Cystitis symptoms, treatment

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

A lot has been said and written about cystitis. But none of the authors speaks about the connection between inflammation of the bladder and gynecological diseases - colpitis, candidiasis, genital infections, etc. This article is the first to make a connection between these problems.

Cystitis is the most common urological disease among women. To one degree or another, signs of cystitis are observed at least once in a lifetime more than half of women. For some, it becomes an annoying nuisance, turns someone's life into hell - unfortunately, and this happens quite often.

We can safely say that cystitis was "unlucky": this disease is at the junction of two specialties - urology and gynecology. In itself, inflammation of the bladder is a urological problem, and the reason, which in the overwhelming case leads to the development of cystitis - a violation of the vaginal microflora - is a problem of gynecology. It turns out that with a competent approach, two doctors should at once treat a woman with cystitis - a urologist and a gynecologist. But life shows that most often both these specialists try to get rid of this unfortunate woman. Everything in order, cystitis symptoms, treatment:

What is the disease

Cystitis is an inflammation of the lining of the bladder. There are toxic, allergic, non-infectious cystitis - all these are rare and we will not talk about them. In the vast majority of cases, cystitis is caused by one or another infection. Most often it is one of the representatives of the opportunistic flora - Escherichia coli, staphylococci, streptococci, etc. Rarely, but nevertheless there are cystitis directly associated with genital infections, for example, mycoplasma.

The infection enters the woman's bladder from the urethra. In women, it is short, wide, and very easy for bacteria to get through. In the urethra, bacteria most often enter the vagina. Cystitis is almost always associated with inflammation of the vagina - colpitis, or a violation of the vaginal microflora - bacterial vaginosis.

Traditionally, exacerbations of cystitis are associated with hypothermia. Yes, indeed, hypothermia causes a decrease in the body's resistance, especially the local immune response, as a result of which the infection actively multiplies and enters the bladder, causing an inflammatory reaction. However, practice shows that more often the inflammation of the bladder is associated with a particularly violent intercourse, or simply with regular sexual activity. Sometimes exacerbations of cystitis are associated with the menstrual cycle.

Honeymoon Cystitis

"There is such a disease - honeymoon cystitis. So I have this honeymoon all my life …" - a quote from a letter from one of my patients. This beautiful term implies the development of signs of cystitis after defloration, that is, deprivation of virginity by a girl.

The following happens in this case. Even before a girl begins sexual activity, her vaginal microflora is disturbed. This happens all the time, thrush in girls is so common that it is considered almost the norm. The first sexual intercourse is not always violent, but it is nevertheless accompanied by an abundant reflux of the vaginal microflora into the urethra and bladder. Their walls are not prepared for such an attack, and an inflammatory reaction develops, that is, cystitis. Rarely does anyone give up sex on their honeymoon, even though they are sick. Therefore, the disease progresses and progresses …

Cystitis symptoms

Inflammation of the bladder is manifested primarily by increased urination. At the same time, the woman constantly has strong urges to visit the toilet, which do not correspond to the amount of urine released during this. Often a woman notes pain at the end of urination, sometimes blood appears in the urine. In acute cystitis, the temperature rises, pains in the lower abdomen appear. If the so-called cervical form of cystitis develops, in which the sphincter of the bladder is involved in the inflammatory process, then there are episodes of urinary incontinence.

Cystitis should not be confused with urethritis - inflammation of the urethra. Urethritis is manifested by unpleasant sensations, pain, burning sensation or cramps when urinating - that's all. Often these diseases accompany one another, but this is not always the case.

What usually happens next

Most often, at the first symptoms of cystitis, on the advice of more experienced friends, the girl takes several pills of the first antibiotic that comes across, the symptoms of the disease fade and they forget about it until the next exacerbation. This can go on for years.

Unfortunately, doctors do no better in such a situation. A urologist at a district clinic will do a urine test, after which he will prescribe some kind of uroseptic. A few days pass, the symptoms diminish, and everything is fine. No one thinks about why an exacerbation has developed and how to prevent it.

However, exacerbations occur over and over again. A woman is forced to wrap herself up in warm clothes even in the heat, always think about what she can and cannot eat, and be afraid of every intimacy with her beloved. This state of affairs can be maddening …

Bacterial vaginosis

Now let's talk about the reasons for everything that happens in more detail.

As I said, in the vast majority of cases, the development of cystitis is associated with an infection in the vagina.

Normally, a microflora lives in a woman's vagina. It is based on the so-called lactobacilli, or Dederlein's sticks, there is also a small amount of bifidobacteria and some other microorganisms. All these microbes are in ecological balance, their numbers are strictly controlled by each other, and they do not allow any other microorganism to appear in the vagina.

Under the influence of various factors, this balance may be disturbed. These factors are very different - from stress and hypothermia to hormonal changes, pregnancy or the abolition of oral contraceptives. The imbalance lies in the fact that a colony of some microorganisms grows in large numbers and suppresses all others. These can be fungi of the genus Candida, and the resulting disease will be called vaginal candidiasis, or simply thrush. It can be gardnerella - then the disease will be called gardnerella. It can be some kind of genital infection - ureaplasmosis, trichomoniasis, chlamydia. It can be almost any microorganism with pathogenic activity.

Often, dysbiosis of the vagina is accompanied by intestinal dysbiosis, which is caused by the same pathogen.

Bacterial vaginosis manifestations

So, a violation of the vaginal microflora has occurred. The classic symptoms for this disease are burning and itching in the genitals, profuse mucous discharge, sometimes with an unpleasant odor, dryness and discomfort during intercourse. These symptoms can be expressed in varying degrees, from very severe to subtle. In addition, bacterial vaginosis is a chronic disease, and proceeds with periods of exacerbations and remissions. It is always funny to hear a patient say: "I had thrush a year ago, then three months ago, but she never did."There was always a violation of the microflora, just exacerbations occurred only a few times.

There is only one step left from bacterial vaginosis to vaginitis, or colpitis - inflammation of the vagina. With this disease, the discharge begins to be purulent, pain and pain in the genitals appear, and sometimes the body temperature rises.

In the same way, one step remained until cervicitis - inflammation of the cervix (pain in the lower abdomen, painful intercourse), urethritis - inflammation of the urethra (pain and burning sensation when urinating). Not far from cystitis …

Treatment of vaginal dysbiosis is not an easy task. In no case should you limit yourself to prescribing antibiotics or suppositories alone, as is done in most cases. After all, it never occurs to anyone to treat intestinal dysbiosis with antibiotics, but here the situation is very similar. It is not enough just to kill the pathogen, it is necessary to restore the normal microflora of the vagina, while not forgetting about the restoration of immunity.

Competent treatment should be carried out simultaneously in two directions. On the one hand, it is necessary to suppress the colony of bacteria that caused the disease, on the other, to populate the normal microflora in the vagina. And it is imperative to start strengthening the immune system, since it is its task to control the microflora.

Complications of cystitis

With a prolonged course, the infection from the bladder enters the kidneys, which can lead to the development of pyelonephritis - inflammation of the kidney tissue. This is manifested by a high fever and lower back pain on one side. Rarely, pyelonephritis is bilateral, and this situation is already life-threatening.

Pyelonephritis, as a rule, is treated seriously, often in a hospital, a thorough diagnosis, massive therapy is carried out … But here, too, no one is engaged in a full-fledged treatment of cystitis and the restoration of vaginal microflora. As a result, the disease will recur, and with each new attack of pyelonephritis, kidney function decreases. As a result, a woman can become disabled.

Interstitial cystitis

And now let's talk about the most terrible cystitis symptoms, treatment of interstitial cystitis. With some structural features of the bladder wall, the inflammatory process extends to its entire thickness, capturing not only the mucous membrane, as in ordinary cystitis, but also the submucosa and the muscular wall of the bladder. This type of cystitis is called interstitial cystitis.

Interstitial cystitis has several distinctive features. Urination in such patients is frequent, up to 100-150 times a day. There may be pain in the lower abdomen, painful urination, fever.

Interstitial cystitis is virtually untreatable. Sometimes it gets a little better against the background of antibiotics, but more often they have no effect or cause a worsening of the condition.

With a prolonged course of interstitial cystitis, the muscle tissue of the bladder wall degenerates into a rough cicatricial, the bladder loses its elasticity and progressively decreases in volume. When the volume of the bladder reaches 50 ml, the disease is called microcyst. Then it doesn't matter if there is inflammation in the bladder or not - life with such a bladder is in any case impossible. Very often, the only real way to treat interstitial cystitis is surgery - complete removal of the bladder and its plastic from the large intestine.

If interstitial cystitis is suspected, a biopsy of the bladder wall should be done. If the diagnosis is confirmed, then the attending physician should raise the question of the operation. With a sharp decrease in the volume of the bladder, the issue of intestinal plastic should be resolved without any additional research.

Every woman who regularly notes exacerbations of cystitis and does not seriously treat it has a chance to get interstitial cystitis.

Cystitis and pregnancy

If a woman suffers from chronic cystitis, it is very likely that another or extraordinary exacerbation of it will occur during pregnancy. Against the background of pregnancy, the hormonal background of the body changes, the violation of the vaginal microflora is most often aggravated, the body's immunity decreases - all this creates conditions for a strong exacerbation of cystitis.

About half of the letters from pregnant women with exacerbated cystitis were about the same thing: “During pregnancy, cystitis appeared, turned to a urologist or a gynecologist at an antenatal clinic, prescribed a medicine, the annotation to which said that it should not be taken during pregnancy. make?"

Indeed, all those drugs that doctors are used to prescribing for cystitis in clinics and antenatal clinics are contraindicated in pregnancy. In addition, in the first trimester of pregnancy, and even better throughout pregnancy, you should not take any medications at all, with the exception of vitamins and herbal preparations - they can cause serious disturbances in the formation of the fetus's body. What then is to be done?

Meanwhile, helping a woman is very easy. In our clinic, a special scheme of urinary bladder instillation has been developed, that is, the injection of the drug directly into the bladder. The symptoms of the disease are eliminated literally in 1-2 procedures, the next few procedures restore the wall of the bladder and prevent the symptoms from returning for one time or another. At the same time, the woman does not take any medications, as a result of which there is no threat to the life and health of the child.

Serious treatment of cystitis and bacterial vaginosis during pregnancy will not work, but it is within the power of the doctor to help a woman carry a child without problems and prepare her for childbirth. And within a few months after childbirth, it will be possible to completely rid a woman of these diseases.

Cystitis and genital infections

Almost everything has already been said about this, but, nevertheless, I will repeat it again. Sexual infections are gonococcus, chlamydia, trichomonas, mycoplasma and ureaplasma. All these pathogens enter the woman's vagina during intercourse. Some time after exposure, they cause inflammation of the vagina - colpitis, inflammation of the cervix - cervicitis, inflammation of the urethra - urethritis, and a violation of the vaginal microflora - bacterial vaginosis. It often happens that the symptoms of the disease are so insignificant that the woman does not attach importance to them, especially since after a few days they disappear on their own without treatment.

Meanwhile, inflammation or disturbance of microflora becomes chronic, causing, among other things, a decrease in the local immunity of the body. Reproducing in the vagina, genital infections can themselves cause inflammation of the bladder, but most often, against the background of a decrease in general and local immunity, a nonspecific flora enters the bladder, causing an exacerbation of cystitis. Therefore, direct or indirect, but there is always a connection between genital infections and cystitis. And competent treatment in this case should be carried out simultaneously, in one course.

Cystitis in men

In men, the phenomena of cystitis are not common and almost always appear against the background of exacerbation of chronic prostatitis. Most often, these symptoms are not too pronounced, and when treating inflammation of the prostate gland, they go away by themselves, without requiring additional measures. In other cases, a course of well-administered treatment of cystitis is usually effective.

Only the problem of interstitial cystitis for men is practically the same as for women. In this case, surgical treatment is also almost always necessary.

Cystitis in children

In children, for a number of reasons, cystitis develops quite often, the frequency of the disease is practically unrelated to either age or gender. In adolescent girls, cystitis is more often associated with vaginal dysbiosis; in boys, cystitis often develops with phimosis (narrowing of the foreskin), but most often the disease develops sporadically, against the background of accidental infection in the bladder.

In principle, the treatment of cystitis in children does not differ from the treatment of adults. Competent diagnosis necessarily includes urine culture, which allows you to identify the pathogen and determine its properties. Inflammation of the bladder in children very easily passes to the kidneys, so it is better not to delay with treatment, and you need to take it very seriously.

Diagnosis of cystitis

It is not difficult to diagnose cystitis - specific symptoms, abnormalities in urine tests, abundant growth of bacteria in the urine, signs of inflammation during ultrasound, cystoscopy, biopsy. But from all that has been said earlier, it follows that in order to diagnose cystitis, it is necessary to examine the condition of the woman's genitals. Therefore, the routine examination of a woman with cystitis should also include an examination for genital infections and a study of the vaginal microflora. Ultrasound of the genitourinary organs allows you to exclude concomitant diseases. Usually these examinations are sufficient.

Treatment of cystitis and bacterial vaginosis

Let's start by addressing the question - who should provide this treatment. Cystitis is a urological disease, and it seems that a urologist should treat it. Bacterial vaginosis is a gynecological disease, and you need to go to a gynecologist with it. It turns out that two specialists should simultaneously treat a woman with cystitis.

However, practice shows that this scheme does not work. For some reason, good understanding between urologists and gynecologists cannot be achieved, the patients remain "abandoned", no one seriously deals with them. At one time I faced this problem, after which I had to go headlong into gynecology to find a way out.

There can be only one conclusion - the treatment of cystitis should be dealt with by a competent urogynecologist, that is, a specialist in both urology and gynecology. Urogynecology is a young and rather rare specialty, it is not easy to find such a specialist. But you must do this if you really want to be cured of a boring disease.

The general treatment regimen is as follows. If a woman deals with an exacerbation of cystitis, then several instillations (the introduction of a drug into the bladder through the urethra) can relieve this exacerbation. After that, a course of instillations is carried out with a specially developed composition that destroys all microflora in the bladder and strengthens the bladder wall, increases its resistance to the effects of microorganisms.

All instillations are carried out without a catheter, so there is practically no risk of infection with nosocomial infections. In addition, such a procedure is quite simple to perform and is easily tolerated by patients.

At the same time, the restoration of the vaginal microflora is carried out according to a specially developed scheme. If during the diagnosis genital infections were detected, then their treatment is also carried out. It is also necessary to examine and treat the partner.

The duration of the main course of treatment is 2-3 weeks. At this time, the woman is invited to give up the use of certain foods, hypothermia and sexual activity. At the end of the treatment, the patients return to their normal life without any restrictions. If we were talking about genital infections, then until all negative results of control tests are obtained, sexual activity is allowed only with the use of a condom.

When the main course of treatment ends, the woman feels, and in fact is completely healthy, and can lead a normal life. After the end of the course of treatment, it is proposed to undergo a prophylactic course again after 3 months. It is much simpler and shorter (2 weeks), does not include antibiotics and in fact only consolidates the result achieved during the main treatment.

Within 1 year after treatment, it is recommended to undergo several such courses. If the symptoms of the disease do not return, then in the future it is suggested that patients undergo one preventive course per year.

The above treatment regimen has already allowed almost a hundred women to get rid of the disease that they have suffered from for many years. For each patient, this scheme is determined individually according to the results of the examination, but the general view of this scheme, as a rule, remains.

Prevention of cystitis

There are several rules that every woman who suffers or has a predisposition to cystitis must follow.

These are the rules:

- Do not overcool - do not sit on the ground and on the curb of the embankment, do not swim in an ice hole, do not wear mini-skirts in autumn and spring, etc.

- Monitor your diet - all spicy, sour, fried, spicy, salty, pickled and alcoholic drink in limited quantities and drink plenty of water.

- Drink as much liquid as possible, at least 2 liters per day, but not tea, coffee, beer or soda, the best is pure water, still mineral water or non-concentrated juices.

- Engage in the treatment of chronic inflammatory diseases: frequent tonsillitis, chronic tonsillitis, carious teeth - all this is not conducive to health.

- If the stool is irregular, there are often constipation or diarrhea, then the diet should be adjusted in such a way as to avoid stool disturbances. They are directly related to bladder problems.

- When visiting the toilet, wipe only with movements from front to back and in no case vice versa! Try to wash yourself after each visit to the toilet.

- With a sedentary lifestyle, try to get up and stretch for at least 5-10 minutes every hour.

- If you use tampons during your period, change them at least every 2 hours. It is much better to use spacers.

- Visit the toilet every 2 hours, even if you do not have such a desire.

- Regularly see your doctor, it is best if it is a competent specialist in urogynecology. Here it is appropriate to cite several rules of sexual hygiene, they are also closely related to all the problems discussed.

- You can't go from anal intercourse to vaginal intercourse, from anal caresses to caresses in the vagina.

- Try to use the toilet before and after each intercourse.

- Try to have a regular sex life without episodes of prolonged abstinence and, on the contrary, excessive activity.

Never forget about contraception and STD prevention. It is best to combine a condom with an antiseptic or spermicide. Don't forget that STDs are transmitted through both oral and anal sex!

- Even if there is no reason, you should visit a gynecologist and be checked for STDs every six months.

And finally, get enough sleep, walk more often in the fresh air, eat more fruits and exercise.

Cystitis symptoms, treatment and even prevention. I am perfectly aware that no normal person will scrupulously follow each of the rules given here. But at least now you know which direction to take. Do not get sick, and if anything - contact me, I will always try to help. Good luck!