In most cases, the inflammatory process in the bladder is registered in men over 40 years old, which is associated with a natural decrease in immunity. Men who have accompanying pathologies of the genitourinary system of an infectious nature are predisposed to the development of cystitis.
Cystitis is a rare disease in men. Thanks to the elongated urethra, it is difficult for infection to penetrate into the bladder. The stream of urine washes away the pathogen that has entered the urethra, but if it manages to stay on the walls of the urethra, then the movement through it is so slow that the cells of the immune system have time to kill the infectious agent.
This explains that the diagnosis of pathology in men occurs 10 times less often than in women. The disease develops only if there are factors that favor the massive development of pathogenic microflora against the background of a marked decrease in immunity. Often such conditions create congestion in the bladder.
Causes of cystitis in men
The disease develops when E. coli, coccal or urogenital infection penetrates the bladder. This process is facilitated by changes such as:
- reduced immunity under the influence of radiation, development of diabetes mellitus, blood diseases;
- the development of a negative response of the immune system;
- inflammatory process in the prostate, kidneys, ureters;
- bladder compression due to prostate cancer or benign hyperplasia;
- formation of fistulas in the rectum;
- sepsis;
- damage to the body by sexually transmitted infections;
- reverse flow of urine;
- bladder injuries, including as a result of surgical interventions in the pelvic area;
- penetration of the protozoan virus into the blood and lymph.
Prolonged hypothermia of the body, which causes a sudden drop in immunity, can also cause the development of pathology.
Types of cystitis
Depending on how clearly the symptoms are manifested, the disease is divided into acute and chronic forms. Acute cystitis is usually divided into those that occur for the first time, that occur at most once a year, or that occur at least twice a year. After the completion of all therapeutic measures, the inflammatory process in the bladder is not detected, and the control laboratory test confirms the normalization of all indicators.
When prescribing treatment, the standard therapeutic regimen is changed taking into account whether the disease is primary or secondary. Primary cystitis is one that occurs independently and is not a complication of another pathology. An acute form of the pathology can arise as a result of exposure to a medical, toxic, infectious or chemical factor. Infection with parasites can also cause pathology. The chronic form can be infectious, traumatic, neurotrophic or caused by radiation.
Chronic cystitis is characterized by a course in which periods of rest are replaced by exacerbations. There are 3 types of chronic form:
- Latent.The disease occurs without the appearance of pronounced symptoms and is detected during a routine medical examination. The pathology has rare periods of exacerbations, the symptoms of which coincide with acute cystitis.
- Persistent.Exacerbation is recorded about 2 times a year. Symptoms of the disease are moderate.
- Intermediate.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 rapid progressive destruction of the bladder walls.
In most cases, when classifying a chronic disease, the urologist focuses on the severity of organ wall damage, the severity of symptoms, and not the frequency of recurrence.
In medical practice, a classification is also used that enables the division of pathology according to the criterion of the affected part of the bladder. In this case, it is common to distinguish cystitis:
- Cervical.The inflammatory process is localized in the neck of the bladder, affecting its sphincters. A man faces the problem of frequent urination and urinary incontinence. The very process of emptying the bladder 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 causes the development of urinary reflux. When the urine is returned, the infectious agent can penetrate into the kidneys, which contributes to the development of pyelonephritis. A man has urinary problems, including urinary incontinence that contains blood or pus.
- Diffuse.Its distinguishing feature is damage to the bladder wall.
When determining the damage to the mucous membrane and the underlying structures, it is not enough for the urologist to diagnose diffuse cystitis, but rather to clarify the subtype of the disease that characterizes the course of the inflammatory process and the resulting damage. according to that.
In order to determine the characteristics of damage to the bladder walls during cystitis, endoscopic methods of examination using biopsy are used. The study of biological material and the analysis of accompanying symptoms allow us to further classify the pathology into:
- catarrhal, which only causes redness and irritation of the mucous membrane;
- hemorrhagic, causing the development of bleeding;
- cystic, in which cysts form on the damaged wall;
- ulcerative, whose name is due to the occurrence of ulcers;
- phlegmonous, diagnosed when pus forms in the problem area;
- gangrenous, recorded in the presence of tissue necrosis.
There are also some types of diseases that are recorded extremely 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 lining of the organ, in this case cystitis is defined as malakoplakia.
Characteristic symptoms of cystitis in men
Signs 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 bladder damage.
Acute cystitis is characterized by difficult urination, which becomes 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 becomes dark and cloudy, may acquire a specific sharp smell or contain impurities of pus or blood.
The inflammatory process in most cases causes an increase in body temperature and severe pain localized in the groin, scrotum and urethra. Intoxication of the body leads to 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 pronounced burning sensation.
In the chronic form of the disease, the intensity of the symptoms is less pronounced, and high temperatures are rarely recorded. In latent cystitis, signs of pathology may be completely absent, and the presence of an inflammatory process can only be detected by laboratory tests.
Interstitial cystitis is accompanied by a significant increase in the 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
Making a diagnosis requires a visit to a urologist, who conducts a personal examination of the patient and studies a series of complaints. The patient should undergo a rectal examination procedure. The doctor inserts a finger into the rectum to examine the state of the prostate. This method allows you to determine whether the symptoms are related to prostatitis or prostatic hyperplasia.
The next stage is referral 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 the medicine to which it will be maximally sensitive. The list of laboratory tests includes:
- General urinalysis.The development of cystitis is indicated by an 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 detection of leukocytosis, increased concentration of eosinophils.
- Sowing tankThe study of pathogens contained in the urine or on the walls of the urethra enables the assessment of their sensitivity to the action of various antibacterial drugs.
- Testing for infectionssexually transmitted diseases.
If the obtained results give a blurred picture, not allowing to unequivocally determine the patient's condition, it is possible to prescribe additional studies, including a biochemical blood test, an immunogram and an 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;
- uroflowmetry.
Bladder ultrasound can provide the most detailed picture of the state of the bladder, but during the acute course of the pathology, it is impossible to fill the organ with urine to the required extent, which makes it impossible to use 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 check-ups with 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 retention of urine with the presence of tissue necrosis or prostate adenoma. In other cases, conservative methods of therapy are used.
When diagnosing acute cystitis, a man is recommended to stay in bed for 3-5 days. A diet that excludes foods or drinks that irritate the bladder walls must be followed:
- alcohol;
- strong tea, coffee;
- salty or smoked food;
- hot spices.
The patient should increase the amount of liquid he consumes to 3 liters a day, avoiding carbonated drinks and energy drinks. To suppress the inflammatory process, the patient is prescribed a complex of antibacterial drugs, antiseptics and antispasmodics. In addition, herbal decoctions with mild anti-inflammatory and pronounced antiseptic effects can be used, for example, based on chamomile and calendula.
To suppress moderate pain, you can additionally use a heating pad on the lower abdomen, but this method is contraindicated for hemorrhagic or tuberculous forms of pathology. Micro enemas with anesthetic can relieve acute pain, but can only be used with the permission of a doctor. The duration of therapy for acute cystitis rarely exceeds 14 days.
Treatment of chronic cystitis involves taking measures to remove factors that support and cause the inflammatory process. In case of congestion, massage and appropriate drugs are prescribed, and if stones or prostatitis are detected, measures are taken to eliminate 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 involves inserting a catheter into the bladder for flushing with an antibacterial or antiseptic solution, for example, based on sea buckthorn oil. Additionally, electrophoresis, mud therapy and inductothermy are used.
For tuberculous cystitis, drugs that can suppress the activity of pathogens and instillations based on fish oil are prescribed.
In the treatment of the radiation form of the pathology, instillations with regenerating agents are additionally used, but in the case of extensive lesions, plastic surgery is recommended. For the treatment of interstitial cystitis, a complex of drugs is prescribed, including painkillers, hormonal, antimicrobial, anti-inflammatory and antihistamines.
Herbal decoctions are used as an auxiliary treatment. Dried flowers or leaves of chamomile, St. John's wort, nettle, eucalyptus can be used to prepare herbal teas. These agents act gently, have no pronounced effect on the immune system, and stimulate the body's natural protective functions. The duration of therapy 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 in time, there is a risk of infection entering the kidneys, which causes the development of pyelonephritis or reverse urine flow. In some forms of pathology, fistula formation can become a complication. Bladder sphincter damage does not always contribute to urinary incontinence, and the development of acute retention 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 state of his immunity, which requires timely treatment of all infectious diseases, the fight against prostatitis and annual medical examinations. 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 the pathology is harmless. With reduced immunity and changes that occur in the body as a result of natural aging (after 40 years), the risk of developing pathology increases significantly.
It must be remembered that the disease can be asymptomatic for some time, so men should not refuse preventive medical examinations that can detect inflammation in the early stages.