chronic cystitis

Chronic cystitis is a<1_img_leftxx>bladder diseases resulting from inflammatory diseases of the genitourinary system, which were not detected in time and started to be treated later.

The constant inflammation of the bladder leads both to a change in its structure and to various functional disorders of this organ. A very important factor in the clinic of chronic cystitis is immunodeficiency of various origins, which contributes to the chronicity of acute cystitis.

Chronic cystitis often occurs in the context of various bacterial infections of the reproductive system (especially in women). Diagnosis and treatment require an integrated approach. In some cases, therapy can be conservative and surgery is sometimes necessary.

Chronic Cystitis Classification

Chronic cystitis, according to the nature of the clinical course, is generally divided into three forms:

  • Chronic latent cystitis. This clinical form is characterized by the fact that the pathological process is asymptomatic and detected only during endoscopic study. Latent cystitis is often a "medical finding", that is, it is discovered by chance. This form of cystitis, in turn, can be stable latent, with rare exacerbations (less than twice a year) or frequent exacerbations (more than twice a year).
  • Persistent cystitis, characterized by chronic inflammation with characteristic symptoms. All patient tests indicate the presence of inflammation, bacterial infection and all laboratory parameters are altered in one direction or another.
  • Interstitial cystitis is an inflammatory disease associated with a decrease in the patient's general immune status. The pathological processes that occur in this clinical form of cystitis lead to an alteration in the structure of the bladder tissues. Chronic interstitial cystitis is not a consequence of the active multiplication of bacterial microflora, but it is the most difficult form and its treatment can be time-consuming and difficult.
  • As a result of the inflammatory process, the bladder mucosal tissues undergo several morphological changes. There is a classification of chronic cystitis, based precisely on the nature of these morphological changes:

  • Ulcerative;
  • Cystic;
  • Polyposis;
  • Necrotic;
  • Built-in.
  • In addition, there is chronic allergic cystitis, which is characterized by the presence of eosinophilic infiltrates.

    Prevention of chronic cystitis

    To prevent the development of chronic cystitis, it is necessary to follow the rules of personal and intimate hygiene, avoid casual sexual intercourse and undergo periodic examinations by a gynecologist or urologist. Only a timely diagnosis makes it possible to avoid the chronicity of the pathological process.

    Any diseases of the genitourinary system must be treated in a timely manner, complying with all the prescriptions of the attending physician. This is especially true for many sexually transmitted diseases, as they are often the cause of chronic cystitis.

    The causes of chronic cystitis

    First, it should be noted that chronic cystitis is more often diagnosed in women than in men. This state of affairs is due to the structural characteristics of the genitourinary system. A woman's vagina and anus are located in the vicinity of the urethra and, during sexual intercourse or if the basic rules of personal hygiene are not followed, the bacterial microflora easily enters the bladder, where it actively multiplies and causes inflammation. A woman's urethra is much shorter and therefore bacteria enter the organs of the urinary system much faster. In men, chronic cystitis is often caused by various diseases of the genitourinary system, which are accompanied by difficulty in urinating or obstruction of some parts of the urinary system (prostate adenoma, strictures of various origins, etc. ).

    Various urological conditions, bladder congestion associated with difficulty urinating (eg, incomplete bladder emptying) can trigger the development of chronic cystitis. Furthermore, chronic cystitis can develop in the context of complex background pathologies - pyelonephritis, diabetes mellitus, vulvovaginitis, prostatitis, urethritis, neoplasms of various etiologies, etc.

    A similar pathological condition is often found in people suffering from urolithiasis. Risk factors can be frequent hypothermia, promiscuous sex life, spicy food and poor personal hygiene. Chronic cystitis often develops in the context of various hormonal changes (pregnancy, lactation, menopause, etc. ).

    Thus, chronic cystitis, whose treatment is usually time-consuming and difficult, requires a series of diagnostic measures that will help to establish the exact cause of the pathology.

    Chronic Cystitis Symptoms

    The symptoms of chronic cystitis depend directly on its form. The insidious character of latent chronic cystitis lies in the fact that this form of pathology does not manifest itself for a long time. Only once or twice a year, the patient may have exacerbations. During these periods, the patient has symptoms of acute cystitis:

    • the presence of blood in the urine and, consequently, a change in its color (slight turbidity or urine the color of "flesh remains");
    • frequent need to urinate;
    • sharp pains at the end of urination, in the anus or perineum (in men, pain may be in the head of the penis);
    • violation of the general somatic state (subfebrile or febrile temperature, malaise, dizziness, etc. ).

    Sometimes the symptoms of chronic cystitis significantly impair the patient's quality of life. This applies not only to physical condition but also psychological. People who suffer from various functional disorders of bladder work often become withdrawn, rarely leave the house, etc.

    The most serious form of chronic cystitis is interstitial. The painful syndrome accompanies the patient constantly, and if at the beginning of the disease the pain may be periodic and not very intense, with time it becomes constant and unbearable. The pain subsides somewhat immediately after urinating, but gradually increases as the bladder fills.

    Diagnosis of chronic cystitis

    The diagnosis of this disease presents some difficulties due to the fact that the symptoms occur periodically and the clinical picture is blurred. To establish a more accurate diagnosis, patients are prescribed additional tests from related specialists. For women, a gynecologist exam is mandatory, and for men - a rectal exam by a proctologist.

    The next step in the diagnostic test is laboratory tests. General urine and blood tests, bacteriological studies for the presence of pathological microflora, antibiotics (a study that allows choosing antibiotics) must be approved. Both men and women take a cotton swab from the urethra, which can detect various sexually transmitted diseases.

    The next step is the study of functional disorders of the bladder. Therefore, instrumental methods of image research are prescribed to the patient (ultrasound, uroflowmetry, cystoscopy, cystography, etc. ). These research methods help the physician to obtain a complete picture of the structural changes that have taken place in the bladder, the nature of the injury and the violation of basic functions, etc.

    If chronic cystitis is suspected, it is necessary to take some measures to help differentiate this disease from neoplasms of various etiologies, malignant and benign.

    Chronic Cystitis Treatment

    First, it is important to note that if you are diagnosed with chronic cystitis, how to treat the condition can only be determined by a qualified physician after a thorough examination of the patient. Self-medication is unacceptable and can lead to irreversible consequences.

    The choice of treatment tactics depends directly on which factors caused the development of the pathology, the individual characteristics of the patient and the presence of concomitant pathologies.

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    The mainstay of treatment for chronic cystitis is antibiotic therapy. The doctor selects antibiotics individually, depending on which microorganisms caused the inflammation. If an antibiogram is not possible, broad-spectrum antibiotics are prescribed. The duration of this therapy is also very individual and varies from 7 to 10 days to 2 to 4 weeks.

    At the same time, general therapy is carried out, which aims to normalize the functioning of the immune system, restore hormonal balance and eliminate other factors that contribute to the development of the pathology. For this, the patient is prescribed immunomodulators (if there are no contraindications), antihistamines, drugs that improve local blood circulation, anti-hypoxia and other drugs. Only the correction of the general condition gives the patient the chance of a successful treatment of the disease and a full life.

    Symptomatic therapy, which aims to eliminate the pain syndrome, is also used. For this, non-steroidal anti-inflammatory drugs are used. If the patient has concomitant bladder diseases (urolithiasis, bladder polyps, etc. ), treatment of these diseases is necessary, even surgical treatment.

    In some cases, doctors may consider flushing the bladder with anti-inflammatory drugs as a topical. In addition, the patient must regularly attend physical therapy procedures that help to normalize blood circulation and strengthen the pelvic floor muscles.

    With the interstitial form of the disease, chronic cystitis, whose symptoms, treatment and signs are very different from the manifestations of other forms of pathology, often requires surgical treatment. Preference is given to organ preservation operations. Procedures such as laser therapy, electrophoresis with the use of various medications, electrical stimulation, etc. , are also effective.