Chronic cystitis is a polyetiologicalbladder disease arising as a result of inflammatory diseases of the genitourinary system, which were not detected early and began to be treated late.
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.
Often, chronic cystitis occurs against the background 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 required.
Classification of chronic cystitis.
Chronic cystitis, depending on 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 is detected only during endoscopic studies. Latent cystitis is often a "medical finding, " meaning it is discovered by chance. This form of cystitis, in turn, can be stably latent, with rare exacerbations (less than 2 times a year) or frequent exacerbations (more than 2 times 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 change in one direction or another.
- Interstitial cystitis is an inflammatory disease that is associated with a decrease in the general immune status of the patient. The pathological processes that occur in this clinical form of cystitis lead to a change 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 long and difficult.
As a result of the inflammatory process, the tissues of the bladder mucosa undergo various morphological changes. There is a classification of chronic cystitis, based precisely on the nature of these morphological changes:
In addition, there is a chronic cystitis of the allergic type, 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 sex and periodically undergo examinations by a gynecologist or urologist. Only the timely diagnosis allows to avoid the chronicity of the pathological process.
Any disease of the genitourinary system must be treated in a timely manner, following all the prescriptions of the attending physician. This is especially true in the case of various sexually transmitted diseases, as they are often the cause of chronic cystitis.
The causes of chronic cystitis.
First of all, it should be noted that chronic cystitis is diagnosed more often in women than in men. This state of affairs is due to the structural characteristics of the genitourinary system. The woman's vagina and anus are located in the immediate 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 impaired urination or obstruction of some parts of the urinary system (prostate adenoma, stenosis of various origins, etc. ).
Various urological diseases, congestion in the bladder associated with impaired urination (for example, incomplete emptying of the bladder) can trigger the development of chronic cystitis. Also, chronic cystitis can develop against the background of complex background pathologies: pyelonephritis, diabetes mellitus, vulvovaginitis, prostatitis, urethritis, neoplasms of various etiologies, etc.
A similar pathological condition is often found in people with urolithiasis. Risk factors can be frequent hypothermia, promiscuous sex life, spicy food, and poor personal hygiene. Often chronic cystitis develops against the background of various hormonal changes (pregnancy, lactation, menopause, etc. ).
Therefore, chronic cystitis, the treatment of which is usually long and rather difficult, requires a number of diagnostic measures that will help to establish the exact cause of the pathology.
Symptoms of chronic cystitis
The symptoms of chronic cystitis directly depend on its form. The insidiousness of chronic latent cystitis lies in the fact that this form of pathology does not manifest itself for quite a long time. Only 1 or 2 times a year, the patient may experience exacerbations. During these periods, the patient has symptoms of acute cystitis:
- the presence of blood in the urine and, as a result, a change in its color (slight cloudiness or urine the color of "meat scraps");
- frequent need to urinate;
- Sharp pains at the end of urination, in the anus or perineum (in men, the pain can be at the head of the penis);
- violation of the general somatic state (subfebrile or feverish temperature, malaise, dizziness, etc. ).
Sometimes the symptoms of chronic cystitis significantly affect a patient's quality of life. This applies not only to the physical condition, but also to the psychological one. People suffering from various functional disorders in bladder work often withdraw, rarely leave home, etc.
The most serious form of chronic cystitis is interstitial. The pain syndrome constantly accompanies the patient, and if at the beginning of the disease the pain can be periodic and not very intense, over time it becomes constant and unbearable. The pain subsides a little immediately after urination, but gradually increases as the bladder fills.
Diagnosis of chronic cystitis
The diagnosis of this disease presents some difficulties because the symptoms appear periodically and the clinical picture is blurred. To establish a more accurate diagnosis, patients are prescribed additional examinations from related specialists. For women, an examination by a gynecologist is mandatory, and for men, a rectal examination by a proctologist.
The next stage of the diagnostic examination is laboratory tests. General urine and blood tests, bacteriological studies for the presence of pathological microflora, antibioticogram (a study that allows you to choose antibiotics) must be approved. Both men and women take a swab from the urethra, which can detect various sexually transmitted diseases.
The next stage is the study of functional bladder disorders. For this purpose, the patient is prescribed instrumental imaging research methods (ultrasound, uroflowmetry, cystoscopy, cystography, etc. ). These research methods help the doctor to get a complete picture of the structural changes that have occurred in the bladder, the nature of the injury and the violation of basic functions, etc.
Given the suspicion of chronic cystitis, it is necessary to carry out some measures that help to differentiate this disease from neoplasms of various etiologies, both malignant and benign.
Treatment of chronic cystitis
First of all, it is worth noting that if you are diagnosed with chronic cystitis, how to treat the disease can only be determined by a qualified doctor after a thorough examination of the patient. Self-medication is unacceptable and can have irreversible consequences.
The choice of treatment tactics directly depends on the factors that caused the development of pathology, the individual characteristics of the patient and the presence of concomitant pathologies.
The mainstay of chronic cystitis treatment is antibiotic therapy. The doctor selects the antibiotics individually, based on the microorganisms that caused the inflammation. If an antibiogram is not possible, broad-spectrum antibiotics are prescribed. The duration of such therapy is also very individual and ranges from 7 to 10 days to 2 to 4 weeks.
In parallel, general therapy is carried out, which is aimed at normalizing the functioning of the immune system, restoring hormonal balance and eliminating other factors that contribute to the development of pathology. For this purpose, the patient is prescribed immunomodulators (if there are no contraindications), antihistamines, drugs that improve local blood circulation, antihypoxatives and other drugs. Only the correction of the general condition gives the patient the opportunity for successful treatment of the disease and a full life.
Symptomatic therapy is also used, which is aimed at eliminating the pain syndrome. For this, non-steroidal anti-inflammatory drugs are used. If the patient has concomitant bladder diseases (urolithiasis, bladder polyps, etc. ), then treatment of these diseases is necessary, up to surgical treatment.
In some cases, doctors may consider flushing the bladder with anti-inflammatory drugs topical. In addition, the patient must regularly attend physiotherapy procedures that help normalize blood circulation and strengthen the pelvic floor muscles.
With the interstitial form of the disease, chronic cystitis, the symptoms, treatment and signs of which 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.