Cystitis
"Cystitis is a common but treatable condition. Early detection and appropriate treatment are essential to prevent complications and improve our patients' quality of life".
DR. FELIPE VILLACAMPA
SPECIALIST. UROLOGY DEPARTMENT
What is cystitis?
Cystitis is an inflammation of the urinary bladder, usually caused by a bacterial infection. It is a common medical condition that can affect people of all ages, although it is more frequent in women due to their anatomy. Cystitis is classified within urinary tract infections (UTI), being one of the most prevalent forms.
The main cause of cystitis is bacterial infection, with Escherichia coli (E. coli) being responsible in most cases. These bacteria, which normally inhabit the intestine, can reach the bladder through the urethra, causing infection. In addition to bacterial infections, cystitis can also be caused by non-infectious factors, such as chemical irritation, the use of certain hygiene products, medical treatments or underlying conditions such as radiation therapy or interstitial cystitis.
There are different types of cystitis, acute cystitis being the most common form, characterized by a sudden onset and intense symptoms. Recurrent cystitis, on the other hand, occurs in repeated episodes, often due to persistent predisposing factors or an underlying infection not completely resolved. Interstitial cystitis, also known as painful bladder syndrome, is a chronic form of cystitis without an identifiable bacterial cause, and its origin is less well understood.
Cystitis is an important medical condition that can have a significant impact on the quality of life of those who suffer from it.
What are the symptoms of cystitis?
Cystitis is defined by a characteristic clinical picture of painful or itchy urination, very increased and scarce frequency of urination (frequency), permanent sensation of desire to urinate (urgency) and sometimes bloody urine (hematuria). The picture is always without fever.
If fever is present, it indicates that another organ is also affected. In a male, the prostate may be the affected organ. The condition is called acute prostatitis.
If the affected organ is the kidney, the picture is called acute pyelonephritis and it is characterized by fever, chills, lumbar pain, malaise..., accompanied by significant bacteriuria.
Most frequent symptoms of cystitis
- Burning, pain or stinging when urinating.
- Very increased frequency of urination.
- Permanent sensation of desire to urinate.
- Bloody urine.
Do you have any of these symptoms?
You may have cystitis
What are the causes of cystitis?
The usual germs come from feces (enterobacteria). The absolute protagonist is the Escherichia Coli, responsible for 85% of uncomplicated infections in sexually active women, 70% of uncomplicated infections in adults and 50% of hospital infections.
After E. Coli, the most common germs are Proteus, Klebsiella, Enterobacter, Citrobacter, Pseudomona, Serratia, Staphylococcus Streptococcus Faecalis and especially Staphylococcus Saprophyticus (15% of infections in sexually active women).
What are the risk factors for cystitis?
There are demographic factors (poverty, nosocomial -hospital environment-, pregnancy), urological factors (probes, anomalies, stones, obstruction), medical factors (diabetes, immunosuppression) and behavioral factors (barrier type contraceptives increase four times the infection rate, the risk increases 40 times in sexually active women) that facilitate urinary infection.
Despite this, there are situations in which the predisposition is more important:
- Diabetes.
- Pregnancy: includes a higher risk of asymptomatic bacteriuria that, if left untreated, can cause pyelonephritis in the last trimester.
- Infection in children and vesico-renal reflux.
- Infectious lithiasis: struvite stones are a consequence of infection. The infection will not disappear until the stones are removed.
- Obstruction: the most important risk factor. It allows greater growth and intrarenal penetration of germs and is decisive in renal destruction.
How is cystitis diagnosed?
To be considered as cystitis, the growth of bacteria in the urine culture must show significant bacteriuria. Then, it is necessary to identify the anatomical location of the infection, using the clinical symptoms and, if necessary, complementary explorations.
Finally, it is necessary to indicate whether it is one:
- Primoinfection or isolated infection.
- Unresolved infection.
- Recurrent infection: either by bacterial persistence or much more frequently by reinfection, which is defined by 2 symptomatic cystitis in less than 6 months or more than 3 in 12 months.
How are cystitis treated?
Treatment of cystitis depends on the underlying cause and severity of the infection, and can range from antibiotics to self-care measures and lifestyle changes.
Antibioticis treatment of cystitis
The standard treatment for bacterial cystitis is the administration of antibiotics. Physicians select the type of antibiotic based on the type of bacteria responsible for the infection and local bacterial resistance. Among the most commonly prescribed antibiotics are:
- Trimethoprim/Sulfamethoxazole: This is one of the most commonly used antibiotics to treat uncomplicated cystitis.
- Nitrofurantoin: Effective for the treatment of lower urinary tract infections, including cystitis.
- Fosfomycin: Often used in a single dose, which facilitates adherence to treatment.
- Fluoroquinolones: Reserved for more severe or complicated cases due to their resistance profile.
The duration of antibiotic treatment can vary from three to seven days in uncomplicated cases, and can be extended in more complex situations.
Self-care measures
In addition to medical treatment, there are several self-care measures that can help relieve the symptoms of cystitis and prevent recurrence:
- Adequate fluid intake: Drinking enough water can help flush bacteria from the urinary system.
- Personal hygiene: Maintaining good genital hygiene can prevent bacteria from entering the urethra.
- Frequent urination: Not holding urine for prolonged periods can reduce the risk of infection
- Proper clothing: Wearing cotton underwear and avoiding tight-fitting clothing can help keep the genital area dry and reduce the risk of infection.
Where do we treat it?
IN NAVARRE AND MADRID
The Department of Urology
of the Clínica Universidad de Navarra
The Department of Urology of the University of Navarra Clinic offers the patient a medical team, composed of first-rate professionals, and state-of-the-art diagnostic and therapeutic means such as the Da Vinci® robotic surgery.
The Department of Urology possesses the certificate of accreditation of the European Board of Urology, a reinforcement of the excellence of the service at the level of care, teaching and research, which in Spain only three hospital centers possess.
Diseases we treat:
- Prostate Cancer
- Kidney Cancer
- Bladder Cancer
- Testicular Cancer
- Benign prostatic hyperplasia
- Urinary Incontinence
- Renal Lithiasis
- Genitourinary Prolapses
- Pediatric Urology
Why at the Clinica?
- A team of top-level professionals trained in international centers.
- State-of-the-art technology for diagnosis and treatment.
- In 24-48 hours you can start the most appropriate treatment.
