Cystitis and its complications: what are the dangers of self-treatment and what to do in emergency situations

Every second woman visits a doctor because of cystitis. Often this happens after attempts at self-treatment and repeated intake of antibiotics. As a result, they develop high resistance to medications and chronic pathology.

How not to miss cystitis and prevent the development of complications is explained by urologist of the capital’s clinic “Oxford Medical” Daria Lebed.

What Is Cystitis

Cystitis refers to symptoms that manifest as painful and frequent urination. The most common types are:

• Acute, sometimes with blood admixtures, which occurs due to hypothermia and the presence of immunodeficiency;

• Postcoital, meaning after sexual intercourse.

The disease is characterized by inflammation of the bladder caused by bacterial or fungal infection.

Unobvious Symptoms or Those Indicating Other Problems

In the case of cystitis, it is important not to miss a symptom that is confused with other diseases: a dull pulling pain above the pubis without frequent and painful urination. Women usually ignore it because they know they have, for example, uterine fibroids or an ovarian cyst. However, ignoring this condition leads to ascending pyelonephritis, and then they end up at the doctor’s with a temperature of 40.

Frequent nighttime trips to the toilet do not necessarily indicate cystitis. One option, of course, may be the onset of this disease. But other causes include:

• Problems with the cardiovascular system. When a person has varicose veins, prolapse, or stenosis of the heart valves, its pumping function is weaker, which causes leg swelling during the day. At night, in a horizontal position, venous return of blood increases, kidney filtration improves, swelling subsides, and the fluid must go somewhere. This is the reason for frequent urination;

• Non-compliance with drinking regimen: excess water in the evening.

Many women mistake for cystitis the manifestations of neurogenic bladder of the hyperactive type. In this case, there is an imperative urge to frequent urination, while the portions of urine are meager, less than 50 ml. However, this urge cannot be suppressed. The reason lies in the peculiar structure of the nervous system, when the mechanism of impulse transmission from the brain through the spinal cord to the bladder is disrupted. While a girl is young, the tone of the pelvic floor muscles helps to hold the bladder, but after childbirth or with age they weaken, and the woman suffers from urinary incontinence. In this case, a comprehensive examination is carried out to exclude inflammation. Therapy can be combined, for example, botox injections into certain areas of the bladder or conservative therapy with drugs of local and central action.

Sometimes after chronic cystitis, which had an infectious agent, even with sterile urine a woman continues to feel discomfort similar to cystitis. These may be problems with the lumbar or sacral spine, with other pelvic organs, or leukoplakia of the bladder, when transitional epithelium cells are replaced with squamous cells. In the latter case, positive dynamics is achieved by laser ablation, which removes pathological cells.

Causes of Cystitis

Any stress, both emotional and related to a change in usual lifestyle, can lead to cystitis.

For example, a long trip with insufficient drinking and lack of proper hygiene, or during menstruation. Or the classic situation: a vacation at a resort, with lots of sun, alcohol, swimming in a pool – due to drafts or hypothermia, immunity weakens, creating a favorable environment for cystitis.

A fairly common cause is staying outdoors in damp or cold weather.

People with immunodeficiency: chronic disease (lupus, rheumatism, bronchitis, colitis) or a banal cold or ARVI, are also prone to cystitis. When the immune system fights another disease, it cannot cope with additional negative factors that cause bladder inflammation. For example, diabetics have a much higher risk of developing cystitis, which very quickly, literally within a day, turns into pyelonephritis.

That is why it is worth strengthening the immune system, covering vitamin deficiencies, drinking plenty of water, and periodically checking the thyroid gland.

Diagnostics

The disease must be verified and treated by a urologist. To do this, you need to come to the doctor’s appointment with a full bladder.

Depending on the situation, the examination includes:

• General urine analysis;

• Ultrasound of the bladder;

• Urine culture to determine the microflora that caused the inflammation. It allows selecting the active substance for the treatment of cystitis and assuming where the infection came from to prevent relapses;

• Synergy test is done if bacteria resistant to all antibiotics are found in the culture. The test determines a combination of uroseptics that can suppress their growth. This is important to create a stable remission for the patient, preventing monthly relapses of cystitis. Such a strategy not only suppresses microflora but truly cures the disease.

How to Collect the Test Properly

For reliable results, external genital hygiene is required before the test. That’s all. The idea that only morning urine should be collected is wrong. It is impossible to predict the onset of cystitis: if pain appears in the middle of the day – on the road, in the office, at work outdoors, or if you urinate with blood, you should not wait until morning to collect night urine. Go to a clinic that accepts tests until evening. In this regard, the presence of a hospital where the laboratory works around the clock becomes a big advantage. This makes it possible to urgently take tests and immediately receive recommendations.

Daria Lebed notes that sometimes girls come to the appointment during menstruation. If they do not use tampons, for maximum objectivity of the analysis they are offered urine collection with a urethral catheter, tiny and thin, without excessive discomfort. This makes it possible to avoid unnecessary erythrocytes in the analysis.

First Line of Help

In the case of cystitis with blood, immediately, without waiting for the results of the culture, a broad-spectrum drug is prescribed to prevent complication – pyelonephritis. Usually ascending pyelonephritis is a consequence of untreated cystitis, most often hemorrhagic.

If the disease does not significantly affect the quality of life: there is no very severe pain during urination, the person stays at home, has sedentary work, can drink plenty of warm water, use diclofenac suppositories, take, for example, cataria, the appointment of antibiotics can be postponed until test results are obtained.

The expert notes that to decide on the treatment strategy, she always consults with the patient about how much the condition affects their usual life.

What to Do in Emergencies

Are you going on vacation, a business trip, abroad? Take care of a travel first aid kit.

Take with you medicines that symptomatically relieve pain, in particular:

• Non-steroidal anti-inflammatory drugs, such as paracetamol, nurofen, ibuprofen;

• Diclofenac suppositories if you suffer from gastritis and cannot take NSAIDs.

But the most important rule in case of cystitis is to drink plenty of water to urinate frequently and prevent pyelonephritis. In some cases, you can apply warmth to the bladder area.

Daria Lebed also warns that self-prescribing antibiotics or uroseptics, such as monural, will do more harm than good. Against their background, the diagnosis of the disease later becomes more complicated and delayed. Additional examinations are required, which may take almost a month to determine the true cause of inflammation. And then six months to treat cystitis.

Danger of Infection Spread in Case of Untimely Diagnosis

Any infection that provokes inflammatory phenomena in the urinary system is an ascending tract infection. Thus, bacteria from the vulva or E. coli, which is normal microflora of the rectum, migrate into the urethra, causing urethritis.

Then cystitis quickly develops, and under unfavorable circumstances – pyelonephritis. If the disease is not treated in time, reproductive organs are affected, blood rheology worsens.

Pyelonephritis is dangerous because kidneys have reduced functional capacity and become a source of infection spread. A severe complication is apostematous pyelonephritis, in which abscesses form in the kidney tissues. They require drainage – surgical intervention to rid the organ of foci of purulent transformation. The most radical method of help is kidney decapsulation.

Treatment Methodology

Usually complex therapy is prescribed:

• Conservative – tablets aimed at the etiological factor, i.e., the bacterium that caused the disease;

• Symptomatic – antispasmodics and anti-inflammatory drugs to relieve such manifestations as spasms, burning;

• Abundant drinking.

If complications occur due to comorbidity or late referral, surgical treatment is possible.

Thus, the earlier you visit a urologist without taking antiseptic-spectrum drugs, the easier and cheaper it will be to diagnose the disease. The specialist will immediately start treatment without risks of complications. If you delay the visit because of self-treatment, there will be more complications, longer time to identify the cause of inflammation and to select medications, and most importantly – risk of chronic pathology and vulnerability to the disease for life.