Cystitis is a disease that is characterized by the development of an inflammatory process that affects the scene of the urinary bladder as a result of the effect of bacterial microorganisms.
Statistical cystitis is one of the most frequent urological pathologies. Much more and cause this inflammation affects women, because of their morphophysiological characteristics.
The penetration of bacterial agents into the cavity of the bladder is possible in three ways:
- Upward way — through the urethra (the urethra). The main roles in this embodiment, penetration of microorganisms belongs to the anatomo-morphological peculiarities of the female urinary ways: short and wide urethra, near-located from the anus and the vagina.
- The downward path – from the kidneys. This option develops, as for renal inflammation, e.g., chronic pyelonephritis.
- Hematogenous route is the most rare variant, is set when the phenomenon Alan cystitis directly after infectious diseases or in identifying another source of purulent infection in the female body. Also, there's a chance of bacterial flora in the bladder in e due to the presence of anatomical anastomoses (connections) between the lymphatic vessels of the genitals and bladder, subject to the occurrence of inflammatory changes in the above.
The most frequent causative agent of the inflammatory process of the bladder is considered to be E. coli (in 4 of 5 cases, which is associated with the above-mentioned anatomical and morphological features and presence of the microflora in the gut).
Less disease cystitis associated with staphylococcal, streptococcal and enterococcal microorganisms. Gram-negative rods cause inflammation of the bladder due to the instrumental and operative interventions.
In the last hour increased the incidence of cystitis associated with fungal pathogens, protozoa and viruses.
Only one skid of infectious microorganisms not enough for the full development of the inflammatory response in the bladder because the body has mechanisms of resistance and pathogenic flora.
The factors in the development of cystitis
Thus, in addition to the etiological factors in the formation of cystitis involves such factors as:
- disorder haemodynamic function (blood circulation) of the pelvic organs and, in particular, of the bladder;
- disorder of the excretory function of the bladder (stagnation of urine);
- jump various immune parts of the body (vitamin deficiency, exposure to cold temperatures, stress, fatigue, etc.);
- harmful effects of biological agents and products of metabolism that are excreted in the urine on the structure of the bladder wall;
- the impact of x-ray beams;
- poor cleanliness of the external genitalia and casual sex;
- pathology of the gastrointestinal tract, the presence of which smoke accumulates and increases activity of microflora, which after gets into the urinary tract;
- regular shifts in hormone metabolismthat leads to lack of tone of the urethra and creates the best conditions for infection.
The first symptomatic manifestations of cystitis in women
Clinics for acute cystitis in women is characterized by sudden and marked the beginning of symptom-complexof:
- The phenomenon of the appearance of frequent urination (pollakiuria), which is characterized by frequency at least once every 60 minutes and small amounts of urine; with a development of frequent imperative urges patients become unable to control and hold urine;
- Dysuria (urinary disorders) accompanied by pain in the hypogastric area (lower abdomen). With the development degree of the inflammatory process in the wall of the bladder these symptoms are progressive: the more he developed, the more likely to have the urge to urinate and intense pain;
- Itching in the urinary tract, which occurs during the act of urination. Develops as a result of effects on the mucosa of the urinary tract metabolic products of microorganisms that caused inflammation of the urinary bladder;
- Phenomenon is the appearance of blood drops in the google + profile of urination;
- The phenomenon of the emergence of turbidity of the urine, which is caused by contact with it a large number of blood cells (leukocytes and erythrocytes), bacterial microflora, cells of the surface epithelium of the inner wall of the bladder;
- For such patients not characteristic change in the General condition. Temperature patients are characterized by normal or slightly elevated (low-gradu) numbers. Scientists attribute this to the fact that the mucous membrane of the bladder is practically not absorb the metabolic products of microorganisms, which get into the blood usually lead to intoxication and development of the characteristic symptoms of inflammation.
An important phenomenon is the relationship suddenly what appeared to symptoms and pre-exposure of the woman's body. Ate Java hours of acute inflammation may occur 2-3 days and to disappear without therapy.
However, often this process takes place over 6 days, hours to 15 days. The presence of the disease at a later date, subject to the appointment of therapy requires the use of additional methods of examination to detect concomitant pathologies of the body.
Characteristics of the pain syndrome cystitis in women
In patients with acute cystitis there is a different degree of severity of pain:
- When lung during the inflammatory process, patients feel a slight heaviness or pain in the lower abdomen. Weak pronounced pain in the google + profile of urination accompany moderate pollakiuria. With the further development of the inflammatory process, the intensity of the pain increases. In the next period, this syndrome is accompanied by a beginning or an entire act of urination. The pain becomes unrelated with the act and acquires a nearly constant nature, it is accompanied by very painful with palpation over the projection of the bladder.
- In a situation when I developed severe cystitispatients have to urinate at least 2-3 times per hour, which is accompanied by significant pain syndrome and the phenomenon of appearance of blood discharge from the urethra in a profile in google + act. Pain significantly affects the patient's quality of life because they do not fade throughout the day.
The presence of blood cells and blood in the urine, cystitis (a syndrome of hematuria)
If in the scenes of the bladder develops inflammation, it affects the areas of tissue near the confluence of the ureters and exit of urethra. The fabric becomes loose and bloody.
This phenomenon is expressed by the appearance of micro - and gross hematuria (or blood) in the urine, which often occurs in the google + profile of urination (terminal hematuria).
One of the most severe forms of acute cystitis is considered to be hemorrhagic. This type of inflammation occurs with a significant penetration of red blood cells (erythrocytes) from the blood stream, that fed the arteries into the cavity of the bladder.
This option is possible in case of increasing the permeability of vessel walls (a condition of anemia, vitamin deficiency, disorders in the blood coagulation system) or destruction of the above-mentioned walls of the bacterial cells (usually streptococcal flora). That was in the cavity of the bladder urine red blood cells stained in blood color.
When phenomena Alen hematuria syndrome doctor must carefully conduct the differential diagnostics between acute complicated cystitis and acute hemorrhagic cystitis. To do this, appoint additional methods of examination, it turns out the injury and select the most correct scheme of treatment.
Peculiarities of acute and chronic cystitis in women
Summing up the above information, it is possible to allocate specific acute cystitis abrupt onset of the disease and the presence of a specific symptom complex:
- frequent urination in small portions,
- pain syndrome of various kinds,
- itching that is associated with the act of urination,
- phenomenon is the appearance of drops of blood in the profile in google + act
- unaltered General condition of women.
With proper and timely diagnosis, the pathological condition can be cured within 6-10 Zen. If no improvement after 15-th day of the disease should consider the chronicity of inflammatory changes.
In addition to bleeding, there are two forms of complicated acute cystitis:
- Gangrenous. Gangrenous form is rare and occurs because of impaired blood supply or innervation of the bladder. Clinically this is manifested cystitis, difficult urination, accompanied by pain, high fever, pain in the sacral region. The process is extremely dangerous development of severe complications such as peritonitis and require quick action regarding treatment.
- Phlegmonous. Phlegmonous form there is a significant intoxication, high fever and the whole is accompanied by release of small amounts of urine (oliguria). The urine in this complicated course becomes putrid smell, turbid in nature, the flakes of fibrin formations, blood impurity.
Duration of the course of disease in case of development of complicated forms is significantly increased.
There is another form of cystitis – interstitial. It is characterized by inflammation of urine-vesico shells. The clinic is dramatically dominated by frequent urination, which takes us back 180 times a day, active complaints of severe pain in the hypogastric region when filling the bladder and its regression after the act of urination. Bladder capacity significantly reduced, resulting in arise of the above symptoms.
Chronic cystitis, in contrast to the hell sharp, very rarely occurs as a primary disease and in most cases the phenomenon is a secondary complication of already existing abnormalities of the bladder, kidneys, urethra.
Given this fact, it is necessary to carefully examine the body for the presence of the above-mentioned pathological changes, and also to exclude or confirm a specific origin bacteria tubercle Bacillus, Trichomonas infestation.
Clinically, chronic cystitis seen in either a continuous course with moderate differences in the complaints and the clinical analysis of urine or recurrent disease with periods of exacerbation (similar to the clinic of acute cystitis) and complete regression (with absence of any manifestations of a pathological process).
Thus, the objective manifestations of chronic cystitis with those of the acute process. They correlate with the overall protective properties of the organism, etiology bacterial agent that caused the infectious process and the severity of inflammation. Pain, frequent urination, itching, presence of blood and urine turbidity are less pronounced at constant current and correspond to the acute process in patients with recurrent chronic cystitis.
Due to lesions of the inflammatory reaction of the mucosa, edema of all layers of urine-the cystic wall and increase intravesical pressure are all conditions for the formation of vesico-ureteric reflux, t.. Zn. the reflux of fluid from the bladder back into the ureter (connects kidney and bladder).
The verification of the diagnosis and prescribing treatment cystitis does the doctor-urologist.
In order to correct diagnosis of inflammatory disease of the you should clearly define the patient's complaints and anamnesis (which preceded the development of disease).
The clinical manifestations are quite specific and can immediately indicate the presence of this disease, however, should be carefully differential diagnosis between all types of cystitis, and hell other pathologies of the bladder, and diseases of the abdominal cavity.
History will be useful data about the transferred stress and exposure to low temperatures, medications, and other lesions, localized in the pelvic organs and urinary system.
After clarification of complaints and medical history to help verify the diagnosis of can clinical (common) urinalysis – it will be discovered elevated levels of red and white blood cells (leukocytes and erythrocytes, respectively).
For species identification of the bacterial pathogen that caused the inflammatory process, is a urine culture on special nutrient medium, which can then be used to select the most effective antibacterial drug.
Before collecting the urine for bacteriological examination should be processed area of the external genitalia with an antiseptic solution. Conducting cystoscopy in the presence of acute inflammatory reactions is contraindicated.
To diagnose chronic cystitis, along with gathering complaints and data history helps to conduct a cystoscopy in remission. This will allow you to install all the necessary characteristics of inflammatory diseases. While this manipulation may take a biopsy – urine-cystic mucous membrane. As for the identification of chronic cystitis is recommended to conduct x-ray examination with contrast.