The inflammatory process in the bladder in most cases is noted in men over 40 years old, and is associated with a decrease in natural immunity. Men with concomitant pathologies of the genitourinary system of an infectious nature tend to develop cystitis.
Cystitis is a rare disease in men. Thanks to the long urethra, it is difficult for infections to penetrate the bladder. A stream of urine will wash away a pathogen that has entered the urethra, but if it lingers on the urethral wall, movement through it is so slow that immune system cells have time to destroy the agent. infection.
This explains that the diagnosis of pathology in men occurs 10 times less than in women. The disease develops only if there are factors favorable to the massive development of pathogenic microflora in the context of a marked decrease in immunity. Usually such conditions create blockages in the bladder.
Causes of cystitis in men
The disease develops when an E. coli, coccal, or urogenital infection enters the bladder. This process is supported by changes such as:
- reduced immunity under the influence of radiation, development of diabetes, blood diseases;
- development of a negative reaction from the immune system;
- inflammatory process in the prostate, kidneys, ureters;
- bladder compression due to prostate cancer or benign hyperplasia;
- fistula formation in the rectum;
- sepsis;
- physical damage caused by sexually transmitted infections;
- reversed urine flow;
- bladder injury, including due to surgical intervention in the pelvic area;
- penetration of protozoan viruses into blood and lymph.
Prolonged hypothermia of the body, which causes a sharp decrease in immunity, can also cause the development of pathology.
Types of cystitis
Depending on the degree of obvious manifestation of symptoms, the disease is divided into acute and chronic forms. Acute cystitis is generally divided into those occurring for the first time, occurring no more than once per year, or being noted at least twice a year. After completing all therapeutic measures, no inflammatory process was detected in the bladder, and laboratory control tests confirmed the normalization of all indicators.
When prescribing treatment, modifications to the standard treatment regimen are carried out taking into account the primary or secondary disease. Primary cystitis is a disease that occurs independently and is not a complication of another disease. An acute form of illness that can arise from exposure to medical, toxic, infectious, or chemical factors. Parasitic infections can also cause pathology. The chronic form may be due to infection, trauma, nervous breakdown, or radiation.
Chronic cystitis is characterized by a process in which periods of rest are replaced by exacerbations. There are 3 types of chronic form:
- Implicit.The disease occurs without the appearance of obvious symptoms and is detected during a routine health check-up. The disease has rare periods of severity, coinciding with the symptoms of acute cystitis.
- Persist.Exacerbations are noted about 2 times a year. Symptoms of the disease are moderate.
- interleaved.This form is characterized by frequent exacerbations and the presence of pain even during periods of rest. This cystitis is considered the most dangerous and difficult to treat type of cystitis, causing rapidly progressive destruction of the bladder wall.
In most cases, when classifying a chronic disease, urologists focus on the severity of organ wall damage, the severity of symptoms, and not on the frequency of recurrences.
In medical practice, a classification is also used that allows the classification of pathology according to the criteria of the affected part of the bladder. In this case, people often distinguish cystitis:
- Cervical.The inflammatory process is localized in the bladder neck, affecting its sphincter. A man faces the problem of frequent urination and urinary incontinence. The process of emptying the bladder will become painful.
- Trigonite.The inflammatory process starts from the sphincter of the affected organ and spreads to the mouth of the ureter. This form often causes the development of urinary reflux. When urine backflows, infectious agents can enter the kidneys, contributing to pyelonephritis. This man had urinary problems, including urinary incontinence mixed with blood or pus.
- Diffusive.Its prominent feature is damage to the bladder wall.
When determining damage to the mucous membrane and underlying structures, it is not enough for a urologist to diagnose diffuse cystitis, but it is also necessary to clarify the subtype of the disease, characterize the features of the processinflammation and damage caused. cause of it.
To determine the characteristics of bladder wall damage in cystitis, endoscopic examination with biopsy is used. The study of biological material and analysis of accompanying symptoms allows us to further classify the pathology into:
- inflammatory bowel disease, causes only redness and irritation of mucous membranes;
- hemorrhage, stimulates the development of bleeding;
- cyst, in which cysts form on damaged walls;
- ulcers, its name is due to the appearance of ulcers;
- sputum, diagnosed when pus forms in the problem area;
- caseation, noted in the presence of tissue necrosis.
There are also some diseases that are reported to be extremely rare, such as urogenital schistosomiasis or fungal infections. The inflammatory process can be accompanied by the appearance of a large number of plaques on the mucous membrane of the organ, in this case cystitis is defined as malakoplakia.
Typical symptoms of cystitis in men
Signs of pathology can vary slightly depending on whether it occurs in an acute or chronic form, the type of pathogen and the nature of the lesion. The severity of the disease is determined by the intensity of symptoms and the degree of bladder damage.
Acute cystitis is characterized by poor urination, which becomes painful and difficult, with frequent urges to urinate, including at night. Patients often complain of a false urge to urinate and the feeling of empty bladder. The urine itself becomes dark and cloudy, may have a particularly pungent odor or contain pus or blood impurities.
The inflammatory process in most cases causes an increase in body temperature and the appearance of severe pain localized in the groin, scrotum and urethra. Intoxication of the body leads to general weakness, lethargy and decreased ability to concentrate. In some forms of pathology, urinary incontinence is noted. With a long course of the disease, urination begins to be accompanied by a pronounced burning sensation.
In the chronic form of the disease, the intensity of symptoms is less pronounced, and high temperature is rarely noted. With latent cystitis, signs of pathology may be completely absent, the presence of the inflammatory process can be detected only through laboratory tests.
Interstitial cystitis is accompanied by a significantly increased urge to urinate, accompanied by persistent, constant pain in the suprapubic area. General changes in the body lead to the development of anxiety, irritability and progressive depression.
Diagnosis of cystitis
Diagnosis requires a visit to a urologist, who conducts an individual examination of the patient and studies a variety of complaints. The patient needs to undergo a rectal examination procedure. The doctor inserts a finger into the rectum to check the condition of the prostate. This method allows you to determine whether the symptoms are related to prostatitis or prostatic hyperplasia.
The next stage is the introduction of laboratory tests, which not only confirm the presence of an inflammatory process, but also determine the type of infectious agent in order to choose a drug with maximum sensitivity. The list of laboratory tests includes:
- General urine analysis.The development of cystitis is indicated by an increase in the concentration of leukocytes, the presence of mucus, bacteria, epithelial cells or blood impurities in biological fluids.
- General blood analysis.Changes in indicators indicate the severity of the pathology. This list includes the finding of leukocytosis, increased eosinophil concentration.
- Seeding tankThe study of pathogens present in urine or on the urethral wall helps to assess their sensitivity to the effects of various antibacterial drugs.
- Infection testingsexually transmitted diseases.
If the results obtained give a blurry picture, not allowing to clearly determine the patient's condition, then additional studies may be indicated, including biochemical blood tests, immunograms and blood concentration assessment. prostate specific antigen levels.
In addition, during a comprehensive examination, instrumental diagnostic methods are used:
- Cystoscopy and cystoscopy;
- Ultrasound of kidneys and prostate;
- Measure urine flow.
Ultrasound of the bladder can give the most detailed picture of the condition of the bladder, but in the acute stage of the pathology, filling the organ with urine to the necessary limit is impossible, which preventsprevent the use of this method.
Treatment of cystitis in men
The course of therapy should only be prescribed by a doctor. For mild or moderate forms of the disease, outpatient treatment is possible, including regular follow-up examinations by a urologist. In severe cases with acute urinary retention, severe pain or bleeding, hospital treatment is indicated.
Surgical treatment is rarely used; Indications for surgery are acute urinary retention in the presence of tissue necrosis or prostate adenoma. In other cases, conservative therapeutic methods are used.
When diagnosing acute cystitis, a man should stay in bed for 3-5 days. He needs to follow a diet that excludes from the diet foods or drinks that irritate the bladder wall:
- wine;
- tea, strong coffee;
- salted or smoked foods;
- hot spices.
Patients need to increase their fluid consumption to 3 liters per day, while avoiding carbonated drinks and energy drinks. To stop the inflammatory process, the patient is prescribed a complex of antibacterial, antiseptic and antispasmodic drugs. In addition, it is possible to use herbal decoctions that have a mild anti-inflammatory and pronounced antiseptic effect, such as those based on chamomile and calendula.
To combat moderate pain, you can additionally use a heating pad in the lower abdomen, but for hemorrhagic or tuberculosis forms of pathology, this method is contraindicated. Microenemas with anesthesia can relieve acute pain, but they can be used only with the permission of the attending physician. The duration of treatment for acute cystitis rarely exceeds 14 days.
Treatment of chronic cystitis includes taking measures to eliminate factors that support and provoke the inflammatory process. In case of blockage, massage and appropriate medication are prescribed; if stones or prostatitis are detected, measures to remove them will be taken. After determining the sensitivity of the pathogen, antibiotic therapy is selected.
Chronic cystitis is treated not only with medication, but also with physical therapy. The second group involves inserting a catheter into the bladder for irrigation with an antibacterial or antiseptic solution, such as one based on sea buckthorn oil. In addition, electrophoresis, mud therapy and thermotherapy are used.
For tuberculous cystitis, drugs that can suppress the activity of pathogens and drops based on fish oil are prescribed.
In the treatment of the radiation form of the pathology, drops with regenerating agents are additionally used, but in case of widespread damage, plastic surgery is recommended. To treat interstitial cystitis, a complex of drugs is prescribed, including painkillers, hormonal drugs, antibacterial drugs, anti-inflammatory drugs and antihistamines.
Herbal decoction is used as an auxiliary treatment. To prepare herbal tea, dried flowers or chamomile leaves, St. John's wort, nettle and eucalyptus. These agents act gently, have no pronounced effect on the immune system and stimulate the body's natural protective functions. The duration of treatment can reach 1 year, while the herbal mixture must be changed every 2 months.
Complications of the disease
If you do not seek medical help promptly, there is a risk of infection entering the kidneys, causing pyelonephritis or reversed urine flow. In some forms of pathology, fistula formation can become a complication. Damage to the bladder sphincter does not always contribute to urinary incontinence and can also lead to acute urinary retention.
Prevention of cystitis
The development of the disease can be prevented by maintaining intimate relationships, including the prevention of sexually transmitted diseases. A man needs to monitor the general condition of his immunity, which requires timely treatment of all infectious diseases, anti-prostatitis and annual medical examination. Quitting smoking, leading an active lifestyle, and avoiding hypothermia can help prevent cystitis.
Cystitis in men is rarely diagnosed, but this does not mean that this pathology is harmless. With reduced immunity and changes that occur in the body due to natural aging (after 40 years of age), the risk of developing pathology increases significantly.
It should be noted that the disease may be asymptomatic for some time, so men should not refuse preventive medical examinations, because inflammation can be detected in the early stages.