Cystitis

Overview: What is urinary bladder inflammation?

An inflammation of the bladder is also known as cystitis or catarrh of the bladder. This is an infection of the urinary bladder, which in most cases is caused by bacteria. Only rarely are other pathogens the trigger for urinary bladder inflammation. Cystitis is a “lower urinary tract infection”. This is an infection of the so-called lower urinary tract, which consists of the urethra and the bladder. (The upper urinary tract are the kidneys and ureters).

The germs almost always enter the urethra from the outside, from where they penetrate into the bladder. Here they trigger an inflammation. If your bladder is inflamed, this can lead to cramping pain in the bladder and pain when urinating. You will probably also need to go to the toilet at shorter intervals than usual – although the amount of urine excreted is often only small.

Urinary bladder inflammation can lead to complications if it is not treated. That’s why you should visit us if you have cystitis. Bladder inflammation can usually be cured quickly with an antibiotic. In mild cases – but only then – you can try to get a bladder infection under control with home remedies (bladder and kidney tea, hot water bottle, sitz baths). However, if any of the following are true, it is not a mild case of cystitis and you should see us:

• Your cystitis is accompanied by a fever.
• Your bladder infection has not subsided after three days.
• You are suffering from repeated bladder catarrh.

A visit to the doctor is also advisable in the case of cystitis if you belong to one of the following groups:

• Men
• Pregnant women
• Children
• Diabetic
• immunocompromised patients

Although inflammation of the bladder occurs less frequently in men than in women, the course of cystitis is often more complicated in men.

Urinary bladder inflammation – frequency and age

Girls and women are affected by cystitis far more frequently than boys and men. As the female body has a shorter urethra, germs that have penetrated the urethra can more easily reach the bladder. More than half of all women therefore have cystitis at least once in their lives. Five to ten percent of those affected experience repeated bladder infections.

Among women, pregnant women are particularly frequently affected by cystitis, as are mothers in the first few weeks after giving birth. The hormonal changes that occur in them can cause the urinary tract to widen and make it easier for bacteria to enter.

In men, cystitis is most likely to occur once they have passed the age of 50. Prostate diseases then increase, for example a benign enlargement of the prostate or the development of a prostate tumor. The increasing size of the prostate can constrict the urethra to such an extent that the flow of urine is reduced. Urine (residual urine) often remains in the bladder and germs are no longer flushed out in sufficient quantities.

Urinary bladder inflammation: Causes and risk factors

In most cases, bacteria are the cause of cystitis. More than three quarters of all bacterial bladder infections are caused by pathogens of the Escherichia coli type (E-coli for short). These bacteria are part of the human intestinal flora. As the distance between the anus and the end of the urethra is only short in girls and women, intestinal bacteria can easily get from the anus to the exit of the urethra (and from there into the bladder). Other bacteria can also cause urinary bladder inflammation in much rarer cases. For example enterococci or staphylococci. Less frequently, cystitis is caused by fungi or viruses.

There are several possible reasons why all the different germs can get into your urethra and bladder in the first place:

• incorrect cleaning technique on the toilet (always wipe your bottom from front to back to prevent intestinal bacteria from reaching your urethra)
• Sex (the bacteria spread during sex, mostly from the intestinal flora, cause an inflammation of the bladder called “honeymoon cystitis” or “honeymoon cystitis”)
• Disturbed vaginal flora (can be caused by excessive, negligent or incorrect intimate hygiene, lack of lactic acid bacteria during the menopause)
• Vaginitis
• Pregnancy (the hormone progesterone dilates the muscles of the urinary tract, making it easier for germs to ascend to the bladder. In addition, the proportion of infection-inhibiting substances in the urine is reduced in pregnant women).

Various risk factors can promote the development of urinary bladder inflammation. This primarily includes hypothermia, for example due to wet swimwear. A weakened immune system, diabetes mellitus, incontinence and bladder stones are further risk factors for cystitis.

Symptoms: Urinary bladder inflammation

Two characteristics are particularly typical of cystitis:

• Burning pain when urinating
• Frequently recurring urge to urinate

In addition to these symptoms, there are a number of other signs of cystitis that do not necessarily occur in every case. Nor do they all appear together:

• Pain in the abdomen
• cloudy urine
• unpleasant smelling urine
• Blood in urine
• Sudden, urgent urge to urinate with incontinence (because there is not enough time to go to the toilet)
• Fever
• Back pain (if the cystitis spreads to the kidneys or, in men, to the prostate)

Urinary bladder inflammation: Diagnosis with us

The typical symptoms of cystitis are so clear that it is not difficult for us to make a diagnosis. However, the mere knowledge that you are suffering from cystitis may not be enough to determine how to proceed. For example, it must be clarified whether you need an antibiotic and, if so, which active ingredient it should contain.

Various methods are available to determine the exact circumstances of an inflammation of the urinary bladder:

• Urine test with a test strip held in the urine. It should clarify whether the urine contains certain substances. White blood cells (leukocytes) indicate inflammation and nitrite (a metabolic product formed by bacteria) indicates the presence of bacteria.
• Urine test in the laboratory. The bacteria contained in the urine multiply on a culture medium. Once a certain quantity has been reached, they can be precisely identified. If the type of bacteria is known, the most effective antibiotic for your cystitis can be determined. This is particularly important for pregnant women and for patients who have already had several bladder infections.
• Ultrasound examination. For example, the images from an ultrasound machine can show whether you have bladder stones or whether the urinary tract has anatomical changes.
• Cystoscopyof the bladder . During this examination, a doctor inserts an endoscope (a thin cable with a camera) through the ureter into the bladder. For example, you can see if there is a tumor there.

Urinary bladder inflammation: prevention, early detection, prognosis

The easiest way to prevent inflammation of the bladder is to drink plenty of fluids. It should be at least 1.5 liters a day. This flushes out bacteria that could cause cystitis and prevents them from settling so easily in the urinary tract. And: keep warm and above all avoid hypothermia of the abdomen and feet.

If you feel the urge to urinate, do not hold your urine for long if possible. You should also urinate soon after sex. This allows bacteria that may have entered the urethra to be excreted. Make sure you wipe yourself properly on the toilet: always from front to back (from the vagina to the anus). This prevents intestinal bacteria from coming into contact with your urinary tract.

Proper intimate hygiene is also important: too much can be just as harmful as too little. It is best to clean your intimate area with warm water, but not with intimate sprays or disinfectants.

It is also possible to be vaccinated against cystitis. This is not done with an injection, but by swallowing a capsule daily over a longer period of time. It contains a vaccine that contains components of E-coli bacteria.

Course and prognosis of urinary bladder inflammation

In most cases, inflammation of the bladder is harmless. Sometimes cystitis even heals on its own. However, timely and correct treatment can also ensure that you get rid of your bladder infection within a few days. However, such a harmless course of bladder catarrh is linked to several conditions: Your kidneys function without interference, you do not have chronic (recurrent) cystitis, there are no anatomical abnormalities in your urinary tract and you do not have any concomitant diseases that could promote cystitis (for example diabetes mellitus).

It is less likely, but quite possible, that your cystitis will take a more difficult course. For example, bacteria can ascend from the inflamed bladder and trigger an upper urinary tract infection (e.g. inflammation of the renal pelvis).

It is also possible that your acute cystitis recurs several times and develops into a chronic bladder inflammation. In extreme cases, bladder tissue could be damaged in the long term and the result could be a shrunken bladder (a smaller bladder).

Urinary bladder inflammation: effective treatment

Depending on the cause and duration of the disease, there are various approaches to treating urinary bladder inflammation. Bladder infections can almost always be treated successfully. In mild cases, you don’t even need to take antibiotics. However, cystitis should not be left untreated. And: If you suffer from inflammation of the bladder, you should always drink plenty of fluids.