Cystitis

Description:

Cystitis is an inflammation of a bladder which affects generally mucous membrane, and happens because of hit of an infection in urinary tract.
Most often cystitis is diagnosed for women of childbearing age that is connected with the anatomic features of a structure of an urethra facilitating hit of an infection in a bladder. Women have an urethra, i.e. an urethra, more widely and well, immt a direct form, and it does not create obstacles for disease-producing bacteria.
Often one woman has cystitis several times during the life. Statistically, about 0,7 cases of the revealed incidence are the share of 1 woman.
At children's age girls aged from 4 up to 12 years are ill more often.
Cystitis can be complicated or uncomplicated depending on depth of injury of a bladder.
In structure of urological diseases cystitis takes the most significant place.

Cystitis reasons:

Causative agents of cystitis most often are such microorganisms as colibacillus, a streptococcus, staphylococcus. From protozoan infections the greatest clinical value has proteas.
Cystitis quite often develops after catheterization of a bladder, operative measures on a bladder. In that case gram-negative microflora becomes the causative agent of cystitis. Except bacteria, big distribution was gained by the cystitis caused by a chlamydial infection, trichomonads, mycoplasmas, various viruses, and also fungal infection.
As it was already mentioned, the frequency of development of cystitis is higher at women, than at males. Anatomo-topografichesky features are that that create optimum conditions for penetration of an infection into a bladder.
At men cystitis can be observed against the background of damage of a prostate gland, seed bubbles and other bodies of urinogenital system.

Pathogeny:

Disease-producing bacteria can get into a bladder cavity  in such ways:
1. The ascending way of infection. This spread of an infection is the most frequent. Hit of microorganisms on the uric channel in a bladder is observed. The ascending way of infection is also called urethral.
2. The descending way of infection means hits of the infectious agent from kidneys, a renal pelvis at an associated disease pyelonephritis, etc.
3. The hematogenous way is observed seldom and has small clinical value.
4. A lymphogenous way – from the next bodies of a small pelvis. Most often the lymphatic way matters at women. Owing to direct lymphatic communication between a bladder and generative organs inflammatory process with ease passes into the last on mucous a bubble. So-called defloratsionny cystitis when the inflammation of a bladder develops after a hymen defloration is known. Development of this form is also connected with a lymphogenous way of infection.

However is normal, even at hit of microbes does not develop in a bladder cavity, an inflammation. To start a disease "push" in the form of the contributing factors is necessary. Can be these factors decrease in immunity and the general resistance of an organism owing to a hypovitaminosis, recently postponed diseases; also disturbance and incomplete bladder emptying, at poisoning with various substances which elemenirutsya (are brought) out of an organism with urine. Physiological features of a vesical epithelium are that that to it with ease stick, i.e. microorganisms adgezirutsya.
Cystitis shares on primary and secondary. Primary cystitis meets at girls more often. Secondary cystitis is observed against the background of anomalies of development of uric ways, and is more often diagnosed for boys.

Cystitis symptoms:

Urination frequency normal for the healthy person makes 5-6 times a day. Increase of an urination is called a polyuria, and arises most often at inflammatory process in a bladder, in particular at cystitis. The speeded-up urination is followed by morbidity, burning, impossibility to hold urine. Urine loses the transparency, quite often in it blood impurity is found.

In a clinical picture of chronic cystitis the various and quite often erased symptoms are presented. Considerably, the symptomatology of chronic cystitis depends on the general condition of the patient. Symptoms of chronic cystitis in the period of an aggravation a little in what differ from clinical displays of acute cystitis, however their expressiveness is much weaker.  The long oligosymptomatic current with a periodic recurrence is characteristic of chronic cystitis.  Cases of slow cystitis which proceeds without the expressed clinical aggravations, but with speeded up and an urodynia, complaints to which remain a long time, are described. For this form of cystitis slight increase of temperature is also inherent.
The fever and hyper thermal syndrome are characteristic of acute cystitis. Body temperature usually rises only to subfibrilny figures. Quite often the "erased" clinical picture of acute cystitis which is followed only by a pain syndrome in the bottom of a stomach meets. Symptoms of acute cystitis can spontaneously disappear, without any treatment in 2-3 days after the beginning of a disease. However cystitis which on condition of adequate treatment proceeds within a week most often meets. If at the patient with cystitis body temperature rose higher than 38 With, it is necessary to exclude an acute infection of upper uric ways.

Cystitis at pregnancy. Cystitis origins at pregnancy – change of a hormonal background and decrease in immunity.  Cystitis of pregnant women is shown as in acute, so in chronic forms. It is shown by the speeded-up urination, morbidity and burning,  fever and impurity of blood in urine.

Treatment of Cystitis:

Treatment acute and exacerbations of chronic cystitis identical.
In most cases uncomplicated cystitis is treated in out-patient conditions. The visit to the doctor is required in situations if:

1. Sharply expressed symptoms do not decrease within a day that threatens with spread of an infection to kidneys;
2. Existence  of fever, lower back pain, blood impurity in urine;
3. Characteristic symptoms arise at the pregnant woman (renal infections are more characteristic of pregnant women);
4. The disease recurs;
5. Emergence of symptoms of a disease when changing sexual partners;
6. Development to cystitis at children.

Rest, bed rest,  sparing diet with an exception of tea, the coffee, alcohol, products rich with calcium is recommended to the patient. Plentiful drink is recommended (to 2 — 2,5 l of liquid a day); it is necessary to avoid overcooling of a body, to monitor regular function of intestines, to exclude the sexual intercourses for the period of a disease. At expressed a pain syndrome appoint rectal or vaginal candles with non-narcotic antiinflammatory analgesics. At acute cystitis of installation in a bladder are not shown. Antibiotics are appointed on the basis of an antibiotikogramma, taking into account sensitivity of the microflora which caused cystitis, during the period before its receiving antibacterial drugs with a broad spectrum of activity  in combination with antihistaminic medicines are shown.  
Important value is given to elimination of the chronic centers of an infection. At the patients with acute cystitis of women first of all pay attention to existence of urinogenital infections.  At men damages of a prostate gland in connection with which urine outflow is broken come to light more often.
Antiinflammatory therapy of chronic cystitis is appointed a course about one month then the patient is transferred to Bactrimum or nutrofurana.  During treatment the urine bakissledovaniye is monthly carried out, made It is necessary to conduct monthly bacteriological research and бакпосев urine. At detection of an infection repeated performing treatment is shown. After the postponed cystitis at children it is necessary to carry out crops of urine on flora 1-2 times a year.

Chronic cystitis, especially intersticial cystitis at women, demands complex and individual treatment. Are appointed antihistaminic and hormonal drugs (a hydrocortisone, Prednisolonum), a geparinoterapiya in the form of instillation and infusional therapy. Locally as the enveloping means apply a liquid paraffin, Linimentum Dibunoli, fish oil, and also silver drugs, a hydrocortisone, sea-buckthorn oil, methyluracil.

Special treatment at intersticial cystitis is occupied by physiotherapy. Wide use was received by ultrasonic therapy, diathermic currents, an electrophoresis with various drugs, including with novocaine, electrostimulation of a bladder. Novocainic blockade apply in the form of prevesical, presakralny and intravesical injections, by a surgical method make stretching of the wrinkled bladder under anesthetic. At cicatricial wrinkling of a bladder surgery is shown (уретероуретероанастомоз, a unilateral nephrostomy, уретеросигмоанастомоз, an ileocystoplasty).

Prevention:

Prevention of cystitis is a complex of the actions directed to prevention of incidence of cystitis.  These are simple rules and recommendations which observance will help you to be saved from a bladder inflammation. It is difficult to revaluate a role of preventive actions at cystitis, i.e. at the same time the probability of infection sharply decreases that to save the patient from unpleasant symptoms of cystitis.

So, for the purpose of prevention of cystitis it is necessary:

1. Maintenance of immunity of an organism at the high level
It is well-known that the inflammation of a bladder is directly connected with decrease in immunity and protective forces of an organism. Preventive measures at cystitis surely include the actions directed to increase and maintenance of the immune status of an organism.  If the immune system is compromised with intercurrent diseases, adverse external factors, then the organism is subject to a disease of many infectious diseases among which a bladder inflammation.
2. To protect an organism from local and general overcooling
Local or general overcooling is the frequent reason of an inflammation of a bladder. Cooling of extremities, and also crotches make an adverse  effect on a bladder, and are the contributing factors for developing of cystitis. Under the influence of a cold factor there is a spasm of blood vessels of a bladder which involves disturbances of blood circulation and failure of mechanisms of protection against emergence of an inflammation.
3. Constant maintenance of personal hygiene.
The caution of hit of an infection in an urethra, requires a daily podmyvaniye warm water the movement in front — back. Reception of bathtubs should be replaced with a shower, for the purpose of an exception of possible hit of chemicals with mucous. Also it is not recommended to use for intimate hygiene soap, gels, shampoos and other hygienic means, for the purpose of prevention of disturbances of microflora, and for avoiding of irritation of mucous. It is considered that the laying used during periods promotes reproduction of microbes therefore use of hygienic tampons is recommended.
Important point is replacement of synthetic, low-quality underwear cotton. According to researches of association of gynecologists shorts thongs are one of the main reasons of an inflammation of a bladder as bacteria from an anus with ease are carried to the area of an outside opening of the uric channel.
4. Timely empty a bladder
Timely bladder emptying — effective prevention of cystitis. You should not suffer in case of need to empty a bladder as it is fraught with an exacerbation of chronic cystitis.
The more often you will empty the bladder, the quicker the bacteria which fell down in it will be removed. It is one of the actions directed to the prevention of active growth and reproduction of pathogenic flora in a bladder. Therefore, it is necessary to include as much as possible liquid in the diet. With the preventive purpose it is necessary to drink cowberry and cranberry fruit drinks as they promote destruction  of some species of bacteria and have diuretic properties.
Empty a bladder before sexual intercourse. The urination after sex promotes washing away of microbes from an urethra and a bladder.
5. Rational diet.
Both at an aggravation, and at prevention of cystitis an important condition is food. Correctly picked up diet can facilitate considerably a condition of the patient, working in two directions at once: to help to get rid of disease-producing bacteria and to make diuretic antiseptic impact. The daily diet has to include various dishes, vitamin-rich, microelements, with the minimum content of salt, extractive substances, spices, acute products.  In total using effective medical supplies, such as Monurel, the listed above rules can result in great success in treatment and prevention of cystitis.

Summing up the results, it is necessary to remind of importance and the special importance of preventive measures once again. For the prevention of cystitis important:
1. It is necessary to avoid overcooling of an organism.
2. It is necessary to give importance to personal hygiene, daily shift of underwear.
3. It is desirable to include a large amount of liquid in the diet, in particular cowberry and cranberry fruit drinks are useful to the prevention of cystitis. The substances which are contained in these drinks are pernicious for bacteria.
4. In time empty a bladder.
5. Pay special attention to personal hygiene during monthly, you make replacement of hygienic laying in time.
6. You do not wear the fitting clothes which interfere with normal blood circulation in bodies of a small pelvis, and also underwear from synthetic material. Choose cotton underwear.
7. Visit a toilet before sexual intercourse.
8. For a toilet of generative organs it is the best of all to use special soap and gels which pH are neutral. At a podmyvaniye it is necessary to pay attention to that the stream was directed in front back.
9. Regulate the chair by means of a diet. At tendency to locks include more vegetables which will promote an exception of the similar phenomena in a diet.