Cystitis in women - causes, symptoms, diagnosis and treatment

Cystitis is one of the most common diseases affecting women, located at the junction of urology and gynecology. According to statistics, in encounters with cystitis every second woman for life. Pathology mainly diagnosed in women of childbearing age (20-40 years); also relatively high incidence of cystitis in girls 4-12 years (3 times more often than boys of that age). In 11-21% of cases of cystitis in women becomes chronic, t. E. Proceeds with 2 or more exacerbations per year.

vaginitis, vulvitis and urethritis caused by candidiasis, gardnerellezom, mycoplasmosis, gonorrhea ureaplasmosis, chlamydia, trichomoniasis, genital tuberculosis, and others. infections.

Traditionally, the primary episode or exacerbation of cystitis in women are associated with hypothermia, acute respiratory viral infection, onset of sexual activity, a change of sexual partner, the onset of menstruation, excessive consumption of spicy foods or alcohol, wearing too tight clothing. Factors causing cystitis in women may also serve pyelonephritis, foreign bodies and stones in the bladder, urinary stasis when diverticula, urethral stricture or a rare bladder emptying, and constipation.

Cystitis in girls can develop in poor health genital mutilation, as well as neurogenic bladder. Cystitis in pregnant women caused hemodynamic and endocrine gestational changes, transformation of the microflora of the urogenital tract.

In some cases, the development of cystitis in women may be triggered by radiation therapy for pelvic tumors, allergies, toxic effects, metabolic disorders (diabetes, hypercalciuria). During menopause cystitis in women develops under the influence of lack of estrogen and atrophic changes in the mucosa of the urogenital tract.

The emergence of cystitis in women contribute to the injury of the bladder mucosa during endoscopic manipulations and operations (catheterization, cystoscopy, transurethral resection of the bladder, and others.). Chronic cystitis in women, except for low intensity of infection, can be caused by uterine prolapse or vaginal chronic parametritis.

acute cystitis in women in most cases, the inflammation affects the epithelial and subepithelial cover the bladder mucosa. Endoscopic picture of catarrh is characterized by swelling and congestion of the mucous, vascular reaction (extension, vascular injection), the presence of fibrinous or mucopurulent raid on the inflamed areas. In a progressive course of cystitis in women may be affected and even submucosal muscle layer of the bladder.

Cystoscopic signs of hemorrhagic cystitis in women is expressed red cell infiltration of the mucosa, bleeding areas rejection mucosa, bleeding on contact.

Ulcers form of cystitis in women are often developed with radiation injury of the bladder. Ulcers may be of single or multiple in nature, affecting all sectors of the gallbladder wall (pantsistit), lead to bleeding, fistula of the bladder. If ulcers develop fibrotic scarring and sclerosis of the bladder wall changes, which leads to its shrinkage.

When phlegmonous cystitis in women have diffuse infiltration of leukocytes submucosa. Purulent inflammation spreads to serosa (peritsistit) and the surrounding tissue (paratsistit). The tissue around the bladder can form ulcers that cause diffuse damage throughout the fiber.

Gangrenous cystitis in women affects all of cystic wall with the development of a partial or complete necrosis of the mucosa, at least - the muscle layer of the bladder wall perforation with peritonitis. Deadened mucous and submucosal layers of the bladder can be torn away and out through the urethra to the outside. The result is a hardening of the gangrenous cystitis and bladder shrinkage.

Endoscopically chronic cystitis in women is characterized by swelling, redness, or thickening of the mucosal atrophy and decreased elasticity. In some cases, mucosal and submucosal layer can be formed microabscesses and ulcerations.

Nonhealing ulcers are inlaid with salt, causing the development of encrusting cystitis. The predominance of proliferative processes entails the growth of granulation tissue with the formation of granular or polypoid growths (granulomatous and polypoid cystitis). Less in the bladder can form cysts, protruding above the surface of the mucous singly or in groups in the form of small hillocks, representing the accumulation of submucosal lymphoid tissue (cystic cystitis).

When interstitial cystitis in women is determined by the presence of characteristic glomerulations (submucosal hemorrhagic formations), a single ulcer Gunner having a linear shape with a bottom covered with fibrin, inflammatory infiltrates. We believe interstitial cystitis in women is the shrinkage of the bladder and decrease its capacity.

urinalysis determined a significant increase in white blood cells, red blood cells, protein slime, salts of uric acid. In bacterial cystitis in women bakposev incontinence is characterized by abundant growth of pathogenic flora.

Routine examination of women with cystitis have to include consultation gynecologist, examination of the patient in the chair, microscopic, bacteriological and PCR study of gynecological smears.

In the diagnosis of recurrent cystitis in women plays an important role cystoscopy and cystography. Cystoscopy allows to define the morphological form of the defeat of the bladder, the presence of tumors, urinary calculi, foreign bodies, diverticula of the bladder, ulcers, fistulas, perform a biopsy.

Ultrasound bladder indirectly confirms the existence of cystitis in women by characteristic changes in the walls of the bladder, the presence of "ehonegativnoe" suspension.

urologist. Relief of acute forms of cystitis in women is usually 5-7 days. Antibiotics are used from the group of fluoroquinolones (ciprofloxacin, norfloxacin), fosfomycin (monural), cephalosporins, nitrofurans. Upon detection of a specific microflora, the relevant anti-microbial, anti-viral, anti-fungal drugs.

To remove the pain appointed NSAIDs (nimesil, diclofenac), antispasmodics (papaverine, baralgin, no-spa). In addition, herbal teas (infusions bearberry, horsetail, knotweed, cranberries sheet, etc), Herbal pharmaceuticals (kanefron, tsiston, Phytolysinum) may be recommended to the main drug therapy.

In acute cystitis women are advised to stick to gentle, mainly milk-vegetable diet, increased water load.

In cases of recurrent cystitis in women, except for the above-mentioned causal and symptomatic therapy, showing a bladder instillation, intravesical iontophoresis, UHF, inductothermy, magnetic-, magnetic. If recurrent cystitis is diagnosed in women in the menopause, it is recommended the use of intravaginal or periurethral estrogensoderjath creams.

With the development of gross hyperplasia of the bladder neck resorted to transurethral resection (TUR) of the bladder.

Prevention of cystitis in women

On the issue of the prevention of cystitis in women the importance attached to respect for personal and sexual hygiene, timely treatment of gynecological and urological diseases, preventing cooling, regular emptying of the bladder. It should be strict adherence to aseptic technique during endovezikalnyh research and bladder catheterization.

To reduce the likelihood of recurrence of cystitis in women need to increase immunity, preventive treatments in autumn and spring.