Acute cystitis is one of the most common infections in which a purulent-inflammatory process affects the bladder mucosa. Women are susceptible to the disease. According to medical statistics, every second woman has experienced this disease during her life, and every third woman under the age of 24 years. At the same time, more than half of the sick do not go to medical institutions, but prefer to be treated at home.
The main cause of acute cystitis, the symptoms of which are difficult to confuse with other diseases, is the penetration of pathogenic microorganisms.
The main causative agents of infection:
- coli or Escherichia coli - causes infection in 80-90% of cases;
- proteus - it accounts for about 7%;
- Klebsiella - 3-4%;
- staphylococci - 3%.
Acute cystitis in women is caused in most cases by one type of microorganism. In a complex form of the disease, several types of pathogens are diagnosed at once.
In some patients, the cause of the disease are viruses, fungi and microflora that cause sexual infections (chlamydia, mycoplasmas).
The infectious agent attaches to the bladder mucosa, then penetrates into its cells and begins to destroy them. The rate of development of inflammation depends on how quickly a colony of pathogens grows.
The natural flow of urine is able to wash out the microorganisms that have penetrated into it from the bladder. However, if they managed to stick to the walls, urine will no longer wash them away.
Provoking factors
The microflora penetrates the bladder, multiplies there and causes inflammation under the influence of the following factors (one or more):
- Anatomical structure.
In 95% of cases, infectious agents enter the bladder, rising from the anus. It is there that the greatest accumulation of various microorganisms. The female urethra (urethra) is short and wide (unlike the male), and its ending is in close proximity to the anal area and vagina. For this reason, it is not difficult for microflora to penetrate the urethra and rise higher into the bladder. And this explains the fact that inflammation occurs predominantly in women than in men. However, in some cases, the infection can also penetrate from the kidneys and other neighboring organs, where there are foci of inflammation.
- The presence of concomitant diseases and especially sexually transmitted infections.
Very often, a urinary infection is adjacent to candidiasis (thrush), bacterial vaginosis, and colpitis. With these gynecological diseases, the balance of the vaginal microflora is disturbed in the direction of an increase in the number of pathogenic microorganisms.
- instrumental intervention.
Examination with instruments, installation of a catheter, the presence of an implant.
- hereditary predisposition.
The bladder has a protective layer that is able to secrete special substances that prevent bacteria from attaching. In some cases, they are produced in smaller quantities, and such a violation can be inherited.
- Features of behavior and sexual life.
Non-compliance with the rules of personal hygiene, lack of urination after sex, frequent sexual intercourse, the use of vibrators, wearing thongs - urologists assign one of the paramount values to these factors in the development of the disease.
Classification
Acute cystitis in women is an uncomplicated lower urinary tract infection. It occurs when there are no concomitant diseases, malfunctions of the kidneys, and when the bladder is functioning normally.
Inflammation can affect the entire mucosa of the bladder (total cystitis) or parts of it (cervical, trigonitis). By the nature of the inflammation, the catarrhal form is distinguished when the mucous membrane is edematous and filled with blood. Cystitis with blood in women, which is called hemorrhagic, develops when red blood cells enter the urine. In this case, the blood in the urine is visible to the naked eye.
Antibiotic therapy
The effectiveness of etiotropic therapy for acute cystitis depends primarily on the right antibiotic. Preference is given to drugs designed for short courses of treatment - up to 3 days and excreted mainly in the urine:
- such therapy is more effective;
- there are fewer side effects from antibiotics;
- microorganisms do not have time to develop resistance;
- the cost of treatment is reduced.
Read also: Exacerbation of cystitis during menstruation: causes and treatment
Treatment of acute cystitis is primarily carried out with the following types of antibiotics:
- Monural (the main substance is fosfomycin);
- Furamag, Furagin (furazidin), Furadonin (nitrofurantoin).
These medicines are only for the treatment of urinary tract infections. They are effective against all major pathogens and microorganisms do not develop resistance to them. Drugs are concentrated directly in the urine and do not penetrate (or penetrate in minimal doses) into the tissues.
Benefits of Monural:
- It is taken once (3 gr.).
- The active substance is concentrated in the urine for about 80 hours. This is enough to have a detrimental effect on microorganisms.
- Minimum adverse reactions.
- Allowed for pregnant women.
Treatment in women with Monural can be carried out before the results of the tests as empirical therapy.
Advantages of nitrofurans:
- a narrow spectrum of action, which means the risk of developing dysbacteriosis is reduced;
- effective against most infectious agents;
- bacteria do not develop resistance to them;
- the most inexpensive medicines for cystitis.
The disadvantages of this group is that all drugs have a toxic effect on the body. This may be manifested by adverse reactions (nausea, dizziness, abdominal pain). However, this property is more pronounced with long-term therapy of chronic inflammation.
If for some reason it is impossible to take these drugs, other groups of antibacterial agents are used:
- Fluoroquinolones: Levofloxacin, Ofloxacin, Ciprofloxacin.
- Beta-lactam antibiotics: Cefixime, Cefuroxime, Ceftibuten. Amoxicillin + Clavulanic acid.
- III generation cephalosporins (Ceforal Solutab).
The spectrum of action of fluoroquinolones is quite wide. However, the resistance of microorganisms to them is increasing. Therefore, from acute cystitis in women, drugs of this group are practically not used. They are used to treat complicated forms, in particular hemorrhagic inflammation. Fluoroquinolones are also used when women have not been treated for the first few days, and microorganisms have managed to infiltrate the deep layers of the bladder walls.
3rd generation cephalosporins are active against Escherichia coli, maintain a high concentration of the active substance in the urine, therefore, in some cases they are also used in therapy. One of the drugs is Ceforal Solutab. Its advantage lies in the fact that it is taken once a day. Ceforal is allowed for pregnant women starting from the 2nd trimester.
Clinical recommendations for taking this drug: 400 mg 1 time per day for 3 days. This is for women not exposed to risk factors (see above). Acute cystitis in women exposed to risk factors is treated with a long course of 7 days.
Outdated drugs
The list of antibiotics used to treat urinary infections is reviewed annually. This is due to the fact that microorganisms develop resistance to them. Once effective drugs are no longer first-line drugs. These funds include:
- Ampicillin;
- Trimethoprim;
- Co-trimoxazole (Bactrim, Biseptol);
- Nitroxoline (5-NOC).
The resistance of Escherichia coli and to Ciprofloxacin increases. Many doctors, especially abroad, consider its use unsafe. These drugs are used to treat complicated forms of the disease, but not as empiric drugs (until a specific pathogen is identified).
Phytotherapy
Treatment of acute cystitis is also carried out with the help of herbal remedies that have anti-inflammatory and diuretic properties. These are herbal tablets, fees, drops and infusions.
- bearberry;
- horsetail;
- St. John's wort;
- goldenrod;
- lingonberry leaves;
- chamomile, etc.
Nettle, strawberry leaves, horsetail have a hemostatic effect and are used in cases where a hemorrhagic form of the disease is diagnosed.
Of herbal preparations, Phytolysin is widely used, which is available in the form of a paste for dissolution in water.
Chronic cystitis detected more by laboratory parameters. Outwardly or subjectively, the patient may not present any complaints. However, laboratory blood and urine tests indicate the presence of an infection in the lower urinary tract. At any time, chronic cystitis can worsen, and all the signs of acute cystitis will appear.
According to the causal factor, one can distinguish
Non-specific- which are caused by conditionally pathogenic microflora (enterobacteria, candida, staphylococcus, proteus, klebsiella).
Specific- caused by sexually transmitted diseases (chlamydia, ureaplasmosis, syphilis) or tuberculosis.
Symptoms of acute cystitis
Some of the main symptoms of a bladder infection are:Pain during urination that gets worse at the end of bladder emptying
frequent urination more than 6 times a day
feeling of incomplete emptying of the bladder after urination
general weakness
temperature rise
pain in the lower abdomen
women of childbearing age may also experience menstrual irregularities
Change in color of urine. It becomes cloudy, in some cases, at the end of urination, a small amount of blood may be released.
There may be purulent discharge from the urethra when urinating
Modern diagnosis of cystitis
The diagnosis of any disease begins with the patient's own observations of his condition. At this stage, we begin to notice a distinctly affected organ and pay increased attention to it. Still, not running to the toilet every 15-30 minutes, painful urination, and even in some cases with blood. How can you not pay attention to your own health? Naturally, these symptoms of a sick person are forced to seek help from a doctor. When you go to the doctor, you will be subjected to an “inquiry” on his part: what worries you, when the first symptoms appeared, whether there were similar symptoms in the past, what diseases you had in the past, etc. It is imperative to answer these questions, as the doctor asks them in order to more clearly imagine the picture of everything that happens to you.
The basis for the diagnosis of cystitis is clinical examination:
Patient examination, as a rule, does not reveal any external changes in a patient with cystitis.
Feeling the abdomen reveals soreness with pressure on the lower abdomen.
Laboratory tests for cystitis
- General blood analysis may reveal signs of non-specific inflammation, an increase in the level of leukocytes and immature forms of neutrophils, as well as an increase in the level of ESR.
- General urine analysis, as a rule, reveals the presence of protein in the urine, an increased number of white blood cells, red blood cells and bacteria. In the event that a general urinalysis revealed an increased content of leukocytes, a urine test is performed according to Nechiporenko and a three-cup test.
- Bacteriological examination of urine after a few weeks, it can help to identify the pathogen, which will allow for more targeted and effective treatment. With a bacteriological examination, it is possible to conduct an antibiogram and determine the sensitivity of the causative agent of cystitis to the main types of antibiotics. This examination will allow you to prescribe the most effective groups of drugs.
- The use of special test strips for the determination of nitrites. These special strips react to the presence of microbial waste products in the urine. Based on the results of this test, one can indirectly judge the presence of an infection in the urinary tract.
- The use of special test strips for the determination of leukocytes. In some cases, test strips are used to determine the increased concentration of leukocytes in the urine. However, the value of this method is doubtful, since the laboratory does a good job with this study by conducting a general urine test.
- Cystoscopy, as a rule, is performed in chronic cystitis, in the acute period this procedure is not only painful, but also dangerous, as it can contribute to the upward progress of the infection.
- bladder ultrasound allows you to exclude stones in the bladder, provides information about the state of the upper urinary tract and the state of the organs adjacent to the bladder. Also, ultrasound examination allows to exclude volumetric neoplasms.
Effective treatment for cystitis
In this section we are talking about acute cystitis, about the tactics of its complex treatment. Antibacterial treatment
In the treatment of acute cystitis, it is necessary first of all to limit the spread of infection, and this requires the use of antibacterial drugs. The main question in this regard is the name of the antibiotic, the duration of its administration and the course dosage. Numerous studies have shown that 3- and 7-day courses of antibiotics and antiseptics are optimal in the treatment of cystitis. Benefits in a longer course have not been identified, but the adverse effects of long-term use of antibiotics have been confirmed in all ongoing clinical studies. You need to understand that the bacteria that cause cystitis are also in constant search of ways to bypass the antibacterial action of medications. Therefore, drugs that currently give almost 100% results in the eradication of infection, in a few years will be effective only in a certain percentage of cases.
At the moment, the drugs of choice are antibiotics from the group of fluoroquinolones, fosfomycin. Unfortunately, other groups of antibiotics do not have sufficient effectiveness against the most commonly causing cystitis bacteria. In case of intolerance or contraindications to the use of drugs of choice, drugs from other groups are prescribed: cephalosporins, levomycetin, nitrofurans.
Here are some antibacterial treatment regimens:
- Monural 3 g 1 time per day - duration of treatment 3 days
- norfloxacin 400 mg twice a day - duration of treatment 3 days
- ciprofloxacin 250 mg twice a day - duration of treatment 3 days
Antimicrobials
With the proven addition of an infectious factor, it is advisable to conduct a course of therapy with antimicrobial drugs that are well excreted in the urine and act on Escherichia coli - the most common causative agent of cystitis, and these include, for example, Macmirror. It has a pronounced antibacterial effect, and is also effective against fungi and protozoa. This is important, since mixed flora can also join, and it is not always possible to detect this in time.
Anti-inflammatory and analgesic therapy
In some cases, pain in cystitis requires the use of anti-inflammatory drugs. Unpleasant sensations and pain in cystitis is associated with the damaging effect of infection in the lumen of the bladder. The toxins they release, damaging the epithelium, cause an inflammatory reaction, which at the local level is manifested by pain. At the same time, pain increases precisely under the influence of filling and emptying the bladder. Which is not surprising, because locally inflamed tissue reacts primarily to mechanical stress. However, the removal of soreness is necessary not only to increase the comfort of the patient, but also because severe soreness reflexively makes the patient drink less, and a decrease in the volume of passing urine adversely affects the dynamics of the disease.
Anti-inflammatory drugs(diclofenac, nimesil) interrupt the cascade of biochemical reactions that leads to the development of inflammation. Due to this, local swelling is reduced, and the fullness of the damaged tissue, which reduces pain.
Antispasmodic drugs- the inflammatory reaction in cystitis also extends to muscle tissue - this is associated with severe pain when the bladder is stretched (when it is filled) and exacerbation of pain when emptying. Antispasmodic drugs (No-shpa, papaverine, baralgin) reduce muscle tension, which reduces pain in the bladder.
Antispasmodic drugs can be used in the form of tablets, water-soluble powders or in the form of rectal suppositories - the effectiveness of the method of application does not change.
Phytotherapy in the treatment of cystitis
The use of herbal remedies in the treatment of this disease is aimed at increasing the daily urine produced (herbal diuretics), as well as the consumption of substances that have a bactericidal effect (infusions of bearberry, knotweed, horsetail,
celandine or cranberries, lingonberries) as part of urine. Currently, there are many industrial preparations based on plant materials (canephron,
phytolysin, cystone). These drugs have proven medicinal properties in the treatment of cystitis. However, these drugs are used only as an addition to the main drug treatment.
Stimulation of immunity in the treatment of cystitis
For effective treatment of immunodeficiency states, it is necessary to understand that immunity depends on many factors: psycho-emotional state, nutrition, human activity. All these factors affect the state of immunity. If your life is replete with stress, or during the day you have never looked away from the monitor screen, then reduced immunity is a natural consequence of an unhealthy lifestyle. Treatment should begin with the exclusion of factors unfavorable for immunity and begin to follow the following rules:
Normalize nutrition- Particular attention should be paid to the composition of the daily food consumed. You need to enrich your diet with easily digestible varieties of meat (veal, hare meat, chicken breast), eat more fresh fruits and vegetables (exclude GMO products - they only have a form and organoleptic properties that correspond to those natural, vitamins and useful substances in their composition are almost absent).
Eliminate stressful situations. If for this it is necessary to refuse work or change your housing and communal conditions, then proceed with the implementation. You can take a vacation from work and go to a well-deserved rest in a dispensary or sanatorium. In the event that neighbors, relatives or obsessive friends are the cause of constant stress, then you should change your place of residence and categorically limit communication with people who annoy you.
Active lifestyle. This is not only daily exercises, a contrast shower, classes in the fitness room, but also an active life position. Remember: "thoughts materialize." If you yourself consider yourself a sick, worthless person, then for others you will look exactly like that. However, every person has a huge potential, most of us do not know even half of the abilities and talents inherent in us. Look for yourself, learn your abilities, do not be afraid to seem funny and inquisitive - after all, curiosity is the source of eternal youth.
If you don't like the job you are currently doing, take courses (there are a lot of them now) in the specialty that you like best (photography courses, management courses, foreign language courses, computer mastery courses). It is highly likely that these courses will help you to do not only what brings money, but also what "raises work to the level of creativity" - your favorite work.
However, in the context of the treatment of acute cystitis, medication may also be needed to boost immunity. The fact is that acute cystitis with the failure of the immune response can turn into chronic, from which you will be treated not for one month, but for years. The course of this annoying form of cystitis actually causes a lot of trouble - the slightest hypothermia or a stressful situation and chronic cystitis worsens with all the consequences ...
A brief overview of a few of the currently used immunostimulants:
Viferon- a preparation containing the active substance alpha interferon. Interferon is a natural compound that is also synthesized in our body during infectious and inflammatory processes. In case of an inadequate immune response, taking this drug mobilizes the immune system and makes it work more actively.
As a rule, for cystitis, this drug is used in the form of rectal suppositories at a dosage of 500,000 IU (1 suppository) 2 times a day with an interval of 12 hours. The course of treatment is 5-10 days.
Treatment with this drug should be preceded by a personal consultation with a general practitioner or urologist. This drug has a number of absolute contraindications and a wide list of side effects. To exclude contraindications and minimize the likelihood of adverse reactions, a full examination and personal consultation of a specialist doctor is necessary.
Likopid- has a pronounced immunomodulatory effect, stimulates the activity of cells that absorb bacteria for their subsequent dissolution, and also stimulates the production of antibodies against infectious agents. In fact, the active substance of this drug is a molecule of the bacterial wall. Due to the form of antigen delivery convenient for the immune system, leukocytes easily recognize this structure and actively begin to produce antibodies, and cellular immunity is also stimulated.
The treatment regimen is selected individually depending on the indicators of peripheral blood and the dynamics of the infectious process. Here is the most commonly used treatment regimen with this drug: taking 10 mg 1 time per day, the duration of treatment is 10 days.
Treatment is prescribed by the attending urologist or gynecologist in an individual combination with other drugs.
Uro-Vaksom- this preparation is a lyophilizate of 18 species of the most common E. Coli bacteria. The fact is that 80% of all cystitis is caused by this particular intestinal bacterium. Therefore, the introduction of this drug allows the immune system to form an adequate immune response as soon as possible. This drug causes the body to produce its own interferon, which stimulates the entire immune system. There is also an active training of special immune cells (T lymphocytes) on the spot to destroy E. Coli. It is also important to stimulate the production of special surface antibodies IgA. These antibodies are located on the surface of the epithelium of the mucous membranes of the urinary tract and prevent the ascending penetration of the infection along the urinary tract.
Prevention of cystitis
In order to prevent the development of cystitis or to prevent its recurrence, it is necessary to follow the recommendations below. It is worth noting that compliance with these recommendations cannot 100% save you from this disease, however, it is possible to minimize the likelihood of this pathology. - As part of hygiene, wash your face at least once a day. Optimal for achieving cleanliness in the vulva area is washing at least 2 times a day using soap (preferably using baby soap that does not contain fragrances and baptizers) and running water.
- Make sure that your sexual partner also follows the basic hygiene rules for the hygiene of the external genital organs - daily washing will help with this.
- Before each sexual contact and after it, it is necessary to wash with soap. This rule applies to both sexual partners.
- It is worth excluding oral secession if there are such pathologies as: stomatitis, angina, oral candidiasis and other infections in the oral cavity. The reason for this recommendation is clear - with saliva it is possible to infect the external genital organs and the urethra.
- Dress for the weather. An extravagant miniskirt for cold weather can cost you years of fighting chronic recurrent cystitis. However, cystitis is not the worst of the pathologies caused by hypothermia - the development of an inflammatory process in all organs of the pelvis is possible, and this threatens with infertility and many years of trips to gynecologists in the hope of recovery.
- Monitor the state of your own immunity - frequent colds may indicate its poor condition. The measures taken to restore it are described in the corresponding chapter of the article.
- Do not restrain yourself when you want to go "a little". Prolonged retention of urine in the bladder contributes to the development of infection.
- Fluid intake should be optimal, in the hot season it should increase by at least 1-1.5 liters.
- If possible, women are encouraged to change tampons to pads. The fact is that tampons can mechanically squeeze the urethra and be a source of infection in the immediate vicinity of the external opening of the urethra.
- Men can only be advised to change their underwear daily. This measure will minimize the likelihood of developing non-specific urethritis.
- After visiting the toilet, it is advisable to wipe in the direction from front to back, and not vice versa. The reason for this tactic of wiping is clear - when wiping from back to front, intestinal bacteria are carried to the external genital organs, which contributes to their penetration into the urethra.
How to treat cystitis during early pregnancy?
cystitis during pregnancy- a fairly common phenomenon that not only presents discomfort for a woman, but is also dangerous for its complications in relation to the kidneys, that is, the development pyelonephritis . Pregnancy is always a big burden on the kidneys, because they work for two, and they also remove a large number of immune complexes, especially when mother and child are incompatible by blood type or Rh factor. Inflammation of the kidneys can lead to severe pregnancy with a threat to the life of mother and baby, this is kidney failure, preeclampsia or late preeclampsia (high blood pressure, edema, protein in the urine) and eclampsia (manifested by convulsions and loss of consciousness, requires immediate caesarean section).
So, every tenth woman
during pregnancy feels all the delights of cystitis.
Why is such a pleasant period for any woman so often gloomy due to cystitis? And everything is explained physiological changes in a woman during an interesting position:
- compression of the bladder by an enlarged uterus;
- influence of progesterone , the main hormone of pregnancy, on the contractility of the bladder, which reduces the tone of its walls;
- ascending infection from the vagina, associated with a change in its microflora (the norm for pregnancy);
- reduced immunity, characteristic of all expectant mothers.
Regimen for cystitis during pregnancy:
- contact a urologist;
- do not risk self-medication and folk methods, because even many herbs can harm the baby, especially in early pregnancy, and increase the tone of the uterus;
- observe bed rest;
- strictly avoid hypothermia and contact with patients with acute respiratory viral infections, influenza and other infectious diseases;
- follow a diet with the exception of spicy, salty, fried and fatty foods;
- it is necessary to consume a sufficient amount of fruits and berries (according to the season, cranberries, watermelons, cherries, cherries, strawberries, citrus fruits, and so on);
- it is necessary to drink a sufficient amount of liquid (water, juices, fruit drinks), carbonated, especially sweet drinks are contraindicated;
- cranberry juice and rosehip broth are good remedies that enhance the treatment and prevention of cystitis;
- visit the toilet in a timely manner, do not endure;
- observe the hygiene of intimate places;
- do not wear tight underwear;
- Strictly adhere to the doctor's recommendations and treatment regimens.
Treatment regimens for cystitis in early pregnancy1. Antibacterial drugs:
- Monural(urinary tract antiseptic) - not recommended during pregnancy for periods of less than 12 weeks (an antiseptic is only possible in severe cases of the disease), after 12 weeks, monural can be used once at 3 g (1 capsule) between meals and immediately after emptying urinary.
- Amoxicillin(Flemoxin, Ospamox, Amosin) - an antibiotic of the penicillin series, a wide spectrum of activity. Apply 500 mg 3 times a day (every 8 hours), for at least 5 days.
- Suprax(an antibiotic of the cephalosporin series) - 200 mg 2 times a day (every 12 hours), for at least 5 days.
When deciding on the appointment of antibiotics, you always need to weigh the pros and cons, that is, the risks of developing complications of the disease and the occurrence of side effects from taking the drug.
2. Herbal preparations:
- Kanefron-N - 2 tab. 3 times a day, the course of treatment is from 2 weeks;
- Urolesan - 8 drops 3 times a day, the course of treatment is an average of 2 weeks;
- Cyston - 2 tab. 3 times a day after meals, the course of treatment is from 2 months.
What is contraindicated in early pregnancy in the treatment of cystitis?
- the use of most antibiotics, except for the above, is dangerous for the development of developmental anomalies in the fetus; fluoroquinolones (ofloxacin, norfloxacin), tetracycline, aminoglycosides (amikacin, gentamicin) are especially contraindicated;
- carry out instillations (introduction of antibacterial drugs directly into the bladder), can lead to miscarriages;
- taking non-steroidal anti-inflammatory drugs (Nimesil, diclofenac, Analgin, and so on) can lead to severe pathologies in the baby;
- the use of physical therapy can lead to miscarriage;
- take hot baths (and, of course, saunas, baths and other types of overheating), high temperatures can provoke uterine hypertonicity.
How to treat cystitis during late pregnancy?
The principles of treatment of cystitis in the second half of pregnancy are very similar to those in the early stages. But the risk of developing fetal pathology associated with therapeutic measures after 20 weeks of pregnancy is much lower. By this time, the baby has already formed the main organs, tissues and systems, they continue to mature and develop. But the risk of developing cystitis itself and its complications during this period becomes higher.Therefore, some drugs and procedures that are prohibited in the early stages can be used in the second half of pregnancy, but the decision on their appointment is made only by a specialist doctor, should be balanced taking into account the risks in case of treatment and without it.
Principles of home treatment of cystitis:
- taking medications for oral use (tablets, decoctions, suspensions, drops, and others), injections and instillations of the bladder are not recommended at home;
- compliance with standard treatment regimens for cystitis, preferably recommended by a doctor after a detailed objective, laboratory and instrumental examination;
- observance of the regime of the day, nutrition, drinking plenty of water, personal hygiene;
- combination of drug therapy with traditional medicine methods;
- use of thermal procedures in the bladder area, prevention of hypothermia, putting on warm clothes, drinking warm drinks.
- antibiotic and / or antiseptic of the urinary tract;
- antispasmodic;
- anti-inflammatory drug;
- immunostimulant;
- herbal preparations.
Some methods of traditional medicine:1. Warm baths with decoctions of herbs (sage, chamomile, succession, celandine, St. treated with disinfectants and given with boiling water. The bath is taken for at least 10 minutes (until the water cools) several times a day.
2. Tinctures that increase immune strength : eleutherococcus, ginseng, echinacea and other tinctures, sold in pharmacies ready-made. A mixture of various tinctures in equal proportions is also effective.
3. Decoction of a mixture of plants : dill, parsley, thyme and St. John's wort in equal proportions. Pour 1 large spoon with 1 cup of boiling water, let it brew. Recommended 1/3 cup of decoction 3 times a day. The course of treatment is several weeks.
4.
Complex collection:
lingonberry leaves (2 measures), St. John's wort (1 measure), rose hips (3 measures), echinacea (1 measure), eucalyptus (1 measure), meadowsweet (2 measures) - mix. The mixture is poured with boiling water and insisted. Recommended 1/3 cup of decoction 3 times a day. The course of treatment is several weeks. 
5.
kidney fee
(ready form in a pharmacy) 2 large spoons pour 300 ml of boiling water, let it brew for 1.5 hours. The course of treatment is 7-10.
It must be remembered that any herbs cannot be used for a long time, since the body gets used to them, it is necessary to regularly change the types of herbal preparations used.
And most importantly, you should not stop treatment (especially with antibacterial agents) after the first improvement, any treatment must be completed with a minimum course to the end, otherwise rapid relapses of the disease may develop and resistance of the pathogen to antibiotics may develop.
Therefore, drugs that currently give almost 100% results in the eradication of infection, in a few years will be effective only in a certain percentage of cases.
In most cases, chronic forms of inflammatory diseases of the urogenital area are the result of an unprofessional approach to therapy. The disease cannot be eliminated if the symptoms and treatment of cystitis in women do not match. The drugs that television advertising imposes bring only temporary relief, and after a certain time the disease returns again.
The only way to get rid of cystitis is to establish the cause of the disease and undergo a full course of treatment under the supervision of a professional urologist.
In medicine, the concept of "cystitis" combines several types of symptomatic urinary pathologies, in which the mucosa of the bladder is damaged. Due to the anatomical features of the body, women suffer from cystitis several times more often than men.
The work of the bladder is associated with all physiological systems, therefore, functional deviations in the internal organs, one way or another, affect the health of the urogenital sphere of a woman.
The development of the inflammatory process may be preceded by:
- viral or bacterial infections - flu, tonsillitis, sinusitis, staphylococcus, Trichomonas, Escherichia coli, caries, furunculosis;
- hypothermia;
- allergic reaction;
- hormonal changes during menstruation, pregnancy, menopause;
- acquired diseases - diabetes mellitus, colitis, spinal injuries, nephrological and endocrine pathologies, tumor formations;
- taking medications;
- decreased immunity;
- anomaly in the development of the organs of the genitourinary system;
- insufficient hygiene of the genital organs;
- acute forms of cystitis most often occur against the background of congestion in the urinary system.
The pathways of penetration of pathogenic microorganisms into the bladder also differ. In diseases of the ENT organs, the infection spreads throughout the body through the blood. In diseases of the gastrointestinal tract, microbes enter the genitourinary organs from the anus. Due to nephrological pathologies, infectious agents move from the kidneys along with urine.
Factors contributing to the development of cystitis include wearing tight synthetic underwear, a tendency to constipation, frequent changes of sexual partners, subject to unprotected sex, as well as conditions that reduce the potential of the immune system - stress, lack of sleep, excessive exercise, irregular meals.
The main symptoms and signs of the disease
The development of cystitis can be acute or with gradually increasing symptoms. The characteristic signs of cystitis in acute form are cramps and pain when urinating.
But as the disease progresses, symptoms such as:
- discomfort in the genital area and pubic area;
- itching and burning in the perineum - the result of irritating effects of toxic substances accumulated in the urine;
- frequent urge to urinate;
- pain in the lower abdomen and back, a feeling of fullness;
- headache;
- increased fatigue;
- slight increase in body temperature;
- cloudy urine;
- a strong unpleasant smell of urine;
- feeling of incomplete emptying of the bladder;
- the appearance of blood in the urine may indicate the development of complications.
Cystitis of an allergic or infectious nature in 95% of cases is accompanied by itching.
Complications of the disease
Due to the high prevalence (pathology is diagnosed in 40% of women in the world), the severity of the consequences of cystitis is often underestimated.
With proper treatment, provided there are no causes supporting the course of the pathology, the symptoms of acute cystitis go away, and the woman's well-being improves markedly. If the necessary therapeutic effect is absent, the disease acquires a chronic form of the course, which is fraught with serious health complications.
Chronic cystitis is characterized by damage to most of the bladder mucosa. At the same time, edema and thickening appear in the affected areas, against the background of a decrease in the elasticity of the epithelium.
The progress of the pathological process leads to complications that threaten the health of vital organs and systems:
- in 95% of cases, kidney disease occurs - pyelonephritis, renal failure;
- organic change in the tissues of the bladder is fraught with rupture of its walls and the development of peritonitis;
- frequent inflammation is one of the main reasons for the formation of adhesions;
- decrease in reproductive function, the danger of a complete loss of the ability to bear children;
- urethritis;
- tumor processes;
- the formation of ulcers on the walls of the bladder, bleeding;
- urolithiasis disease;
- muscle damage and loss of tone of the tissues of the bladder, which leads to its dysfunction and urinary incontinence.
In a woman's body during her life, there are periods when a predisposition to the development of cystitis is associated with natural physiological changes.
Periods of vulnerability to cystitis in a woman's life
The first critical period occurs before the age of three. At this age, children with congenital pathologies of the urinary tract may develop vesicoureteral reflux, in which urine returns from the bladder back to the kidneys. The consequence of the pathology is vulvovaginitis and ascending infection of the bladder.
Puberty is the second period in a woman's life, which is important in terms of the degree of predisposition to cystitis. In addition to the hormonal changes inherent in puberty, the risk of infection during unprotected sex is added.
Menopause is manifested not only in a decrease in the hormonal level in the female body, but also in a drop in the protective properties of the bladder mucosa, as well as in a change in its anatomical position. All these changes contribute to the development of inflammation of the urinary tract and other pathologies inherent in cystitis.
Diagnostic measures
A medical examination of patients with suspected cystitis involves not only confirming the diagnosis, but also determining the underlying disease that provoked inflammation of the bladder mucosa.
Along with the study of anamnestic data and symptoms of the disease, urologists use the following diagnostic measures:
- general urine analysis;
- general blood analysis;
- cystoscopy - examination of the bladder through an endoscope;
- analysis of the composition of the microflora of the vagina;
- Ultrasound of the genitourinary system;
- PCR - method of molecular research;
- bacterial culture of urine.
In some cases, doctors use information obtained by biopsy, a microscopic examination of samples of affected tissues, to make a diagnosis.
Medicines for the full course of treatment of the disease
Treatment of cystitis is to eliminate not only the inflammation of the bladder mucosa, but also the diseases that support them. The choice of therapeutic methods and means depends on the form of the disease and associated pathological processes.
To stop the symptoms of an acute form of cystitis, the patient is prescribed bed rest, a special diet, heating pads, as well as antispasmodic, antibacterial and diuretic drugs.
The minimum course of treatment for acute cystitis is 7 days. An interrupted course of treatment is one of the main reasons for the development of a chronic form of cystitis.
Antibacterial drugs
The appointment of antibacterial drugs is appropriate for cystitis, the causative agent of which is bacteria.
Among the most effective antibacterial agents:
- Monural- an antibiotic based on fosfomycin. Produced in the form of granules. It is taken once in the acute form of cystitis;
- Palin- pills for cystitis and other acute or chronic infections of the urinary system. Belongs to the group of quinolones. The active substance is pipemidic acid;
- Furagin- a popular antibiotic based on nitrofuran. It is relevant when exposed to bacteria, the sensitivity of which in Furagin has been proven by sowing;
- Nolicin (analogues of Norbaktin, Normaks)- an antibiotic preparation of a reserve. It is prescribed if the use of other drugs has not provided a therapeutic effect. The active substance is norfloxacin from the group of fluoroquinols;
- Nitroxoline- a medicine from the group of oxyquinolines. It is active against most bacteria and Candida fungi;
- Furadonin- an antimicrobial agent that suppresses the activity of bacterial infections. The use of tablets is also appropriate as a prophylactic for urinary tract diseases.
Taking any antibacterial drugs is possible only as directed by a doctor. Despite the high therapeutic efficacy, modern drugs have many contraindications and can cause unwanted side reactions.
Antispasmodics
Means with antispasmodic properties are an indispensable component of restorative and maintenance therapy for cystitis.
The most popular antispasmodics are: No-Shpa, Papaverine, Drotaverine. The action of antispasmodic drugs is expressed in the elimination of spasm of the smooth muscles of the bladder and the effect of relaxation, relieving pain.
Taking antispasmodics is appropriate both for acute forms of cystitis and for relapses of chronic infections.
Anti-inflammatory pills
To relieve inflammation of the bladder mucosa with cystitis, it is recommended to take non-steroidal anti-inflammatory drugs (NSAIDs) - Ibuprofen, Nurofen, Diclofenac, Nemesil. Along with the elimination of inflammatory processes, the drugs of this group provide an analgesic effect, relieving pain and discomfort inherent in the pathology.
Phytopreparations
The use of phytopreparations is an effective way to enhance the impact of drug therapy. Herbal remedies are based on natural plant components with biological activity.
Urolesan- an agent that provides antiseptic, antispasmodic and diuretic action. Available in the form of capsules, syrup or drops.
cystone- tablets based on extracts from plants with nephrolitic and antimicrobial properties.
Phytolysin- paste based on orange and fir oils. It has a diuretic, anti-inflammatory and antispasmodic effect. Prevents the development of urolithiasis.
Reception of phytopreparations is most effective in the initial stage of the development of cystitis.
Probiotics
As a result of exposure to infectious microorganisms, and after taking antibiotics, there may be a decrease in the activity of beneficial microflora.
To maintain the natural physiological level of the microflora of the mucous membranes of the intestines and genital organs, it is necessary to use probiotics - food supplements containing live cultures of microorganisms.
Among the popular probiotic products are Linex, Hilak Forte and Bifiform.
Treatment of the chronic form of the disease
To get rid of the chronic form of the disease, it is necessary to diagnose all potential foci of infection and provide complex therapy that suppresses the vital activity of pathogens and its consequences.
The main methods of treatment of chronic cystitis:
- etiological therapy is aimed at eliminating the causative agent of infection and consists in taking antibacterial drugs;
- pathogenetic therapy allows you to restore the functions of the immune system, normalize the hormonal background and eliminate the structural pathologies of the internal organs. The main objectives of therapy are the restoration of the natural outflow of urine and the elimination of all possible foci of infection. Treatment involves taking immunomodulatory and anti-inflammatory drugs, and in some cases, surgical correction;
- disease prevention - a set of measures that prevent the possibility of recurrence of infection.
As additional therapeutic measures, physiotherapy is prescribed - electrophoresis, electrical stimulation of tissues, laser exposure, as well as special exercises that normalize blood circulation in the pelvic organs.
Folk remedies for cystitis in women
The list of folk remedies recommended for the treatment of cystitis includes well-known and affordable herbal remedies: a decoction of dill seeds, millet infusion, teas, infusions and baths from pharmaceutical chamomile, parsley seed infusion, and St. John's wort teas.
In addition, lingonberry leaves and cranberries are considered an invariable component of the home treatment of cystitis.
Due to the unique composition, lingonberry leaf provides a complex therapeutic effect on the organs of the genitourinary sphere - antimicrobial, diuretic and anti-inflammatory. Cowberry leaf tea is prepared according to the recipe for making ordinary tea leaves. I take this tea three times a day for half a glass.
The use of cranberry-based drinks provides a powerful healing effect.
Thanks to cranberry proanthocyanidins, berry tea:
- suppresses vital activity of pathogenic microorganisms;
- prevents the sedimentation of pathogens on the walls of the organs of the urinary system;
- relieves inflammation;
- protects the body from fungi and microbes;
- enhances the elasticity of blood vessels;
- has an immunomodulatory effect.
For the preparation of a healing drink, fresh or frozen sticks are used. The berries are crushed, poured with boiled water and kept in a steam bath for 10 minutes. Two cups of a drink a day with the addition of honey will improve well-being and health in record time.
Nutrition and microflora
Proper nutrition during the treatment of cystitis is of particular importance. It depends on what types of products will be present in the diet, how quickly it will be possible to remove inflammation and start the restoration of damaged bladder tissues.
In addition, a properly organized diet maintains the functionality of the microflora that lives on the mucous membranes of the internal organs. This ensures the elimination and withdrawal of pathogenic microorganisms, as well as the normalization of recovery processes.
The therapeutic diet is based on specially selected products and drinking regimen.
It is extremely important that nutrition is in line with the following principles:
- all consumed products must have diuretic properties;
- the amount of salt consumed should be reduced to a minimum;
- exclude the menu of spicy, fatty, fried, smoked, sweet and dairy dishes, as well as preservation;
- limit the intake of foods containing protein;
- when cooking, you should limit yourself to minimal heat treatment;
- strong drinks and alcohol are completely excluded;
- the total volume of liquid drunk per day is at least two liters.
From drinks, preference should be given to herbal teas and fruit drinks from cranberries and lingonberries.
Prevention of cystitis
The predisposition to the disease remains throughout the life of a woman who has had cystitis at least once.
Preventive measures will help prevent recurrence:
- timely treatment of any ailments;
- minimizing stress;
- compliance with the rules of personal hygiene;
- taking a shower is preferable to a bath;
- regular visits to the gynecologist and urologist, testing;
- compliance with the drinking regime.
In the summer, it is important not to miss the opportunity to flush the kidneys and bladder by eating more watermelons.
And most importantly, you should not sacrifice health for beauty and always dress according to the weather, especially in spring and autumn - their warmth is deceptive, and the risk of getting sick is too high.
Acute cystitis is an inflammatory process of mainly infectious origin, localized in the mucous membrane of the bladder and clinically manifested by frequent and painful urination, subfebrile temperature, the appearance of blood or pus in the urine.
Acute cystitis is one of the most common urological diseases.
Acute cystitis is an inflammation of the lining of the bladder
Causes and risk factors
The infection enters the bladder mainly by ascending (through the urethra) or descending (from the kidneys) route. Much less often, pathogenic microorganisms enter the bladder by the hematogenous route, that is, they are brought in with the blood flow from the source of the primary infection, or by contact through the bladder wall.
Against the background of the inflammatory process, the blood vessels of the bladder wall expand, and their permeability increases. The mucous membrane becomes hyperemic and swells. Subsequently, in the focus of inflammation, sweating of red blood cells occurs, which leads to hemorrhagic phenomena. In a severe form of the disease, inflammation can also capture the deeper layers of the bladder.
Most often, the development of acute cystitis leads to gram-negative microbial flora (E. coli, Klebsiella, Proteus). Gram-positive microorganisms (staphylococcus, proteus), as well as microbial associations, cause inflammation in about 20% of cases.
Predisposing factors for the development of acute cystitis are parainfluenza, herpetic and adenovirus infection, which cause disturbances in the innervation and blood supply of the bladder wall, which creates favorable conditions for the development of bacterial flora.
Normally, the human urinary tract is constantly cleansed by the flow of urine. In addition, uroepithelial cells synthesize a special substance of mucopolysaccharide nature, which covers the inner surface of the bladder, thereby protecting it from infection. The production of a protective substance is regulated, among other things, by female sex hormones - progesterone and estrogen. It is in connection with the change in the level of these hormones in women that acute cystitis is more common in the postmenopausal period.
Any damage to the protective mucous layer creates prerequisites for the development of acute cystitis. Such damage can be caused by:
- injuries of the inner layer of the bladder (ureteroscopy, cystoscopy, catheterization of the bladder);
- violations of urodynamics, i.e., the correct flow of urine (neurogenic bladder);
- metabolic diseases, accompanied by the development of crystalluria;
- exposure to ionizing radiation, aggressive chemical and toxic substances;
- decrease in general and local immunity due to frequent viral infections, hypovitaminosis conditions.
In girls and women, acute cystitis most often develops against the background of vaginal dysbacteriosis (dysbiosis) or as a result of a violation of personal hygiene rules. The development of acute cystitis in men and boys is often associated with the presence of anatomical and functional pathology (phimosis, urethral stenosis, neurogenic dysfunction, diverticulum or bladder neck stenosis).
An important role in the pathological mechanism of the development of the disease is played by stagnation of blood in the small pelvis.
With a predisposition to acute cystitis, it is recommended to introduce cranberry juice into the daily diet, since cranberries contain benzoic acid, an antiseptic that is excreted in the urine.
Forms of the disease
In accordance with the clinical picture, catarrhal and hemorrhagic acute cystitis are isolated. The hemorrhagic form of the disease is characterized by micro- or macrohematuria (admixture of blood in the urine).
According to the degree of spread of the inflammatory process:
- focal (trigonitis, cervical);
- total (diffuse).
Depending on the type of pathogen:
- specific (tuberculous, gonorrheal, chlamydial, trichomonas);
- nonspecific.
The risk of developing specific acute cystitis in men and women increases with an active sexual life with a frequent change of sexual partners.
Symptoms of acute cystitis
The clinical picture of acute cystitis is very bright, it is characterized by:
- imperative (suddenly arising, strongest, often with the impossibility of restraint) urge to urinate;
- urine output (miction) in small portions;
- pain and cramps that occur at the end of the act of urination;
- terminal hematuria (an admixture of blood that appears in the urine at the end of urination);
- change in the transparency and color of urine (cloudy, sometimes with a reddish tinge);
- pain, sometimes very intense, in the bladder, anus, perineum.
In acute cystitis, the urge to urinate occurs even when a small amount of urine (less than 150 ml) has accumulated in the bladder, which is due to reflex contraction of the detrusor. The frequency of urination is determined by the severity of the inflammatory process and can reach up to 3-4 times per hour.
Symptoms of acute cystitis in the localization of the pathological process in the region of the bladder neck:
- acute constant pain radiating to the head of the penis, anus;
- acute reflex urinary retention due to spasm of the pelvic floor muscles and the external sphincter under the influence of intense pain irritation.
Diagnostics
Diagnosis of acute cystitis is based on the characteristic clinical manifestations of the disease. The diagnosis is confirmed by the results of laboratory and instrumental examination, including:
- general urinalysis (characterized by bacteriuria, leukocyturia, erythrocyturia, a significant amount of mucus and squamous epithelial cells);
- bacteriological examination of urine - allows you to identify the causative agent of the disease, as well as determine its sensitivity to antibacterial drugs;
- a general blood test (with an uncomplicated course of acute cystitis, changes are usually not detected, the analysis is carried out in order to determine the general state of health and detect possible comorbidities);
- Ultrasound of the bladder against the background of physiological filling (an echo-negative suspension is found in the cavity of the bladder, thickening of the inner walls of the organ);
- urodynamic examination (performed with complicated acute cystitis and aimed at identifying possible neurogenic dysfunction of the bladder);
- study of prostate secretion, bacteriological culture of discharge from the urethra, ultrasound of the prostate gland (with acute cystitis in men).
- gynecological examination, microscopy and bacteriological examination of discharge from the vagina, urethra and cervical canal, PCR studies for sexually transmitted diseases (with acute cystitis in women).
Acute cystitis is one of the most common urological diseases.
After the acute inflammatory process subsides, cystography and cystoscopy are performed to clarify the cause of the disease.
Acute cystitis requires differential diagnosis with urolithiasis and bladder tumors, acute paraproctitis, acute appendicitis, acute pyelonephritis.
Treatment of acute cystitis
In acute cystitis, the patient is prescribed bed rest, a sparing milk-vegetarian diet and plenty of fluids (2.5-3 liters of fluid per day). Sexual life is excluded for the entire period of therapy. For the success of the treatment, it is important to achieve daily bowel movements.
In the treatment of acute cystitis, local thermal procedures are widely used (warm sitz baths with herbal decoctions, dry heat on the bladder area), which help to reduce the symptoms of the disease. However, hot baths and bladder lavages in the acute phase are strictly contraindicated.
Drug treatment of acute cystitis consists in the use of antibacterial, uroseptic, antihistamines and painkillers. Antibacterial drugs are prescribed taking into account the type of pathogen and its sensitivity to antibiotics. Until the results of bacteriological examination are obtained, broad-spectrum antibiotics are used, which are mainly excreted in the urine, as well as nitrofuran preparations. For example, Macmirror - its active ingredient, nifuratel, has a pronounced antibacterial effect, and is also effective against fungi and protozoa. In the treatment of cystitis, especially recurrent, a single use of an antibiotic is not enough, since pathogenic microorganisms quickly develop resistance. For example, the intestinal bacterium e. coli most often responsible for the exacerbation of cystitis has become resistant to many types of antibiotics. As a result, the dosage of antibiotics has to be constantly increased. Macmirror belongs to the category of antimicrobial agents with antibacterial, antifungal and antiprotozoal effects, and microbes have practically no resistance to it.
In case of recurrent cystitis, an examination by a gynecologist is recommended and, if vaginitis, bacterial vaginosis is detected, Macmirror Complex vaginal capsules are used topically together with an antimicrobial drug inside. This increases the efficiency and speed of healing.
And the fact that untreated gynecological infections can affect the frequency of relapses of cystitis is a fact proven in medicine.
For uncomplicated acute cystitis in adults, Monural or fluoroquinolones (Ciprofloxacin, Norfloxacin) are used, and in children, nalidixic acid, cephalosporins (Ceftibuten, Cefaclor, Cefuroxime) or Ampiox. The choice of antibiotic is strictly the attending physician. Antibacterial therapy continues for 7-10 days.
The treatment regimen for acute cystitis can be supplemented by taking herbal remedies. Pharmaceutical collections from medicinal herbs with anti-inflammatory, antiseptic, tanning and diuretic effects are recommended.
After the relief of symptoms of acute cystitis, physiotherapeutic procedures are prescribed (induction, UHF, electrophoresis, magnetic and / or laser therapy).
Possible consequences and complications
The most common complications of acute cystitis are:
- the transition of inflammation into a chronic form, characterized by a stubborn, therapy-resistant course with periods of remissions and exacerbations;
- interstitial cystitis - the inflammatory process affects not only the mucous, but also the deeper layers of the bladder wall (submucosal, muscular);
- paracystitis - the release of the inflammatory process outside the bladder with damage to the surrounding tissue;
- cystalgia - painful and frequent urination, not accompanied by the development of pyuria (more often develops in women);
- acute pyelonephritis - an infection from the bladder through the ureters penetrates the kidneys, causing inflammation in them;
- gangrenous cystitis is a serious complication that threatens to rupture the bladder and develop peritonitis.
In girls and women, acute cystitis most often develops against the background of vaginal dysbacteriosis (dysbiosis) or as a result of a violation of personal hygiene rules.
Forecast
The mucous membrane of the bladder has a high regenerative capacity, therefore, provided that treatment is started on time, in most cases, acute cystitis ends with a complete recovery within 7-14 days. The prognosis worsens with the development of complications.
Prevention
Prevention of acute cystitis includes the following activities:
- regular emptying of the bladder, which helps prevent stagnation of urine;
- correct water regime, providing sufficient diuresis (1-1.5 liters per day);
- compliance with the rules of personal hygiene;
- adequate and timely treatment of sexually transmitted infections and other infectious diseases;
- increasing the general immunity of the body (proper nutrition, giving up bad habits and promiscuity, playing sports, observing the daily routine);
- the most careful and sparing performance of urological operations and manipulations on the bladder.
With a predisposition to acute cystitis, it is recommended to introduce cranberry juice into the daily diet, since cranberries contain benzoic acid, an antiseptic that is excreted in the urine.
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Acute cystitis is an acute inflammatory process of the bladder mucosa, more often than an infectious genesis.
Acute cystitis affects mainly females, the peak incidence falls on the age group in the range from 20 to 40 years - almost every third woman is sick here. In total, up to 36 million cases of this disease are diagnosed annually in Russia. If among women every third suffers from acute cystitis, then among men only 7 people out of 10,000. This fact is explained by the peculiarity of the female urethra: it is much shorter and wider than the male, which facilitates infection of the bladder from the outside.
There are acute primary and acute secondary cystitis. In the first case, the disease is an independent nosological unit and occurs mainly in women. In the second, it complicates the course of other diseases, for example, prostate adenoma, and is detected mainly in men.
Despite the fact that the mucous membrane of the bladder has a pronounced local immunity, and it can contain a certain amount of microbes without causing inflammation, nevertheless, it is believed that the trigger is a general or local hypothermia of the body and a weakening of its general defenses. This usually leaves the microbes in the bladder free to multiply and cause disease. The reasons may be the neglect of the rules of intimate hygiene (mainly for women), the pathology of the anatomical structures surrounding the bladder, the impact of infectious agents, drugs and chemicals on the bladder mucosa. In some cases, the causes are microtrauma of the urethra and bladder mucosa during catheterization or sexual intercourse. However, most often, acute cystitis is caused by a combination of several factors.
The microbial spectrum of causative agents of cystitis is represented by a wide range of microorganisms. More often among them there are staphylococci, Escherichia coli, Proteus. Fungi and Trichomonas are often found in the urine. Adenovirus infections in males are often complicated by viral cystitis, when the infection enters the bladder through the blood. In total, there are four ways for infection to enter the bladder:
- The ascending path in women from the genitals and intestines.
- Descending path from the kidneys when they are inflamed.
- With blood flow from other foci of infection in the body.
- During instrumental medical manipulations.
Acute cystitis begins with pain in the lower abdomen and frequent imperative urge to urinate. The emission of urine is accompanied by burning and itching in the genitals and perineum. After urination, pain may appear in these areas. With each time, urination becomes more frequent, and the amount of urine released at the same time is less and less. There are pains in the urethra, blood or pus in the urine, sometimes a fetid odor. Urinary incontinence occurs periodically. An increase in body temperature, vomiting, the appearance of chills and pain in the lumbar region may indicate involvement of the kidneys in the pathological process.
It is generally accepted that the following symptoms are present in acute cystitis: impaired urination, the presence of blood in the urine and the presence of pus in it. Although it is possible to talk about acute cystitis already with an increase in the number of leukocytes in the urine test and the presence of clinical manifestations of the disease.
Diagnosis of acute cystitis
- General urine analysis.
- Urinalysis according to Nechiporenko.
- Sowing urine on nutrient media to identify pathogens.
- Polymerase chain reaction for the diagnosis of major infections.
- The study of the microflora of the vagina for dysbacteriosis.
- Ultrasound scanning of the abdominal organs to exclude concomitant pathology.
- Cystoscopy (performed only after the end of the inflammatory process).
- A biopsy may be performed if indicated.
Treatment of acute cystitis
Bed rest is usually prescribed. Hot spices, sauces, canned foods, alcohol are excluded from the diet. Preference is given to vegetables, fruits, dairy products. Thermal procedures have a good analgesic and antispasmodic effect: warm general baths and a heating pad on the bladder area. With severe dysuric phenomena, the appointment of antispasmodics is indicated. In some cases, with severe pain, even narcotic analgesics can be used. Antibacterial therapy is mandatory, taking into account the sensitivity of microorganisms, if possible. It is advisable to use antibiotics for a course of at least 2 weeks. This time is usually enough for the patient's condition to normalize.
Essential drugs
There are contraindications. Specialist consultation is required.
- Fosfomycin trometamol () is an antibiotic of the group of phosphonic acid derivatives, a uroantiseptic. Dosage regimen: for adults, the drug is prescribed 3 g 1 time / day. The course of treatment is 1 day. If necessary (for severe or recurrent infections, the elderly), it is possible to re-take the drug at a dose of 3 g after 24 hours. Before taking the granules, dissolve in 1/3 cup of water. The drug is taken 1 time / day. on an empty stomach 2 hours before or after a meal (preferably at bedtime), after emptying the bladder.
- Nitrofurantoin (broad-spectrum antibacterial agent for urinary tract infections). Dosage regimen: The adult dose is 50 mg orally every 6 hours. The duration of the course of treatment is 7 days.
- (an antibacterial drug of the fluoroquinolone group). Dosage regimen: for acute cystitis inside, 250 mg 2 times / day. The duration of treatment is 3 days.
- (an antibacterial drug of the fluoroquinolone group). Dosage regimen: the drug is prescribed orally for adults - 200 mg, the frequency of use - 2 times / day. The course of treatment is 3 days.
