In most cases, the inflammatory process in the bladder is registered in men over 40 years of age, which is associated with a natural decrease in immunity. Men who have concomitant pathologies of the genitourinary system of an infectious nature are prone to the development of cystitis.
Cystitis is a rare disease in men. Thanks to the elongated urethra, it is difficult for the infection to penetrate into the bladder. A stream of urine washes away the pathogen that has entered the urethra, but if it manages to stick to 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 the pathology in men occurs 10 times less often than in women. The disease develops only if there are factors favoring the massive development of pathogenic microflora against the background of a pronounced decrease in immunity. Often such conditions create congestion in the bladder.
Causes of cystitis in men
The disease develops when E. coli, cocci or urogenital infections penetrate the bladder. This process is facilitated by such changes as:
- reduced immunity under the influence of radiation, development of diabetes mellitus, blood diseases;
- development of a negative response from the immune system;
- inflammatory process in the prostate gland, kidneys, ureters;
- bladder compression due to prostate cancer or benign hyperplasia;
- formation of fistulas in the rectum;
- sepsis;
- damage to the body from sexually transmitted infections;
- reverse flow of urine;
- bladder injury, including as a result of surgical interventions in the pelvic area;
- penetration of protozoan viruses into the blood and lymph.
Prolonged hypothermia of the body, which provokes a sharp decrease in immunity, can also provoke the development of pathology.
Types of cystitis
Depending on how clearly the symptoms are manifested, the disease is divided into acute and chronic form. Acute cystitis is usually divided into those that appear for the first time, those that occur no more than once a year, or those that occur at least twice a year. After completion of all therapeutic measures, no inflammatory process was detected in the bladder, and the control laboratory test confirmed the normalization of all indicators.
When prescribing treatment, changes are made to the standard therapeutic scheme, 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 pathology can occur as a result of exposure to a medicinal, toxic, infectious or chemical factor. Infection with parasites can also provoke pathology. The chronic form can be 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 form:
- Latent.The disease occurs without the manifestation of pronounced symptoms and is detected during a routine medical examination. The pathology has rare periods of exacerbation, which coincide in symptoms with acute cystitis.
- Stubborn.Exacerbation is recorded about 2 times a year. The symptoms of the disease are moderately pronounced.
- Interstitial.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, provoking rapidly progressive destruction of the bladder walls.
In most cases, when classifying a chronic disease, the urologist focuses on the severity of damage to the wall of the organ, the severity of symptoms, and not the frequency of recurrences.
In medical practice, a classification is also used, which allows to subdivide 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 person 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 provokes the development of urinary reflux. When the urine flows backwards, the infectious agent can penetrate into the kidneys, which contributes to the appearance of pyelonephritis. The man has urinary problems, including incontinence of urine containing blood or pus.
- diffuse.Its distinguishing feature is damage to the bladder wall.
When identifying damage to the mucous membrane and the structures located under it, it is not enough for the urologist to diagnose diffuse cystitis, he must also clarify the subtype of the disease, which characterizes the characteristics of the course of the inflammatory process and the damage caused. from him.
To determine the characteristics of damage to the walls of the bladder during cystitis, endoscopic research methods using biopsy are used. The study of biological material and the analysis of accompanying symptoms allows us to further classify the pathology as:
- catarrhal, which only provokes redness and irritation of the mucous membrane;
- hemorrhagic, provoking the development of bleeding;
- cystic, in which cysts form on the damaged wall;
- ulcerative, whose name is due to the appearance of ulcers;
- phlegmonous, diagnosed when pus forms in the problem area;
- gangrenous, registered 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 mucous membrane of the organ, in this case cystitis is defined as malakoplakia.
Characteristic symptoms of cystitis in men
Signs of the pathology may 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 the symptoms and the degree of damage to the bladder.
Acute cystitis is characterized by impaired 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 pungent odor or contain impurities of pus or blood.
The inflammatory process in most cases provokes 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 reduced concentration. Urinary incontinence is recorded 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, the presence of an inflammatory process can only be detected through laboratory tests.
Interstitial cystitis is accompanied by a significant increase in the urge to urinate, accompanied by constant, constant pain in the suprapubic area. General changes in the body are reduced 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 number of complaints. The patient should undergo a rectal examination. 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 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 a drug to which there will be maximum sensitivity. The list of laboratory tests includes:
- General analysis of urine.The development of cystitis is manifested 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 the detection of leukocytosis, an increased concentration of eosinophils.
- Sowing tankThe study of pathogens contained in the urine or on the walls of the urethra allows to assess their sensitivity to the action of various antibacterial drugs.
- Testing for infectionssexualy transmitted diseases.
If the obtained results give a blurred picture that does not allow an unambiguous determination of the patient's condition, it is possible to prescribe additional tests, 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 gland;
- uroflowmetry.
Ultrasound of the bladder can give 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 limit, which excludes the use of this method.
Treatment of cystitis in men
The therapeutic course should be prescribed only by a doctor. In mild or moderate forms of pathology, an outpatient form of treatment is possible, which includes regular control 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 the presence of tissue necrosis or prostate adenoma. In other cases, conservative treatment methods are used.
When acute cystitis is diagnosed, a man is advised to stay in bed for 3-5 days. He must follow a diet that excludes from the diet foods or drinks that irritate the walls of the bladder:
- alcohol;
- strong tea, coffee;
- salted or smoked foods;
- hot spices.
The patient should increase the volume of fluid consumed to 3 liters per day, while 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 a mild anti-inflammatory and pronounced antiseptic effect can be used, for example, based on chamomile and calendula.
To combat moderate pain, you can additionally use a heating pad in the lower abdomen, but in hemorrhagic or tubercular forms of the pathology, this method is contraindicated. Microenemas with anesthetic can relieve acute pain, but they can be used only with the permission of the attending physician. The duration of treatment of acute cystitis rarely exceeds 14 days.
Therapy of chronic cystitis involves taking measures to eliminate the factors that support and provoke the inflammatory process. In the presence of congestion, massage and appropriate drugs are prescribed, if stones or prostatitis are detected, measures are taken to remove them. After determining the sensitivity of the pathogen, antibiotic therapy is selected.
Chronic cystitis is treated not only with drugs, but also with physiotherapy. The second group involves the introduction of a catheter into the bladder for rinsing with an antibacterial or antiseptic solution, for example, 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, 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 pain relievers, hormonal, antimicrobial, anti-inflammatory and antihistamines.
Herbal decoctions are used as adjunctive treatment. Dried flowers or leaves of chamomile, St. John's wort, nettle, eucalyptus can be used to prepare herbal tea. These agents act mildly, have no pronounced effect on the immune system and stimulate the body's natural protective functions. The duration of therapy can reach 1 year, and 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 leads to the development of pyelonephritis or reverse flow of urine. In some forms of pathology, fistula formation can become a complication. Damage to the bladder sphincter does not always contribute to urinary incontinence, the development of acute retention is also possible.
Prevention of cystitis
The development of the disease can be prevented by maintaining intimate relationships, including prevention of sexually transmitted infections. A person should monitor the general condition of his immunity, which requires timely treatment of all infectious diseases, 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 occurring in the body as a result of 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 in the early stages.