In most cases, the inflammatory process in the bladder is recorded in men over 40 years old, which is associated with a natural decrease in immunity. Men with accompanying pathologies of the genitourinary system of an infectious nature are prone to the development of cystitis.
Cystitis is a rare disease among men. Due to the elongated urethra, it is difficult for the infection to penetrate into the bladder. A stream of urine washes away the pathogen that enters the urethra, but if it manages to remain on the walls of the urethra, the movement through it is so slow that the cells of the immune system have time to kill the infectious agent.
This explains why pathology is diagnosed 10 times less often in men than in women. The disease develops only in the presence of factors that contribute to the massive development of pathogenic microflora against the background of a sharp decrease in immunity. Often, such conditions cause blockage in the bladder.
Causes of cystitis in men
The disease develops when E. coli, coccal or urogenital infections penetrate the bladder. This process is facilitated by the following changes:
- reduction of immunity under the influence of radiation, development of diabetes mellitus, blood diseases;
- the development of a negative reaction from the immune system;
- inflammatory process in the prostate gland, kidneys, ureters;
- bladder compression due to prostate cancer or benign hyperplasia;
- the formation of fistulas in the rectum;
- sepsis;
- damage to the body by sexually transmitted infections;
- reverse flow of urine;
- as a result of surgical interventions in the pelvic area, including damage to the bladder;
- penetration of protozoan viruses into blood and lymph.
Long-term hypothermia of the body, which causes a sharp decrease in immunity, can also lead to the development of pathology.
Types of cystitis
Depending on the severity of the symptoms, the disease is divided into acute and chronic forms. Acute cystitis is usually divided into those that occur for the first time, those that occur no more than once a year, or those that occur at least twice a year. After all therapeutic measures are completed, no inflammatory process is detected in the bladder, and the control laboratory test confirms the normalization of all indicators.
When prescribing treatment, adjustments are made to the standard therapeutic regimen, taking into account whether the disease is primary or secondary. Primary cystitis occurs independently and is not a complication of another pathology. The acute form of the pathology can be caused by exposure to a drug, toxic, infectious or chemical factor. Infection with parasites can also cause pathology. The chronic form can be caused by infectious, traumatic, neurotrophic or radiation.
Chronic cystitis is characterized by a course in which periods of rest are replaced by exacerbations. There are 3 types of chronic forms:
- Hidden.The disease occurs without obvious symptoms and is detected during a regular medical examination. In pathology, there are rare periods of exacerbation that coincide with symptoms of acute cystitis.
- Resistant.Exacerbation is recorded about 2 times a year. Symptoms of the disease are moderate.
- Interstitial.This form is characterized by frequent exacerbations and pain even during periods of rest. This cystitis is considered the most dangerous and difficult to treat type of cystitis, which causes rapid progressive destruction of the bladder walls.
In most cases, when classifying a chronic disease, the urologist focuses not on the frequency of relapses, but on the severity of organ wall damage and the severity of symptoms.
In medical practice, a classification is also used that allows to divide the pathology according to the criterion of the affected part of the bladder. In this case, it is customary to distinguish cystitis:
- Cervical.The inflammatory process is localized in the neck of the bladder, affecting its sphincters. A man often faces the problem of urination and urinary incontinence. The process of emptying the bladder itself becomes painful.
- Trigonite.The inflammatory process starts from the sphincter of the affected organ and spreads to the mouth of the ureter. This form often leads to the development of urinary reflux. When urine flows back, the infectious agent can penetrate the kidneys, contributing to the development of pyelonephritis. The man has urinary problems, including incontinence of urine that contains blood or pus.
- Diffuse.Its distinguishing feature is damage to the bladder wall.
When determining the damage to the mucous membrane and underlying structures, it is not enough for the urologist to make a diagnosis of diffuse cystitis, he must also clarify the features of the course of the inflammatory process and the subtype of the disease that characterizes the damage caused. with him.
During cystitis, endoscopic examination methods using biopsy are used to determine the characteristics of damage to the walls of the bladder. The study of biological material and the analysis of the accompanying symptoms allow to further classify the pathology:
- catarrhal, causes only redness and irritation of the mucous membrane;
- hemorrhagic, causing the development of bleeding;
- cystic, where cysts appear on the damaged wall;
- ulcerated, the name is related to the appearance of ulcers;
- phlegmonosis, it is diagnosed when pus appears in the problem area;
- gangrenous, recorded in the presence of tissue necrosis.
There are also some diseases that are recorded very rarely, for example, with urogenital schistosomiasis or caused by a fungal infection. The inflammatory process can be accompanied by the appearance of a large number of plaques on the mucous membrane of the body, in this case, cystitis is defined as malakoplakia.
Characteristic symptoms of cystitis in men
Symptoms of pathology may differ 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 the symptoms and the degree of damage to the bladder.
Acute cystitis is characterized by a violation of urination, painful and difficult, with frequent urges, including at night. Patients often complain of a false urge to urinate and a feeling of incomplete emptying of the bladder. The urine itself is dark and cloudy, may have a peculiar pungent odor, or may contain impurities of pus or blood.
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 causes general weakness, lethargy and decreased concentration. Urinary incontinence is noted in some forms of pathology. With a long course of the disease, urination begins to be accompanied by a clear 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, pathological signs may be completely absent, the presence of an inflammatory process can be detected only by laboratory tests.
Interstitial cystitis is accompanied by a significant increase in the urge to urinate, accompanied by continuous, constant pain in the suprapubic region. General changes in the body lead to the development of anxiety, irritability and progressive depression.
Diagnosis of cystitis
To make a diagnosis, you need to visit a urologist who conducts an individual examination of the patient and studies a number of complaints. The patient should undergo a rectal examination procedure. The doctor inserts a finger into the rectum to check the state of the prostate gland. This method allows you to determine whether the symptoms are related to prostatitis or hyperplasia of the prostate gland.
The next stage is the application to laboratory tests, which will 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 urinalysis.The development of cystitis is indicated by the increased concentration of leukocytes, the presence of mucus, bacteria, epithelial cells or blood impurities in the biological fluid.
- General blood analysis.Changes in indicators indicate the severity of the pathology. This list includes the detection of leukocytosis, an increase in the concentration of eosinophils.
- Planting tankThe study of pathogens in the urine or on the walls of the urethra allows us to assess their sensitivity to the effects of various antibacterial drugs.
- Test for infectionssexually transmitted diseases.
If the obtained results give a vague picture that does not allow to determine the patient's condition unambiguously, it is possible to prescribe additional studies, including a biochemical blood test, immunogram, and assessment of the concentration of prostate-specific antigen.
In addition, instrumental diagnostic methods are used during a comprehensive examination:
- cystography and cystoscopy;
- Ultrasound of kidneys, prostate gland;
- uroflowmetry.
Ultrasound of the bladder can give the most detailed description of the state of the bladder, but in the acute course of the pathology, it is impossible to fill the organ with urine to the required extent, which excludes the use of this method.
Treatment of cystitis in men
The therapeutic course should be prescribed only by a doctor. For mild or moderate forms of pathology, an outpatient form of treatment is possible, which includes regular re-examinations by a urologist. In severe cases with acute urinary retention, severe pain or bleeding, hospital treatment is prescribed.
Surgical treatment is rarely used, the indication for surgery is acute urinary retention in case of tissue necrosis or prostate adenoma. In other cases, conservative therapy methods are used.
When acute cystitis is diagnosed, a man is recommended to stay in bed for 3-5 days. He should follow a diet that excludes from the diet foods or drinks that irritate the walls of the bladder:
- alcohol;
- strong tea, coffee;
- salty or smoked foods;
- hot spices.
The patient should avoid carbonated drinks and energy drinks and increase the amount of fluid he consumes up to 3 liters per day. To suppress the inflammatory process, the patient is prescribed a complex of antibacterial drugs, antiseptics and antispasmodics. In addition, for example, herbal decoctions based on chamomile and calendula, which have a mild anti-inflammatory and pronounced antiseptic effect, can be used.
To combat moderate pain, you can use a heating pad under the abdomen, but this method is contraindicated for hemorrhagic or tuberculous forms of the pathology. Microenemas with anesthesia can relieve acute pain, but they can be used only with the permission of the attending physician. The duration of therapy for acute cystitis rarely exceeds 14 days.
Therapy for chronic cystitis consists of taking measures to eliminate factors that support and provoke the inflammatory process. In case of congestion, massage and appropriate drugs are prescribed, if stones or prostatitis are detected, measures are taken to get rid of them. After determining the sensitivity of the pathogen, antibiotic therapy is selected.
Chronic cystitis is treated not only with drugs, but also with physical therapy. The second group includes, for example, inserting a catheter into the bladder to rinse with an antibacterial or antiseptic solution based on sea buckthorn oil. In addition, electrophoresis, mud treatment and inductothermy are used.
For tuberculous cystitis, drugs that can suppress the activity of the pathogen and instillations based on fish oil are prescribed.
In the treatment of the radiation form of the pathology, instillation with restorative substances is additionally used, but in case of extensive lesions, plastic surgery is recommended. A number of drugs are prescribed for the treatment of interstitial cystitis, including pain relievers, hormonal, antimicrobial, anti-inflammatory and antihistamines.
Herbal decoctions are used as adjuvant treatment. Dried flowers or leaves of chamomile, St. John's wort, nettle and eucalyptus can be used to make herbal tea. These agents act gently, do not have an obvious effect on the immune system, and stimulate the body's natural protective functions. The treatment period can reach 1 year, and the herbal mixture should be changed every 2 months.
Complications of the disease
If you do not consult a doctor in time, there is a risk of infection entering the kidneys, which leads to the development of pyelonephritis or reverse urine flow. In some forms of pathology, the formation of a fistula can become a complication. Bladder sphincter damage does not always help with urinary incontinence, and the development of acute seizures is also possible.
Prevention of cystitis
The development of the disease can be prevented by maintaining intimate relationships, including the prevention of sexually transmitted infections. A man should monitor the general condition of his immunity, which requires timely treatment of all infectious diseases, fight against prostatitis and undergo an annual medical examination. Quitting smoking, maintaining an active lifestyle, and avoiding hypothermia can help prevent cystitis.
Cystitis in men is rarely diagnosed, but this does not mean that the pathology is harmless. With the decrease of immunity and changes in the body due to natural aging (after 40 years), the risk of developing pathology increases significantly.
It should be borne in mind that the disease can be asymptomatic for some time, so men should not refuse preventive medical examinations that can detect inflammation at an early stage.