Symptoms of cystitis in women and basic methods of treating pathology

The first symptoms of cystitis in women cannot be ignored, since the disease is prone to chronicity. Treatment of cystitis in women will be most effective if therapy is started at an early stage, when the disease is in an acute stage.

Symptoms of cystitis in women

The course of cystitis can manifest itself in acute or chronic form. Symptoms of cystitis in women vary depending on the severity and form of the pathology.

Symptoms of cystitis appear suddenly, against the background of absolute well-being. Acute pain occurs in the lower abdomen in the projection to the bladder, intensifying with urination. Cystitis in women can affect not only the mucous membrane of the bladder, but also the muscle layer. In this case, cystitis manifests itself with specific signs:

• urinary incontinence;
• feeling of heaviness in the bladder;
• feeling of fullness.

Acute cystitis in women produces more pronounced symptoms, so patients rush to the doctor for treatment. If a woman has chronic cystitis, the disease may not manifest itself for a long time. In this case, the chronic form will reveal itself as relapses as soon as the patient’s immunity weakens.

Hemorrhagic cystitis, which manifests itself in patients as cystitis with blood, can be seen with the naked eye. In the urine, in addition to changes in the color of the urine, streaks of blood will be visible.

Signs of cystitis in women

1. The appearance of sharp pain in the lower abdomen, aggravated by urination.
2. Aching pain at rest.
3. The appearance of itching and burning when urinating.
4. Changes in the color and smell of urine, cloudy urine, possible blood impurities.
5. Feeling of incomplete emptying of the bladder.

6. Frequent urge to go to the toilet, sometimes to no avail.
7. Increased body temperature, feverish state.
8. Painful sensations in the genitals.
9. Worsening of general symptoms - headache, weakness, fatigue, decreased performance.

Treatment of cystitis in women

Cystitis in women is treated with several types of medications. First of all this:

• antibiotics;
• anti-inflammatory drugs;
• antipyretic tablets;
• painkillers;
• diuretics and uroseptics.

Treatment of cystitis in women with drugs is selected by the doctor, since before prescribing an antibiotic it is necessary to determine the type of pathogen, and only then decide on the choice of drug.

After conducting a urine test for bacterial culture, the doctor selects the optimal drug for therapy. A fast-acting medicine for women in the acute period of cystitis development is Monural. The drug quickly eliminates signs of cystitis in women and neutralizes pathogenic microflora.

Cystitis can be quickly treated not only with Monural, but also with other medications, if they are correctly selected and treatment is started in the initial period of development of the pathology. Chronic cystitis cannot be treated quickly, since the infection is carefully hidden, and pathogenic microorganisms sometimes become resistant to many antibiotics.

Antibiotics in the treatment of cystitis help neutralize pathogenic microorganisms that cause the development of the inflammatory process. This is the main group of drugs that are used for cystitis.

To relieve signs of inflammation, anti-inflammatory drugs are prescribed in parallel. Many of them already have an antipyretic effect. Anti-inflammatory drugs eliminate irritation of the bladder mucosa, swelling, and normalize blood circulation. They also help with severe pain. The drugs quickly relieve negative symptoms and patients feel much better.

Quick treatment of cystitis is impossible without diuretics and uroseptics. Medicines for cystitis in women with a diuretic effect are aimed at increasing the excretion of fluid from the body, which allows the evacuation of dead pathogenic microorganisms and cleansing of the bladder.

Uroseptics also help with this, some of which are made on the basis of natural components. For treatment to be successful, a diet for cystitis is necessary so that the mucous membrane does not become irritated during the treatment process.

Drugs for the treatment of cystitis in women

Medicine for cystitis in women

Medicine for cystitis in women is prescribed after examination. For the treatment of cystitis, various forms of medications are available that are convenient for use. Cystitis in women can be treated with medications in the form of tablets, suppositories, and folk remedies.

Pills

Tablets are the most convenient form of treatment for cystitis. They can be taken at any convenient place, and tablets for cystitis in women will provide quick treatment if you need to go to work.

Among the tablets against cystitis we can mention:

• Cystinol;
• Renel;
• Cyston;
• Canephron;
• Urolesan;
• Monurel.

These drugs are made on a plant basis. This includes components that have uroseptic, anti-inflammatory and analgesic effects. First aid for cystitis with these drugs is possible in mild cases of the disease, when signs of cystitis only appear.

Antibiotics

The list of antibiotics for cystitis in women is wide and allows you to choose the optimal remedy, taking into account individual characteristics. A therapist or urologist will help you choose an effective remedy for cystitis in women, because some medications have significant limitations in use.

For example, it is not recommended to take drugs aggressive for the gastrointestinal tract for cystitis in women if there are diseases of the digestive system, and antibiotics for cystitis with teratogenic properties and embryotoxic effects are prohibited during pregnancy.

List of effective antibacterial agents:

• Monural;
• Nolitsin;
• Palin;
• Nevigramon;
• Rulid;
• Levomycetin;
• Norfloxacin.

Candles

Vaginal or rectal suppositories are a convenient remedy for cystitis. Suppositories for cystitis in women have an antibacterial effect, provide an antispasmodic and analgesic effect.

With the help of suppositories, local symptoms are relieved, signs of intoxication disappear and overall well-being improves.

Suppositories for cystitis in women activate blood circulation, increasing metabolism and speeding up recovery.

The most effective candles are:

• Hexicon;
• Viferon;
• Papaverine;
• Methyluracil;
• Betadine;
• Acylact;
• Indomethacin;
• Terzhinan.

Folk remedies

Treatment of cystitis in women at home is also possible with the help of traditional medicine. There are many herbal remedies that can help get rid of the symptoms of cystitis. Folk remedies for cystitis are used along with traditional methods of treating the disease.

Treatment of cystitis with folk remedies can be carried out in various forms. This includes drinking decoctions and infusions of medicinal herbs, baths, douching, and applications. Herbs for cystitis in women have no worse properties than herbal-based tablets. For cystitis, you can take decoctions and infusions from the following plants:

• centaury;
• bearberry;
• flax seeds;
• cranberry;
• plantain;
• corn silk;
• Birch buds;
• juniper;
• liquorice root;
• parsley.

With complex treatment of cystitis using both synthetic drugs and traditional medicine, cystitis can be cured in a short time and completely, without the threat of relapse.

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Cystitis in women: types and causes of the disease

Cystitis is an infectious and inflammatory disease. Localized in the cavity of the bladder. The causative agent is bacterial in nature.

According to drug statistics, women, due to the physiological characteristics of the body, are more predisposed to the development of this pathology.

If symptoms of cystitis appear, effective treatment should be started immediately. Otherwise, the disease may become chronic.

Anatomical predisposing factors

• the length of the female urethra is less than the male one;
• relatively wide urethra;
• the outer part of the urethra, vagina and anus are located close.

The disease develops when an infectious pathogen penetrates through the urethra into the bladder cavity. Colpitis (inflammatory process in the intimate area) is also a factor that provokes cystitis.

Conditions and causes of the disease

Why does cystitis appear? This disease can make itself felt at any age. The main reasons for the development of pathology include:

• Hypothermia of the pelvic area.
• Physical inactivity (lack of physical activity due to a sedentary lifestyle).
• Abuse of unhealthy foods (fast food, fatty and fried foods).
• Consequence of ineffective treatment of sexually transmitted or gynecological diseases.
• The presence of an inflammatory process in the body (chronic diseases and others).
• Chronic lack of sleep.
• Decreased immune system function due to intense emotional stress.
• Neglect of personal hygiene standards.
• Unprotected sexual intercourse.
• Hormonal imbalances.
• Diabetes.

In addition to the above, pregnancy can cause cystitis. Carrying a child is accompanied by radical changes in the body:

• decrease in protective properties;
• hormonal disbalance;
• decreased bladder tone due to hormonal changes.

An enlarged uterus has a detrimental effect on metabolic processes in the genitourinary system.

Classification of cystitis in women

Depending on the stage of the disease, cystitis is usually divided into acute and chronic. In the first case, the course of the pathology is caused by an intense inflammatory process in the bladder cavity under the influence of one or more provoking factors. Acute cystitis is characterized by obvious symptoms.

The chronic form develops as a result of ineffective treatment. Symptoms in this case appear only partially. This is due to a decrease in the protective properties of the body against the background of the inflammatory process.

According to the nature of the pathogen, cystitis is divided into bacterial and non-bacterial. In the first case, the disease develops as a result of penetration into the bladder cavity of such microorganisms as:

• streptococci;
• staphylococci;
• enterococci;
• pathogens of STDs.

Nonbacterial cystitis occurs as a result of irritation of the bladder mucosa by chemicals or medications.

1. Catarrhal. In the acute course of the pathology, the inflammatory process is localized on the integument of the bladder mucosa. Also, during endoscopy it is possible to detect purulent plaque on the affected areas. Without timely treatment, damage to the muscular or submucosal layer is possible.
2. Ulcerative. It develops mainly under harmful radiation exposure. Characterized by the presence of ulcers and corrosion on the walls of the organ. Without medical intervention, this leads to shrinkage and deformation of the bladder.
3. Phlegmonous. Characterized by diffuse penetration of leukocytes into the submucosal layer. As a result, a purulent-inflammatory process develops. Purulent formations often spread to nearby tissues.
4. Gangrenous. Intense irritation of the walls of the organ, which leads to tissue necrosis. The affected areas are rejected and excreted through the urethra. Against the background of gangrenous cystitis, peritonitis may occur. Without timely surgical intervention, this leads to sclerosis of the bladder.
5. Endoscopic. Develops under the influence of the chronic course of pathology. Characterized by thickening of the mucosa or its atrophy. Basically, this form of cystitis is accompanied by the formation of ulcers in the bladder cavity.
6. Encrusting. Formed when ulcers appear that do not heal for a long time. If therapy is ineffective, a cyst may form in the organ cavity, which is one of the types of lymphoid tissues.
7. Interstitial. Diagnosed due to the characteristic presence of glomerulations. Without qualified treatment, it leads to shrinkage of the bladder and a decrease in the volume of its cavity.

Main symptoms of the disease

The key symptom of the pathology is an acute and frequent need to urinate. This is due to the body's inability to regulate bladder activity. Without timely treatment, the phenomenon leads to the development of enuresis.

The acute form of the disease is accompanied by symptoms such as:

• itching and pain when urinating;
• frequent urge to empty the bladder cavity (frequency ranges from 5 to 30 minutes, even at night);
• urine has a strong odor;
• pus and a large number of leukocytes are released along with the urine;
• pain in the groin area and lower abdomen;
• in some cases, an increase in body temperature is possible.

Advanced forms of this disease are accompanied by dysuria - acute pain when visiting the toilet. In mature patients, fluid retention in the cavity of the affected organ is possible. Pain syndrome with progressive dysuria spreads to the pelvic region and lower abdomen.

Severe cystitis is characterized by high fever, which is often accompanied by chills, nausea and vomiting.

If blood clots are released during urination, this indicates an advanced pathology of the genitourinary system, which requires immediate medical treatment.

Diagnostics

To prescribe the correct therapeutic course, it is important to consult a doctor and undergo all the necessary diagnostic procedures. Based on the initial examination, the specialist will issue a referral for some of the following studies:

1. General urine and blood tests. This is necessary to confirm the presence of pathology and a characteristic inflammatory process.
2. Biochemical analysis of urinary fluid to determine the form of the disease is important to identify the presence of nitrites, proteins and salts in the urine.
3. Urine culture allows you to determine with maximum accuracy the pathogen and its sensitivity to antibacterial drugs.
4. Venereological tests will determine the presence of sexually transmitted infections and establish the causes of cystitis.
5. Uroflowmetry – diagnosis of the ureter.
6. Ultrasound examination of the kidneys and the bladder itself makes it possible to accurately determine the size of the organs, the presence of an inflammatory process, and the level of damage to the mucous membrane and adjacent tissues.
7. Consultation with a urologist.
8. Biopsy and cystoscopy. The procedure involves inserting a camera with forceps through the urethra into the bladder cavity to determine the condition of the walls and take a tissue sample for microscopic examination. This measure is especially appropriate for the interstitial form of pathology.

After undergoing the procedures necessary for an accurate diagnosis, the attending physician will prescribe the most effective therapeutic course, depending on the type of cystitis and the individual characteristics of the body.

After completion of treatment, it is recommended to undergo a re-examination. Poor quality therapy contributes to the development of a chronic form of the disease.

Treatment of cystitis in women

Regardless of the form of the pathology, therapy should be carried out comprehensively. It is not enough to simply take prescribed medications on time. Effective treatment requires compliance with the following recommendations:

• Strict bed rest (at least 4 days).
• Maintaining a proper diet (preference is best given to dairy products and foods of plant origin).
• Attendance at prescribed physical therapy sessions (if necessary).
• Brewing and consuming diuretic herbs.
• Taking prescribed medications (antibiotics and others).
• Rinsing the bladder cavity with antiseptic solutions to suppress the activity of the pathogen.
• It is acceptable to take painkillers if particularly necessary.

For effective treatment, it is important to understand the cause of inflammation. This is especially true for chronic pathologies.

In some cases, based on objective data, a girl suffering from cystitis may be offered surgery. This is possible if conservative methods are not able to eliminate the cause of incomplete emptying of the cavity of the affected organ. In case of necrosis and wrinkling of the bladder, a special solution is injected inside under high pressure to expand it.

With progressive tissue death, part of the organ can be replaced by the intestine. Such manipulations are carried out exclusively under general anesthesia of the patient.

Complications

If you do not seek medical help in a timely manner and in the absence of effective treatment, the following consequences may occur:

• development of chronic pathology;
• reduction in the volume of the affected organ;
• inability to have sex;
• spread of infection to the kidneys (pyelonephritis), urethra (urethritis) and nearby tissues.

Preventive measures

Inflammation of the bladder is a disease with very unpleasant symptoms. The acute course of the pathology is easily replaced by a chronic one, significantly worsening a person’s life and threatening complications. Therefore, you should take preventive measures in advance. To prevent cystitis, it is important to follow these recommendations:

• maintain a daily routine;
• avoid hypothermia;
• maintain a proper diet;
• drink at least 1.5 liters of purified water daily;
• observe hygiene standards;
• exclude synthetic underwear;
• do not wear tight clothes (interferes with normal blood circulation);
• Attend annual consultations with a urologist.

If you suspect cystitis, it is advisable to consult a doctor as soon as possible and follow his advice. Self-medication contributes to the development of an intractable chronic form of the disease, so such experiments are unacceptable!

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Acute cystitis in women: symptoms and treatment

Acute cystitis is one of the common infections in which a purulent-inflammatory process affects the mucous membrane of the bladder. Women are susceptible to the disease.

According to medical statistics, every second woman has encountered 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.

Etiology

The main cause of acute cystitis, the symptoms of which are difficult to confuse with other diseases, is the penetration of pathogenic microorganisms.

Main pathogens:

• E. coli or Escherichia coli – causes infection in 80-90% of cases;
• Proteus – it accounts for about 7%;
• Klebsiella – 3-4%;
• staphylococci – 3%.

In some cases, the cause of the disease is viruses, fungi and microflora that cause sexually transmitted infections (chlamydia, mycoplasma).

The infectious agent attaches to the bladder mucosa, then penetrates its cells and begins to destroy them. The speed of inflammation development depends on how quickly the colony of pathogenic microorganisms grows.

The natural flow of urine is able to wash out microorganisms that have penetrated into it from the bladder. However, if they have managed to stick to the walls, urine will not wash them away.

Provoking factors

Microflora penetrates the bladder, multiplies there and causes inflammation under the influence of the following factors (one or more):

In 95% of cases, infectious agents enter the bladder, rising from the anus. This is where the greatest concentration of various microorganisms is.

And this explains why inflammation occurs more often 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 coexists with candidiasis (thrush), bacterial vaginosis, and colpitis. With these gynecological diseases, the balance of the vaginal microflora is disturbed towards an increase in the number of pathogenic microorganisms.

• Instrumental intervention.

Examination with instruments, installation of a catheter, presence of an implant.

• Hereditary predisposition.

The bladder has a protective layer that is capable of secreting special substances that prevent the attachment of bacteria. In some cases, they are produced in smaller quantities, and this disorder can be inherited.

• Features of behavior and sexual life.

Failure to comply with personal hygiene rules, lack of urination after sex, frequent sexual intercourse, use of vibrators, wearing thongs - urologists consider these factors to be of paramount importance 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 functions normally.

Inflammation can affect the entire mucous membrane of the bladder (total cystitis) or parts of it (cervical, trigonitis). Based on the nature of the inflammation, the catarrhal form is distinguished, when the mucous membrane is swollen and filled with blood. Cystitis with blood in women, which is called hemorrhagic, develops when red blood cells enter the urine. In this case, blood in urine is visible to the naked eye.

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First signs

The main manifestations of acute cystitis in women:

• frequent urination with pain, cutting, burning and small portions of urine;
• there is an unbearable desire to urinate;
• urine may be cloudy, with flakes of mucus.

Diagnostics

The acute form of cystitis is diagnosed based on the woman’s complaints. If they do not coincide with the characteristic signs of the disease, there is vaginal discharge and at a doctor’s appointment it turns out that there are risk factors, then a laboratory urine test and examination in a gynecological chair are prescribed.

If 6 or more leukocytes are found in the urine under a microscope, this is a clear sign of inflammation.

If pyelonephritis is suspected, if the symptoms of acute cystitis are not typical, or a pregnant woman is ill, then before treating the inflammation, urine culture must be prescribed. An indicator of the disease is the presence of more than 100,000 CFU/ml of pathogenic bacteria in a portion of urine.

Treatment of acute form

Etiotropic therapy for acute cystitis is aimed at eliminating the infectious agent from the bladder. Therefore, taking antibiotics is a mandatory part of treatment. Since inflammation is accompanied by pain, painkillers and antispasmodics are prescribed.

Herbal medicines are used to enhance the effect of antibiotics and to prevent relapses. Diet and changes in sexual activity are indicated. Treatment is carried out on an outpatient basis. The sick person cannot perform work duties, therefore she has the right to count on sick leave.

It is issued on average for 3-7 days.

Inflammation occurs spontaneously. It often happens that a woman does not feel unwell or have any symptoms foreshadowing illness, but suddenly feels that her bladder is full and has an unbearable urge to go to the toilet. The urge to go to the toilet is very frequent, it can happen every 3-5 minutes, and in this state it is impossible to go to the clinic.

What to do when inflammation begins:

• The most important thing is to drink a lot of water. The more the bladder is filled, the faster microorganisms are washed out in the urine.
• Maintain bed rest.
• Change your diet. Avoid spicy, fried, salty foods, meat dishes (on the first day), tea, coffee, soda.

If symptoms persist after 24 hours, you need to go to the doctor or call him at home. However, if signs of acute cystitis are accompanied by an increase in body temperature (more than 37.5), then you should immediately consult a doctor. Temperature is the first sign of kidney inflammation (pyelonephritis).

Patients with the disease are referred to a urologist, or in some cases to a therapist. The doctor prescribes pills without waiting for test results. If they do not help, a urine culture is prescribed and the treatment regimen is changed.

It is noted that more than half of the patients prefer to be treated independently.

They strive to relieve an acute attack of cystitis using all known methods and methods that were advised by friends or passed on to them from their grandmothers, and also begin to take medications.

The danger with this approach is that the symptoms are eliminated, but not the disease. In every third woman, the disease becomes chronic, which subsequently threatens the development of cancer and interstitial cystitis.

Antibiotic therapy

The effectiveness of etiotropic therapy for acute cystitis depends primarily on the correctly selected antibiotic. Preference is given to drugs designed for short courses of treatment - up to 3 days and excreted primarily in the urine:

• such therapy is more effective;
• Fewer side effects from antibiotics occur;
• microorganisms do not have time to develop resistance;
• the cost of treatment is reduced.

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• Monural (main substance fosfomycin);
• Furamag, Furagin (furazidin), Furadonin (nitrofurantoin).

These medications are only intended to treat urinary tract infections. They are effective against all major pathogens and microorganisms do not develop resistance to them. Medicines are concentrated directly in the urine and do not penetrate (or penetrate in minimal doses) into the tissues.

Advantages of Monural:

• Taken once (3 g).
• The active substance is concentrated in the urine for about 80 hours. This is enough to have a detrimental effect on microorganisms.
• Minimum of adverse reactions.
• Allowed for pregnant women.

Treatment in women with Monural can be carried out before test results as empirical therapy.

Advantages of nitrofurans:

• 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 are that all drugs have a toxic effect on the body. This may result in undesirable reactions (nausea, dizziness, abdominal pain). However, this property is more pronounced during long-term therapy of chronic inflammation.

If for some reason it is impossible to take these medications, 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, drugs from this group are practically not used for acute cystitis in women.

They are used to treat complicated forms, in particular hemorrhagic inflammation.

Fluoroquinolones are also used when women have not received treatment for the first few days, and microorganisms have managed to penetrate into the deep layers of the walls of the bladder.

Clinical recommendations for taking this drug: 400 mg once a 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 medicines

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 medications. Such means include:

• Ampicillin;
• Trimethoprim;
• Co-trimoxazole (Bactrim, Biseptol);
• Nitroxoline (5-NOC).

The resistance of E. coli to Ciprofloxacin also increases. Many doctors, especially abroad, consider its use unsafe. These drugs are used to treat complicated forms of the disease, but not as empirical therapy (until the 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, mixtures, drops and infusions.

They contain the following plants:

• 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 the hemorrhagic form of the disease is diagnosed.

Among herbal preparations, Phytolysin is widely used, which is available in the form of a paste for dissolution in water.

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Urolesan is no less popular. It is available in the form of drops, syrup and capsules. The substances included in the composition have anti-inflammatory, diuretic and antispasmodic effects. The advantage of Urolesan is that it begins to act 20-30 minutes after administration. In order to prevent relapses, it is prescribed in a course of 1 month.

Lessons, Canephron, Cyston, Uroflux are also used. The main purpose of their use is to prevent the development of complications of infection.

Analgesics and antispasmodics

The acute form of cystitis is often accompanied by painful sensations. They occur at the end of urination or have a constant aching character.

Painkillers prescribed:

• Nimesulide (Nise, Nimesil);
• Ketorolac (Ketanov, Ketorol);
• Paracetamol;
• Phenazopyridine.

Among the antispasmodics recommended for use are NO-Shpa, Drotaverine, Papaverine.

Immune boosters and hormones

The causes of inflammation in women are often associated with a weakening of both general and local immunity of the bladder. Therefore, the drug Uro-Vaxom is recommended for the treatment of acute cystitis in women. It is used in conjunction with antibiotics, speeds up recovery and is a means of preventing relapses.

However, this remedy is used more for chronic inflammation.
When cystitis is diagnosed in the elderly, the causes in older women are often associated with insufficient levels of the hormone estrogen and vaginal dryness.

In this case, along with antibiotics, the hormonal drug Ovestin is prescribed in the form of cream or suppositories.

Diet

Inflammation of the bladder requires not only antibiotic therapy, but also changes in diet.

Basic diet requirements:

• Drink more fluid. It is better to drink plain water, still mineral water, cranberry and lingonberry fruit drinks. Avoid tea, coffee, carbonated drinks, and alcohol.
• Do not eat foods containing large amounts of salt, spices, fatty soups, vegetables rich in essential oils.

Such drinks and foods irritate the urinary tract and increase inflammation. Fruits rich in vitamins, dairy and plant foods are shown.

Recommendations

Acute cystitis in women with timely treatment has a favorable prognosis. However, it is equally important to carry out appropriate prevention:

• Treat genital infections promptly.
• Be sure to urinate after sexual intercourse and perform water procedures before and after intimacy.
• You cannot tolerate or deliberately delay emptying. This weakens the urinary immunity.
• During treatment and after, for the purpose of prevention, drink more fluid (at least 2.5-3 liters per day). In addition, high fluid intake is the first prevention of bladder cancer.
• Don't wear thongs. Such underwear makes it easier for E. coli to enter the urethra.

When treatment is completed and the symptoms of acute cystitis have disappeared, a repeat general analysis and urine culture are not performed. If within 2 weeks after treatment signs of the disease reappear, a bacteriological culture must be prescribed to determine the sensitivity of microorganisms to antibiotics. In this case, the doctor recommends another drug, but for a longer course.

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Cystitis in women

Cystitis in women is an inflammatory lesion of the mucous (less often submucosal and muscular) layer of the bladder with an acute or chronic course. It is accompanied by painful frequent urination with residual burning and stinging sensations, pain in the pelvic area, a feeling of insufficient emptying of the bladder, low-grade fever, and the appearance of mucus and blood in the urine. Diagnostics includes urine examination (general analysis, according to Nechiporenko, bacterial culture), examination by a gynecologist with examination of the vaginal microflora, ultrasound of the bladder, and cystoscopy. Therapy uses antibiotics, uroseptics, bladder instillations, and physiotherapy.

Cystitis is one of the most common female diseases, located at the intersection of clinical urology and gynecology. According to statistics, every second woman experiences cystitis during her life.

Pathology is predominantly detected in patients of childbearing age (20-40 years); The prevalence of cystitis in girls 4-12 years old is also quite high (3 times more often than in boys of this age).

In 11-21% of cases, the disease becomes chronic, that is, it occurs with 2 or more exacerbations per year.

Cystitis in women

In most cases, cystitis in women is infectious.

Features of the anatomy of the female urethra (short and wide urethra), as well as the topographic proximity of the vagina, anus and urethra, facilitate the upward penetration of pathogenic flora into the bladder.

In addition to the urethral (ascending) route of spread, infection of the bladder can occur through descending (from the upper urinary tract), lymphogenous (from the pelvic organs), and hematogenous (from distant organs) routes.

The causative agents, as a rule, are Escherichia coli (70-95%), staphylococci (5-20%), less often - Klebsiella, Proteus, Pseudomonas aeruginosa.

The pathology often develops against the background of colpitis, vulvitis and urethritis caused by candidiasis, gardnerellosis, mycoplasmosis, gonorrhea, ureaplasmosis, chlamydia, trichomoniasis, genital tuberculosis and other infections.

Traditionally, the initial episode or exacerbation is associated with hypothermia, acute respiratory viral infections, the onset of sexual activity, a change of sexual partner, the onset of menstruation, excessive consumption of spicy food or alcohol, and wearing too tight clothes.

Factors that provoke cystitis in female patients can also be pyelonephritis, foreign bodies and stones in the bladder, stagnation of urine due to diverticula, urethral strictures or rare emptying of the bladder, constipation.

Cystitis in girls can develop with poor genital hygiene, as well as with a neurogenic bladder.

Cystitis in pregnant women is caused by hemodynamic and endocrine gestational changes, transformation of the microflora of the urogenital tract.

In some cases, pathology can be provoked by radiation therapy for pelvic tumors, allergies, toxic effects, metabolic disorders (diabetes mellitus, hypercalciuria). During menopause, cystitis develops under the influence of a lack of estrogen and atrophic changes in the mucous membrane of the urogenital tract.

The occurrence of the disease is facilitated by injury to the bladder mucosa during endoscopic manipulations and operations (catheterization, cystoscopy, transurethral resection of the bladder, etc.). Chronic cystitis, in addition to sluggish infection, can be caused by prolapse of the uterus or vagina, chronic parametritis.

According to the etiology, cystitis in women can be bacterial (infectious) and non-bacterial (radiation, allergic, chemical, medicinal, toxic). Depending on the pathogenic pathogen, infectious cystitis, in turn, is divided into specific (ureaplasma, mycoplasma, chlamydial, gonorrheal, etc.) and nonspecific, caused by opportunistic flora.

According to the nature of the course, acute and chronic (persistent) cystitis is distinguished: primary (occurring independently) and secondary (developed against the background of other urological diseases). In acute cystitis, inflammation usually affects the epithelial and subepithelial cover of the bladder mucosa.

The endoscopic picture of catarrhal inflammation is characterized by swelling and congestion of the mucous membrane, a vascular reaction (dilation, injection of blood vessels), and the presence of fibrinous or mucopurulent plaque on the inflamed areas.

With a progressive course, the submucosal and even muscular layer of the bladder may be affected.

Cystoscopic signs of hemorrhagic cystitis in women are pronounced erythrocyte infiltration of the mucosa, areas of hemorrhage with rejection of the mucous membrane, bleeding on contact.

The ulcerative form of cystitis in women often develops with radiation damage to the bladder. Ulcers can be single or multiple, affecting all layers of the bladder wall (pancystitis), leading to bleeding and the formation of bladder fistulas.

With scarring of ulcers, fibrous and sclerotic changes in the wall of the bladder develop, which leads to its shrinkage.

With phlegmonous cystitis, diffuse infiltration of leukocytes in the submucosal layer is noted. Purulent inflammation spreads to the serous membrane (pericystitis) and surrounding tissue (paracystitis). In the tissues near the bladder, ulcers can form, causing diffuse damage to all tissue.

The consequence of gangrenous cystitis is sclerosis and shrinkage of the bladder.

Endoscopically, chronic cystitis in women is characterized by swelling, hyperemia, thickening or atrophy of the mucosa and a decrease in its elasticity. In some cases, microabscesses and ulcerations may form in the mucous and submucosal layer. Long-term non-healing ulcers can be encrusted with salts, causing the development of encrusting cystitis.

The predominance of proliferative processes entails the growth of granulation tissue with the formation of granular or polypoid growths (granulomatous and polypoid cystitis).

Less commonly, cysts can form in the bladder, protruding above the surface of the mucosa singly or in groups in the form of small tubercles, representing a submucosal accumulation of lymphoid tissue (cystic cystitis).

With interstitial cystitis, the characteristic presence of glomerulations (submucosal hemorrhagic formations), a single Gunner's ulcer, which has a linear shape with a bottom covered with fibrin, and inflammatory infiltrates, is determined. The outcome of interstitial cystitis in women is a shrinkage of the bladder and a decrease in its capacity.

Acute pathology manifests suddenly, as a rule, after exposure to one or more provoking factors (hypothermia, infection, trauma, coitus, instrumental intervention, etc.). Manifestations of cystitis include the classic triad: dysuria, leukocyturia (pyuria), terminal hematuria.

Urinary disorders are caused by increased neuro-reflex excitability of the bladder under the influence of inflammation, swelling and compression of nerve endings, which leads to increased tone of the bladder wall.

Symptoms increase quickly. The urge to urinate occurs every 5-15 minutes and is imperative in nature, while the volume of an individual portion decreases. Spasmodic contractions of the detrusor lead to urinary incontinence. Severe pain accompanies the beginning and end of urination; outside of micturition, pain, as a rule, remains in the perineum and pubic area.

The nature and intensity of pain with cystitis in women can vary from mild discomfort to unbearable pain. In young girls, acute urinary retention may occur due to pain. With cervical cystitis, dysuria is more pronounced. Extremely painful manifestations are observed with interstitial cystitis, as well as inflammation caused by chemical and radiation factors.

An obligatory and constant sign is leukocyturia, due to which the urine becomes cloudy and purulent. Hematuria is often microscopic in nature and develops at the end of urination.

The exception is hemorrhagic cystitis in women, in which gross hematuria is the leading manifestation.

In acute cystitis, body temperature can rise to 37.5-38°C, and general well-being and activity suffer sharply.

A feature of the course of cystitis in women is the frequent recurrence of the disease: in more than half of the patients, relapses occur within a year after the first episode of the disease. If there is a repeated attack of cystitis that develops within a month after completion of therapy, one should think about maintaining the infection; later than 1 month – about reinfection.

The manifestations of chronic cystitis are similar to those in the acute form, but are not so pronounced.

During periods of exacerbation, a clinical picture of acute/subacute inflammation develops; During remission, clinical and laboratory data about an active inflammatory process are usually absent.

Recognition of cystitis in women is based on clinical and laboratory information and echoscopic and endoscopic examination data. Palpation of the suprapubic region is sharply painful.

A general urine test reveals a significant increase in leukocytes, red blood cells, protein, mucus, and uric acid salts. In bacterial cystitis in women, urine culture is characterized by abundant growth of pathogenic flora.

A routine examination must necessarily include a consultation with a gynecologist, examination of the patient in a chair, microscopic, bacteriological and PCR examination of gynecological smears.

In the diagnosis of recurrent cystitis, the role of cystoscopy and cystography is great.

Cystoscopy allows you to determine the morphological form of bladder damage, the presence of tumors, urinary stones, foreign bodies, bladder diverticula, ulcers, fistulas, and perform a biopsy.

Ultrasound of the bladder indirectly confirms the presence of cystitis in women by characteristic changes in the walls of the bladder and the presence of “echo-negative” suspension.

Treatment should be carried out under the supervision of a gynecologist and urologist. Relief from acute cystitis usually takes 5-7 days. Antibiotics from the group of fluoroquinolones (ciprofloxacin, norfloxacin), fosfomycin, cephalosporins, and nitrofurans are used. If specific microflora is detected, appropriate antimicrobial, antiviral, and antifungal drugs are used.

In addition to basic drug therapy, herbal teas (infusions of bearberry, horsetail, knotweed, lingonberry leaf, etc.) and herbal pharmaceuticals may be recommended.

In case of acute cystitis, women are advised to adhere to a gentle, predominantly dairy-vegetable diet and increase their water load.

For recurrent cystitis, in addition to the above etiotropic and symptomatic therapy, bladder instillations, intravesical iontophoresis, UHF, inductothermy, magnetic laser therapy, and magnetotherapy are indicated.

If recurrent cystitis is diagnosed in a menopausal woman, intravaginal or periurethral use of estrogen-containing creams is recommended.

With the development of gross hyperplasia of the bladder neck, they resort to transurethral resection - TUR of the bladder.

When it comes to preventing cystitis in women, great importance is attached to maintaining personal and sexual hygiene, timely treatment of gynecological and urological diseases, avoiding cold, and regular emptying of the bladder.

Strict adherence to asepsis is necessary when conducting endovesical examinations and bladder catheterization.

Source: https://www.KrasotaiMedicina.ru/diseases/zabolevanija_urology/women-cystitis