Cystitis is an inflammation of the bladder wall - the most common urological disease, which occurs more often in women because they have a shorter and wider urethra (in men, the urethra is longer and narrower, so the infection often lingers there, causing urethritis).
Cystitis is acute and chronic. Cystitis is infectious and non-infectious. Cystitis of non-infectious origin occurs when the mucous membrane of the bladder is irritated by urine-secreted chemicals, including drugs with long-term use in large doses (for example, phenacetin or urotropinic cystitis).
The cause of non-infectious cystitis can also be burns (accidental introduction into the bladder of concentrated solutions of chemicals or solutions with a temperature above 45 ° when washing it), damage to the mucous membrane by a foreign body (for example, urinary calculus), etc.
But, as a rule, infection is at the heart of cystitis. The causative agents of infection in cystitis can enter the bladder during inflammatory processes in the urethra or the external genital organs (ascending infection), with kidney disease (descending infection, for example, with kidney tuberculosis), if there are foci of infection in other organs and tissues (with blood or lymph flow).
The causative agent of infection in cystitis can be Escherichia coli, Proteus, Staphylococcus aureus, various fungi, Trichomonas, and other microorganisms. Because the lining of the bladder is highly resistant to infection, the infection alone is usually not enough to develop cystitis. For the development of cystitis, other predisposing factors are also needed:
- condition after serious illness or surgery
- impaired outflow and stagnation of urine, which may occur against the background of some other diseases of the genitourinary organs (adenoma of the prostate gland, narrowing of the urethra, etc.)
Acute and chronic cystitis
Acute cystitis occurs suddenly some time after hypothermia or exposure to another provoking factor. In this case, the inflammatory process usually affects only the mucous membrane of the bladder. The main signs of acute cystitis are frequent painful urination, pain in the lower abdomen, and the presence of pus in the urine (based on laboratory results). The intensity of pain during urination in patients with cystitis increases, the pain becomes almost constant, patients (especially children) are sometimes unable to hold urine.
Sometimes all these phenomena of acute cystitis disappear within 2-3 days without special treatment. However, more often acute cystitis, even with timely initiation of treatment, lasts 6-8 days. A longer course of cystitis indicates the presence of a concomitant disease (for example, prostate adenoma).
Chronic cystitis occurs when acute cystitis is improperly treated, and the entire wall of the bladder is involved in the process. The main manifestations of chronic cystitis are the same as those of acute cystitis but are less pronounced.
Chronic cystitis proceeds either in the form of a continuous process with constant more or less pronounced signs of the disease or has a recurrent course when exacerbations of the disease alternate with light intervals.
Diagnosis of cystitis
The diagnosis of cystitis is made based on a doctor's examination and laboratory data (a large number of leukocytes in the urine). In the presence of a chronic process, cystoscopy is performed (in acute cystitis, it is contraindicated) - a study of the internal state of the bladder using special equipment.
According to the condition of the bladder wall, the degree of its damage is judged, tumors, stones, fistulas, bladder ulcers, signs of kidney and ureter disease are detected.
If necessary, other methods of urological examination are also used to verify cystitis.
Treatment of acute and chronic cystitis
In acute cystitis, patients need bed rest. An abundant drink and a diet except for spicy and salty foods, alcoholic beverages are prescribed.
In acute cystitis, it is useful to use a decoction of herbs (kidney tea, bearberry), which have a diuretic effect. To reduce pain in a patient with cystitis, use warm baths, heating pads. With pronounced pain, you can use drugs that relieve spasm of the muscles of the bladder (drotaverine, papaverine). In acute cystitis, antibacterial treatment is also used.
Treatment of chronic cystitis is aimed primarily at restoring normal urine flow (treatment of prostate adenoma, urethral narrowing, etc.). Be sure to identify and treat all foci of infection in the body (for example, chronic tonsillitis). Antibacterial treatment for chronic cystitis is carried out only after urine culture, identification of the causative agent of the infection, and its sensitivity to antibiotics.