Chronic cystitis - Causes, Symptoms, Diagnosis and Treatment

Suffice prevalence of chronic cystitis in urology, are often resistant to the causal treatment, making it a serious medical problem. Transition of acute cystitis is a chronic form occurs in about a third of all cases. In chronic cystitis inflammatory process proceeds for a long time (more than two months), while not only affected mucosa and deeper layers of the bladder wall. Long-term inflammation in the wall of the bladder (cystitis) can lead to sclerotic changes of connective tissue elements of the muscular layer and the shrinkage of the bubble.

gonorrhea, tuberculosis, chlamydia, mycoplasma), viruses (herpes, adenovirus), candida fungi, protozoa. Exacerbations of chronic cystitis caused in most cases of re-infection, or other agent of persistent infection of the same species or strain.

Depending on the morphological picture of chronic cystitis may be catarrhal, ulcerative, cystic, polypous, encrusted or necrotic. The morphological changes in chronic cystitis characterized by metaplasia of transitional epithelium - the formation of foci of keratinization, mucous cysts, sometimes - polypous growths and leukocyte infiltration in the subepithelial layer. When interstitial cystitis are observed ulceration of the mucous membrane, and multiple signs hyalinosis glomerulations, in allergic cystitis - eosinophilic infiltrates in the subepithelial and muscular layers.

pyelonephritis, vulvovaginitis, prostatitis, urethritis, sexually transmitted diseases, tuberculosis, tonsillitis, caries) create favorable conditions for the development of chronic cystitis. Provoke inflammation in the bladder can be available in its cavity tumor formation, polypous sprawl, diverticula, stones.

Anatomical features of the urethra cause a high incidence of cystitis in women, as they contribute to getting into the bladder of the microflora of the vagina and the anus, especially after sexual intercourse, or in violation of hygienic rules. Chronic cystitis in men often occurs against the backdrop of urethral strictures in its various departments, benign prostatic hyperplasia. Chronic inflammation of the bladder promotes incomplete regeneration after acute cystitis urothelial on the background of impaired tissue homeostasis.

Risk factors for chronic cystitis can be diabetes, hormonal changes (pregnancy, menopause), hypothermia, poor personal hygiene, sexually active, spicy foods, stress.

The etiology and pathophysiology of noninfectious interstitial cystitis hitherto uncertain.

urolithiasis, hydronephrosis, and others.).

gynecological examination with inspection in the mirror; men - rectal prostate research.

The next stage of diagnosis of chronic cystitis is to perform laboratory tests: urinalysis - general at Zimnitsky, Nechiporenko, bacterial inoculation test with antibiogram urine, urethral smear from STI, women - vaginal smear on the flora and STIs.

Functional study of the urinary tract in chronic cystitis include ultrasound of the kidneys and bladder, cystoscopy (in remission), uroflowmetry, cystography. Against the background of chronic inflammation may develop precancerous changes in the epithelium of the bladder, such as hyperplasia, dysplasia, metaplasia, so endovezikalnaya performed a biopsy and morphological analysis of biopsies if necessary.

The differential diagnosis of chronic cystitis performed with bladder cancer and prostate cancer, a simple ulcer, tuberculosis and schistosomiasis.

removal of stones, bladder polyps, resection of the bladder neck, prostatectomy, and so on.).

In identifying the foci of chronic infection spend their sanitation, women - treatment of inflammatory gynecological diseases and dysbiosis genitals. To stimulate the immune defense of the body shows the immunotherapeutic and immunomodulatory drugs. In chronic cystitis necessarily prescribe antihypoxants, venotoniki, antiplatelet agents, antihistamines. Expressed pain syndrome cropped using nonsteroidal anti-inflammatory drugs.

As a topical anti-inflammatory treatment is carried out with sufficient indications instillation into the bladder drugs (p-pa dioksidina nitrate, silver, colloidal silver, heparin). Therapeutic exercise, physiotherapy to help strengthen the muscles of the pelvis and pelvic blood circulation normalize.

With interstitial cystitis, a chronic, rather difficult to treat, apply medication and topical therapy, physiotherapy (ultrasound, diathermy, iontophoresis, electrical stimulation of the bladder, lazerolechenie, magnet). Perform predpuzyrnuyu, intravesical and Presacral procaine blockade; in the case of scar shrinkage bladder surgery shows: ureterosigmo- and ureteroureteroanastomoz, unilateral nephrostomy, ileotsistoplastika.

urologist preventive courses of therapy (antibiotics, including postkitalnaya; herbal diuretics; postmenopausal - HRT estriol).

An important role in the prevention of chronic cystitis plays compliance with personal hygiene and sexual health, timely elimination of urogenital pathology associated purulent processes in the body, hormonal disorders.