Cystitis in men - causes, symptoms, diagnosis and treatment

The prevalence of cystitis in men is much lower than among women. In urology Cystitis is diagnosed in 0.5% of men, mostly older than 40 years. Atypical cystitis for men is due to the peculiarities of the male urethra: a long, narrow, curved urethra, in most cases delays infection and prevent its ascent into the bladder. At the same time, the development of cystitis in men is more often due to bladder outlet obstruction - podpuzyrnym compression of the urinary tract (at the level of the urethra or bladder neck), prevents the free flow of urine.

foreign bodies and bladder stones, tumors, diverticula, prostatic adenoma, urethral stricture. Boys cystitis is often accompanied by phimosis - narrowing of the foreskin, neurogenic bladder dysfunction.

Infectious cystitis in men tend to occur against a background of urethritis, prostatitis, orchitis, vesiculitis, epididymitis. Activators cystitis in men as well as women and cystitis, primarily act nonspecific bacteria - E.coli (80%), St. saprophyticus, Klebsiella, Proteus (15%), Pseudomonas aeruginosa, yeast-like fungi Candida and others. Specific cystitis in men caused by mycoplasma, chlamydia, trichomonas, Mycobacterium tuberculosis, gonococcus. The rare form of cystitis in men include actinomycosis, purpura, schistosomiasis, and others.

Infectious cystitis in men can develop upward, downward, lymphogenous, hematogenous, direct ways. When ascending pathways pathogens get into the bladder from the urethra, prostate, testis or epididymis, seminal vesicles. Down mechanism often seen with renal tuberculosis, pyelonephritis, pyonephrosis. Hematogenous drift pathogens into the bladder occurs in remote pockets of purulent tonsillitis at available, sinusitis, furunculosis, pulp, etc. Direct infection is usually associated with holding endourological manipulation - Bladder catheterization, cystoscopy. It is also a direct hit of pathogens into the bladder can occur in the presence of a fistula of the bladder, dissection into the cavity of the bladder appendiceal infiltrate, prostatic abscess.

Among other factors that increase the likelihood of developing cystitis in women, it should be noted diabetes, spinal cord injury, transurethral surgery (resection of the prostate, urethra, tumors of the bladder), stress, exposure to cold, alcohol, spicy food.

acute cystitis in men are frequent urination (in Vol. h. nocturia), urgency, difficult and painful urination character (strangury), terminal hematuria, urine turbidity. Associated symptoms may include fever and chills, decreased disability.

Pain during urination, especially in its initial and final stages, accompanied by sharp pain and burning in the urethra. Outside miktsii felt pain in the suprapubic area, groin, scrotum, penis. The volume of a single portion of urine is reduced to 10-20 ml, in some cases, may develop urinary incontinence.

Typical symptoms of cystitis in men are leucocyturia and pyuria, microscopic or macroscopic hematuria.

In severe forms of cystitis in men (hemorrhagic, phlegmonous, gangrenous) develops intoxication due to high fever, oliguria. The urine is cloudy color, putrid smell, blood contains impurities, fibrin layers torn away mucosa.

Chronic cystitis in men is characterized by a poor symptomatology may have an undulating or continuously during stable. In chronic cystitis in men is not as frequent urination and excruciatingly painful; leucocyturia saved, proteinuria, periodic microhematuria admixture of mucus in the urine.

Complications cystitis in men may be paratsistit (inflammation paravesical fiber), pyelonephritis, sclerosis of the walls of the bladder with a sharp decrease in its capacity.

urologist.

In men, cystitis is obligatory inspection of the genitals, palpation of the scrotum, the study of the prostate through the rectum. These studies make it possible to confirm or rule out the connection with phimosis cystitis, and prostatitis orchiepididymitis.

To determine the pathological flora, causing cystitis in women, conducted bacteriological urine culture and a urethral smear, PCR study scraping on sexual infections. In urinalysis detected erythrocytes, leucocytes and mucus epithelium in large quantities; for tuberculosis cystitis is characterized by acid reaction of urine.

To exclude organic obstruction, cystitis often accompanying men, held uroflowmetry; in order to confirm or exclude detrusor-sphincter dyssynergia - urodynamic examination.

Holding ultrasound of the bladder with acute cystitis in men is difficult, because patients may not accumulate urine, allows you to visualize the bladder wall in the expanded state. Therefore of prime importance prostate ultrasound with determination of residual urine output and renal ultrasound, allowing to identify abnormalities of the urinary tract, complications of cystitis in men.

In gross hematuria and chronic cystitis in men is a cystoscopy. During endoscopic examination fails to recognize the nature and form of inflammation, to identify stones, tumors, foreign bodies bladder biopsy to make a fence.

In doubtful situations, as well as to difdiagnostiki conducted cystography, multislice cystourethrography.

bladder irrigation with antiseptics holding predpuzyrnyh, intravesical, Presacral novocaine blockade. After the relief of acute inflammation of the treatment of cystitis in men is supplemented by physical therapy: sessions inductothermy, electrophoresis, UHF-therapy, ultrasound, magnetic therapy and magnetic-, mud applications.

In identifying the man accompanying cystitis urological diseases, their removal is necessary - therapy of pyelonephritis, prostatitis, epididimoorhita, kidney stones, enlarged prostate, prostatectomy.

When deformation of the bladder neck is shown TOUR bladder; with urethral strictures performed its probing. Cicatricial Sclerosis bladder may require implementation of unilateral nephrostomy, imposing ureteroureteroanastomoza, ureterosigmoanastomoza holding ileotsistoplastiki.

Prevention of cystitis in men

Prevent the development of cystitis in men allows compliance with personal hygiene, STD prevention, elimination of stress factors and hypothermia, timely treatment of diseases of the male genitalia, pyelonephritis, septic foci sanitation. When performing endovezikalnyh research and manipulation requires careful observance of asepsis, antibiotic advance.