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Cystitis in men

Content:

Cystitis is an inflammation of the walls of the bladder. Typically, in men, cystitis occurs after 40 years and is a complication of various other urological diseases, in which there is stagnation in the bladder or infection penetration into it.

If among women, cystitis is common, then due to the characteristics of the urethra, men rarely get sick: 6–8 cases per 1000 men and 100–200 cases per 1000 women.



Why men rarely suffer from cystitis?

In men, cystitis is relatively rare due to the special structure of the lower urinary system: they have a long and convoluted urethra, which in most cases prevents the penetration of the infection directly into the bladder.

Under normal conditions, even if the infection enters the urethra, it is partially flushed out with a stream of urine, and the rest is destroyed by the cells of the immune system before the infection reaches the bladder.

In men, cystitis in most cases occurs when immunity decreases, congestion in the bladder occurs, or infectious agents enter it in large numbers.

Causes of cystitis in men

Cystitis in men Acute or chronic cystitis in a man most often develops as a result of the following factors:

  • radiation,
  • allergies
  • infectious diseases of the kidneys, ureters,
  • the presence of genital infections
  • immunodeficiencies, as well as a general decline in immunity due to the presence of another disease - for example, diabetes mellitus or blood diseases,
  • penetration of the bladder through the lymph, blood or with the urine current of mycobacterium tuberculosis or other bacteria, protozoa, viruses,
  • prolonged hypothermia
  • sepsis,
  • prostatitis, urethritis,
  • adenomas and prostate cancer,
  • reverse flow of urine, when in the urethra it starts to move turbulently,
  • traumatic injuries of the bladder, including during its catheterization and other medical procedures,
  • fistula between the rectum and bladder, etc.

The most typical pathogens of cystitis:

  • Proteus,
  • E. coli
  • pathogens of urogenital infections,
  • cocci.



Types of cystitis

Acute and chronic

The nature of the disease cystitis is:

  • sharp
  • chronic.

Acute cystitis is divided into:

  • first arisen
  • rarely occurring (once per year or less),
  • often occurring (annually from 2 times and more often).

After recovery in acute cystitis, all laboratory parameters and data obtained by instrumental means do not differ from the norm.

Chronic cystitis in turn is the following types:

1. Asymptomatic (latent), which has:

  • stable asymptomatic course (to identify such cystitis is possible only on the basis of data of endoscopic studies),
  • rare periods of exacerbation,
  • exacerbations 2 or more times a year.

The period of exacerbation of the latent flow resembles a picture of acute or subacute cystitis.

2. Persistent cystitis. Usually exacerbated 2-3 times a year, the obtained laboratory and instrumental examination data indicate the presence of an inflammatory process.

3. Interstitial cystitis. The most severe form of chronic cystitis, characterized by frequent exacerbations, almost constant pain in the area of ​​the bladder, progressive changes in its walls.

Interestingly, when it comes to acute or chronic cystitis, its appearance determines the nature of the identified changes in the bladder mucosa more than the frequency of exacerbations during the year.

Primary and secondary cystitis

By the nature of the occurrence of cystitis is:

  • primary,
  • secondary.

Primary cystitis occurs by itself and is not associated with any other disease. In turn, the following types of primary cystitis are distinguished:

  • acute cystitis (infectious, chemical, medicinal, toxic, thermal, neurogenic, alimentary);
  • chronic cystitis (infectious, inlaying, radiation, ulcerative neurotrophic, post-traumatic, involutional, etc.);
  • parasitic.

Secondary inflammation develops due to some other disease. Secondary cystitis are:

  • gallbladder origin (for example, stones, foreign bodies, traumatic injuries, tumors, developmental abnormalities, bladder surgeries);
  • extracellular origin (prostate adenoma, diseases and injuries of the spine, prostatitis, strictures of the urethra, etc.).

Cervical and diffuse cystitis

Depending on what part of the bladder is inflamed, the following types of cystitis are distinguished:

  • cervical cystitis (only the bladder neck is inflamed),
  • trigonite (inflamed bladder triangle, limited to the mouth of the ureter and the opening of the urethra)
  • diffuse cystitis (the bladder wall is involved in the process of inflammation).

With cervical cystitis, the sphincters of the bladder become inflamed, which is manifested by painful urination and urinary incontinence. Among other symptoms - frequent urge to urinate.

With trigonite, inflammation affects not only the sphincters of the bladder, but also the mouth of the ureter, which is fraught with such complications as vesicoureteral reflux (urine is thrown back into the ureter and can reach the kidneys, causing the development of pyelonephritis and congestion). For trigonite, urination disorders, the presence of blood and pus in the urine are characteristic.

Diffuse cystitis is characterized by total inflammation of the mucous membrane and typical symptoms, which will be discussed below.

Catarrhal and ulcerative

Depending on how the mucous membrane and deep-lying structures change, the following types of inflammation in cystitis are distinguished:

  • catarrhal - mucous just hyperemic,
  • hemorrhagic - hemorrhages are observed,
  • cystic - inflammation is accompanied by the appearance of cysts,
  • ulcers - ulcers appear on the mucous membranes,
  • phlegmonous - with the presence of a large amount of pus,
  • gangrenous - bladder tissue necrosis is observed,
  • other types (for example, inlaying, interstitial, granulomatous).

The type of inflammation in cystitis depends on the properties of the pathogen itself and the state of the body's defenses. In catarrhal cystitis, changes in the mucous membrane are minimal compared to other forms. To determine one or another type of inflammation can only endoscopically (for example, with cystoscopy), followed by a biopsy.

Rare forms of cystitis

The rare forms of cystitis include:

  • cystitis in urogenital schistosomiasis (bilharciasis),
  • actinomycosis (damage to the bladder with the appropriate fungus),
  • Malakoplakyy - the appearance of many plaques and growths on the mucous membrane of the bladder (and some other organs), accompanied by inflammatory reactions,
  • cystitis that occurs with purpura.

The main symptoms of cystitis in men

Depending on whether acute cystitis or chronic exacerbation, the course of the disease can be mild, moderate or severe.

Acute cystitis

The most characteristic symptoms of acute cystitis:

1. Urination:

  • painfully
  • difficult
  • with frequent and false desires,
  • observed at night.

2. Urine:

  • with blood (terminal hematuria),
  • with pus (leukocyturia),
  • muddy,
  • sometimes with an unpleasant smell.

3. Other symptoms:

  • temperature rise,
  • general weakness
  • reduced performance
  • soreness in the suprapubic region, as well as in the penis, groin, scrotum,
  • urinary incontinence (with cervical form and trigonite),
  • burning in the urethra,
  • pains in muscles, joints, due to high temperature.

Chronic cystitis

Chronic cystitis occurs less rapidly than acute, and is generally characterized by:

  • less soreness
  • less urinary dysfunction,
  • the best overall well-being.

Chronic latent cystitis can generally occur imperceptibly for the patient and can only be diagnosed by changes in the urine and cystoscopy data. But interstitial cystitis leads to increased urination (almost every hour), persistent and persistent pain in the suprapubic area and associated irritability, depression, anxiety and reduced quality of life. Usually, patients suffering from interstitial cystitis undergo more than one course of unsuccessful antibiotic treatment until they have an accurate diagnosis.

Diagnostics

Examination by a urologist

Preliminary diagnosis is based on the patient's complaints, as well as urological examination data, including examination and palpation of the external genital organs and a digital examination of the prostate through the rectal wall. Already at this stage, it becomes clear whether cystitis is associated with the presence of adenoma, prostatitis, orchiepididymitis or not.

After that, the doctor will prescribe additional laboratory and instrumental examination, which allows to identify the pathogen and clarify the nature of inflammation.

Laboratory research

1. General urine analysis. Cystitis is characterized by the following changes in the urine:

  • increase of leukocytes (leukocyturia),
  • the presence of blood (hematuria),
  • in some cases - mucus, desquamated epithelial cells, bacteria, protozoa.

2. Complete blood count . The blood picture will reflect the severity of cystitis and some of its features (for example, an increase in eosinophils in allergic cystitis, an increase in ESR, and leukocytosis in the event of a fever).

3. Bacteriological culture of the contents of the urethra and urine. With this study, the causative agent of cystitis is detected and its sensitivity to antibiotics is determined.

4. PCR - research . It is prescribed for suspected genital infections. With the same purpose, scraping is done.

A more comprehensive and in-depth study may include an immunogram, a biochemical blood test (urea, creatinine, electrolyte composition), a level of prostate-specific antigen, etc.

Instrumental studies

To clarify the cause of cystitis, men are assigned:

  • uroflowmetry
  • comprehensive urodynamic examination,
  • cystoscopy,
  • Ultrasound of the prostate, kidney,
  • cystography.

Ultrasound of the bladder during an exacerbation of chronic or acute cystitis is not performed due to the impossibility of maximizing the urine of this organ during this period.

Treatment of cystitis in men

The treatment of cystitis should be carried out only by an outpatient specialist or, in case of incessant pain, acute urinary retention, hemorrhagic cystitis - permanently.

Most forms of cystitis are treated conservatively. For surgical intervention in men resorted in the following cases:

  1. Gangrenous cystitis. During the operation, the bladder is relieved of necrotic tissues, adequate flow of urine is provided, and plastic is made if necessary.
  2. Chronic cystitis caused by prostate adenoma . According to indications, excision of the entire prostate gland or its part is carried out, as a result of which urine outflow is normalized and inflammation disappears.

Acute cystitis

Recommended:

  • bed rest in the early days,
  • plentiful drink (2–3 liters per day),
  • exclusion from the daily ration of spices, seasonings, alcohol, coffee, spicy dishes,
  • refusal for the period of treatment from smoking,
  • antispasmodics (for example, no-shpa, papaverine),
  • decoctions of herbs with antiseptic and anti-inflammatory effects,
  • antibacterial drugs (furagin, blacks, oxacillin, tetracycline, oletetrin, etc.) for 1–1.5 weeks.

To reduce the pain prescribed by the doctor, you can use heat on the lower abdomen (except for hemorrhagic and tuberculosis cystitis), warm baths, microclysters with warm 2% novocaine.

Chronic cystitis

For successful treatment of chronic cystitis, it is necessary to identify and eliminate the causes that cause and maintain inflammation. For example, eliminate urine stagnation, remove stones, treat prostatitis.

Antibiotics are prescribed after identifying the pathogen and determining its sensitivity to the drug.

Local treatment is reduced to the appointment of bladder washes with solutions of furatsilina, silver nitrate for 2 weeks. Instilled (injected into the bladder) sea buckthorn oil, emulsion of antibacterial agents.

From physiotherapy for the treatment of chronic cystitis using UHF, iontophoresis, mud applications, inductothermy.

Features of treatment of some forms of cystitis

  1. Tuberculous cystitis. In addition to anti-tuberculosis drugs, instillations of sterile fish oil, saluzid, PAS are prescribed.
  2. Radiation cystitis Topical treatment is supplemented with instillation of healing stimulating agents. If large parts of the mucous membrane are affected, they perform plastic surgery.
  3. Interstitial cystitis. In addition, the treatment is complemented by the appointment of instillations of hormonal drugs, antibacterial and painkillers. An anti-inflammatory and antiallergic medication can be administered inside.

Phytotherapy

For the treatment of cystitis are widely used fees, which may include the following plants: calamus root, St. John's wort, lemon balm, kidney tea, knotweed, bearberry, fennel, nettle, chamomile, wild rosemary, horsetail, corn silk, birch buds, flax, oregano, eucalyptus and some others.

The course of treatment of chronic cystitis is up to 1.5 years, alternating herbal teas between themselves every 2 months.

Complications of Cystitis

The most serious complications of cystitis are the occurrence of vesicoureteral reflux (when urine is thrown from the bladder back into the ureters) and pyelonephritis. Severe forms of cystitis (eg, gangrenous) can lead to fistulas and inflammation of the paravesical cellulose. Inflammation in the sphincter of the bladder is sometimes accompanied by acute urinary retention.

Prevention of cystitis in men

In order to prevent the occurrence of cystitis in men, you need:

  • maintain genital hygiene,
  • avoid sexually transmitted infections
  • do not supercool
  • timely treat adenoma, prostatitis or cancer,
  • drink enough liquid
  • strengthen the immune system.

Conclusion

Despite the fact that cystitis in men is relatively rare, it is necessary to remember that after 40 years the situation may change due to the occurrence of prostatitis, prostate adenoma or prostate cancer.

Due to the fact that cystitis may be completely asymptomatic for a long time, it is necessary to undergo regular medical examinations, including a complete urinalysis.

In most cases, in the early stages, cystitis responds well to treatment and can be defeated.


| January 19, 2014 | | 14 147 | Uncategorized
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Emely Taveras: I notice that I get the pain most when I intake anything with tomatoes. ladies keep a look at the symptoms you get after eating certain foods!

Claudia Draper: Everybody chill , I’m 14 and I am on birth control , every month I get 6 days of the most painful cystitis ever !! It’s awful and I honestly feel so bad for all the women who suffer from it like I do , the best thing to do is go to Tesco / local shop and buy cranberry sachets they really help ease the pain and also distract yourself , praying for all you girls out there love you all!!💖💖

Rigel Moon: I believe IC to be caused by a pathogen that has yet to be cultured.  Like peptic and duodenal ulcers, that went for years unchallenged by microbiology, someone somewhere realized that microbes can survive in extreme environments like outer space and in the deepest oceans where boiling, hot water near volcanic vents provide a home for the most hardy types of nasty, little critters.  The pathophysiology of IC mirrors that of the peptic and duodenal ulcers: we have ulcers in and on our bladder walls.  What's destroying our GAG layer? Something has to be involved.  It's not "auto-immune", for crisake.  "Auto-immune" is a new moniker for saying "they don't have a clue", just like "idiopathic".  Who is continuing research on pathogenic causes of IC?  These websites tell us nothing new.  As well meaning as these sites may be, they're all a generic psycho-babble that we've heard ad nauseam for how long now?   It's so frustrating!  Find the virus/bacteria that's responsible!!  Just because they can't culture it doesn't mean it isn't there.

Yvonne Wilkinson: I am so tired of this. The pain is so bad now I'm on morphine. Would it be better to remove my bladder I dont know. Would that be another nightmare.

Truth: My fiance is going through this and it has devastated her quality of life in a matter of 2 months. Nothing is the same. It's horrible that there isn't more focus on this amongst the medical community. I'm watching my wife to be fall apart in front of me. My heart is broken. If I could take the pain from her so I don't have to endure watching her thrash about in agony, I would. Our lives are not the same anymore.

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