Women’s equipment of the person, certainly, is more beautiful than men’s, but in functionality obviously loses. In addition to all the other vicissitudes that fall to the female share (menstruation, childbirth, lactation, menopause), the Creator did not bother much with the excretory system-change the penis to the vagina, and the urethra, which passes in it… m-m-m, just shorten to 3 cm, and that’s all. So it turned out that men from the bladder comes a long narrow tube with three sphincters, so you can tolerate for a long time, and the bacteria in this tunnel until the bladder gets, already forget why it went. In women, the bladder can be said to exist wide open. One sphincter, a short wide urethra, and it opens in not the most “sterile” place-at the entrance to the vagina, and just below the anus – that is, two constant sources of diverse bacterial flora, constantly mixing with each other. All this causes endless queues in the women’s toilet (by the way, the problem is known, why they are not initially designed twice as much as men’s??) and the fact that the disease “cystitis” is considered purely female, despite the fact that cystitis occurs in men, but it is extremely rare and only in the presence of concomitant relatively rare pathology.
The length of the urethra in a woman is about 3 cm.
With cystitis at least once faced every second woman, half of them do not end with a single acquaintance, that is, the disease is repeated from time to time. But there is a separate small category of patients who have symptoms of cystitis occur so often that it turns their lives into continuous suffering.
So, restore order in the knowledge of cystitis.
- Cystitis-inflammation of the bladder. Its symptoms are known to all: painful frequent urination in small portions, pain in the abdomen.
- In 80% of cases, cystitis is caused by E. coli (its special species, called UPEC, that is, those who are particularly attracted to the epithelium of the bladder), in other cases – Staphylococcus and other opportunistic microorganisms.
• When infected with venereal diseases (chlamydia, trichomoniasis, gonorrhea), there may be symptoms of cystitis, but in these cases, the picture of the disease in the vagina and external genitals will be no less bright, that is, cystitis will only accompany, and not be the only manifestation of the disease. In other words-if you only have cystitis, do not think about STDs.
• However, with such common disorders of the vaginal flora as thrush, bacterial vaginosis and aerobic vaginitis, painful urination can be, but there is usually no frequent urination, and pain occurs outside, that is, when urine enters the inflamed mucous membrane.
Cystitis as an independent disease occurs only a few times in a woman’s life and is independently resolved in 3-4 days.
- In continuation of previous points – if you have normal white mucous or dairy allocation from vaginas without smell, and there is only cystitis, then surrender smears and undergo full inspection have gynecologist impractical, namely with this why something are beginning most doctors.
- It is important to understand that most women have cystitis if it occurs, then only a few times in their lives, and it will pass independently within 3-4 days. Those women whose cystitis begins to recur more than twice in six months have a congenital predisposition or a concomitant disease or condition.
• In the beginning, let’s talk about simple cystitis. As I said, it can occur several times in a lifetime, lasts 3-4 days. Can pass on their own, but if add monural 3 g couple of sachets through day and actively to drink cranberry juice, – all can end faster and easier. This may be a one-time phenomenon, which will be repeated in a few years.
- It is important to remember that if a few days after the onset of cystitis you have a fever, lower back pain, nausea, weakness, malaise, it is necessary to urgently consult a doctor, as cystitis can be complicated by pyelonephritis (inflammation of the kidneys).
- There are patients who, after the first episode of cystitis, the disease begins to relapse constantly. It is assumed that they have a birth defect in the mucous membrane of the bladder, which allows E. coli to adhere very easily to the epithelial cells and multiply there. A special kind of such cystitis is postcoital cystitis (“honeymoon cystitis”), that is, the exacerbation of the disease occurs after each sexual intercourse.
• Now is the time to list what provokes cystitis: an active sex life (especially anal sex) – it is believed that this contributes to cast flora; infringement of rules of hygiene (movement in the crotch from back to front, right – front-back); long patience; incomplete bladder emptying; use of diaphragms and spermicides (now rarely used). It is obvious that all of the above occurs with most women constantly, but does not lead to cystitis, but can contribute to the exacerbation of the disease in those who have a predisposition to it.
• “Sitting on the cold” in itself does not provoke cystitis, but the overall stress of the body from hypothermia can activate the exacerbation of the existing disease by reducing immunity (hit or already located in the bladder Escherichia coli will not resist the immune system, and inflammation will occur).
Sitting on cold can indirectly cause cystitis.
- Here are the background diseases that can provoke the development of cystitis (that is, they should be excluded): urolithiasis, some anatomical defects, diabetes, impaired innervation of the bladder, pregnancy, menopause, frequent catheterization of the bladder, HIV infection, etc.
- We must admit that the problem of recurrent cystitis and have not learned to fully solve. At the moment, in the Arsenal of doctors there are the following means: prophylactic antibiotic after sexual intercourse, if it is postcoital cystitis (the most common-Biseptol tablet at the end of pleasures); recommendation to write to the last drop, especially after sexual intercourse, that is, squeeze everything to the last; prophylactically drink cranberry juice or better juice; long courses of antibacterial drugs; operation to change the position of the opening of the urethra (if it is very close to the vagina) – the effectiveness is not proven; taking a drug that should form a local immunity to E. coli (Uro-vaxom); as a rule, within a few years of fighting cystitis, it suddenly recedes, and what is the cause (treatment or changes in the body), is unknown.
• But the story does not end there: in addition to the usual bacterial cystitis, there is another cystitis, more precisely, a mysterious disease that is now commonly called “interstitial cystitis / painful bladder syndrome” (IC/SBMP). Here everything is not very optimistic. With this type of cystitis, women complain of constant pelvic pain, frequent painful urination, imperative urge to urinate. In this case, all tests are normal or within acceptable limits. That is, it is not an infectious disease. This condition is often combined with fibromyalgia (muscle pain), irritable bowel syndrome, vulvodynia (discomfort and itching in the vulva), a constant increase in temperature to 37.2-37.5), chronic fatigue syndrome, etc. Most often the disease occurs after 30 years. This type of cystitis is included in the complex of “somatoform disorders”, about which there is a separate paragraph below. Since only advanced urologists have heard about this disease, the history of such patients is terrible: the endless intake of antibiotics, herbal medicines, instillation of various substances into the bladder, immunomodulators, acupuncture, etc.Relief if it comes, it is temporary, life turns into hell, personal life collapses, there are severe depressive States. Relative effectiveness in this type of cystitis have the following means: introduction into the bladder cavity of hyaluronic acid, chondroitin sulfate, botulinum toxin (Botox) injections and other means, also introduced into the bladder cavity. Of great importance is psychotherapy, often therapy is supplemented by the appointment of antidepressants.
To sum up: cystitis as an accident can happen to any woman and repeat several times in life. The risk factors are quite nonspecific, meaning sitting in the cold will not necessarily lead to cystitis. To cystitis, which can turn a patient’s life into hell, you need an innate predisposition. It is important to recognize interstitial cystitis in time, to distinguish it from infectious and not to torment the patient with endless courses of antibiotics.
One of the types of cystitis – interstitial – somatoform is a disease that is largely determined by psychological problems.
