the result is negative, then the administration of drugs is stopped.

Then, throughout the pregnancy, the woman will need to take a urine test for bacterial culture. And if pathogens are found again, then it is necessary to undergo microbial suppressive therapy again.

In the absence of contraindications, phytopreparations Brusniver, Kanefron N, Cyston or Zhuravit can be used to treat cystitis in early pregnancy.

How to treat cystitis in late pregnancy

Treatment for cystitis in late pregnancy is about the same as in early pregnancy. The main difference is the possibility of using stronger drugs that are contraindicated in the first trimester.

Treatment for cystitis in women, which quickly helps to eliminate the cause of its occurrence, includes:

• Antibacterial therapy. With a mild form and onset of the disease, Monural, Suprax or Amoxicillin are prescribed. In severe cases of the disease - drugs of the Cephalosporin group (macrolipids, penicillins and others).
• Instillation. Anti-inflammatory and antibacterial drugs are injected into the bladder.
• Taking herbal medicines - Cyston, Urolesan or Kanefron.
• Antispasmodics to relieve spasms and pain.
• Physiotherapy methods (up to the 34th week of pregnancy). Prescribed only in the absence of contraindications.
• Taking immunostimulating drugs, with Viferon or Flavoside.

It is important to remember that the treatment of cystitis during pregnancy should only take place under the supervision of a doctor. Self-medication can negatively affect the development of the fetus or provoke a spontaneous miscarriage.

Forecast and prevention

With a timely visit to a doctor, the prognosis for the treatment of cystitis is quite favorable. With the observance of preventive measures, the disease will never return. Otherwise, it can become chronic or cause serious complications.

Adherence to a number of the following rules will help to significantly reduce the risk of developing cystitis:

1. Perform intimate hygiene procedures twice a day, morning and evening. It is necessary to wash the external genitals under running water using baby soap or a hypoallergenic detergent.
2. Before intercourse, both partners should wash their genitals.
3. Refuse oral sex if there are diseases of the oral cavity - candidiasis, tonsillitis, stomatitis.
4. Do not practice anal sex, as there is a high probability of transferring intestinal bacteria to the genitals and urethra.
5. Avoid hypothermia. It is very important for a woman to dress for the weather, especially carefully to keep her feet warm. Hypothermia can cause not only cystitis, but also other diseases that lead to infertility.
6. In case of too frequent ARVI, it is necessary to drink a course of immunostimulating drugs. In addition, hardening, sports exercises and daily walks should be used to strengthen the immune system.
7. It is imperative to go to the toilet in a timely manner, since with an overflowing bladder, inflammation of its mucous membranes may begin.
8. Drink enough liquid (at least 1.5 liters of clean water per day), especially in the hot season.
9. It is better to use pads during menstruation, as tampons can cause mechanical compression of the urethra, thereby damaging its mucous membrane. It is recommended to change hygiene products every 2 hours.
10. Refuse to use scented intimate hygiene products and deodorants for washing.
11. After using the toilet, wipe with toilet paper from front to back to minimize the ingress of bacteria from the intestines to the external genitals and urethra.

It is important for mothers to remember that it is necessary to teach girls to intimate hygiene from early childhood. This will help protect them not only from cystitis, but also from the development of many other diseases of the pelvic organs.

Outcomes

Cystitis is a dangerous, most often infectious disease of the bladder, the development of which can be prevented by observing all preventive measures. It is important to remember that at the first sign of its appearance, you should seek medical help. It is strictly forbidden to self-medicate, as it can lead to all sorts of complications.