In most cases, the inflammatory process in the urinary bladder is recorded in men over 40 years old, which is accompanied by 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 the infection to penetrate into the bladder. A stream of urine removes the pathogen that has entered the urethra, but if it manages to stay in 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, colic or urogenital infections penetrate the urinary bladder. This process is facilitated by changes such as:
- decreased immunity under the influence of radiation, development of diabetes mellitus, blood diseases;
- the 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;
- the formation of fistulas in the rectum;
- sepsis;
- damage to the body from sexually transmitted infections;
- reverse flow of urine;
- damage to the bladder, including as a result of surgical interventions in the pelvic area;
- penetration of protozoan viruses into 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 forms. Acute cystitis is usually divided into those that occur for the first time, that appear no more than once a year, or that are recorded at least twice a year. After the completion of all therapeutic measures, no inflammatory process is detected in the bladder and a control laboratory test confirms the normalization of all indicators.
When prescribing treatment, changes are made to the standard therapeutic regimen taking into account whether the disease is primary or secondary. Primary cystitis is one that appears independently and is not a complication of another pathology. An acute form of pathology may arise 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-induced.
Chronic cystitis is characterized by a course in which periods of rest are replaced by exacerbations. There are 3 types of chronic forms:
- latent.The disease appears without the appearance of pronounced symptoms and is discovered during a routine medical examination. The pathology has rare periods of exacerbations, which coincide with the symptoms of acute cystitis.
- Persistent.Worsening is registered about 2 times a year. Symptoms of the disease are moderate.
- Interstitial.This form is characterized by frequent irritations 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 rapid progressive destruction of the bladder walls.
In most cases, when classifying a chronic disease, the urologist focuses on the severity of damage to the organ wall, the severity of symptoms, and not the frequency of relapses.
In medical practice, a classification is also used that allows the division of pathology according to the criterion of the affected part of the bladder. In this case, it is common to distinguish cystitis:
- Cervix.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 provokes the development of urinary reflux. When the urine backs up, the infectious agent is able to penetrate the kidneys, contributing to the appearance 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 identifying the damage to the mucosa and the structures located under it, it is not enough for the urologist to diagnose diffuse cystitis; it should also clarify the subtype of the disease, which characterizes the characteristics of the course of the inflammatory process and the damage caused. from her.
To determine the characteristics of damage to the bladder walls during cystitis, endoscopic examination methods using biopsy are used. The study of the biological material and the analysis of the accompanying symptoms allows us to further classify the pathology as:
- catarrhal, which only provokes redness and irritation of the mucous membrane;
- HAEMORRHAGIC, provoking the development of bleeding;
- cystic, in which cysts are formed in the damaged wall;
- ulcerative, whose name is due to the appearance 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 mucosa of the organ; in this case, cystitis is defined as malakoplakia.
Characteristic symptoms of cystitis in men
Signs of pathology may vary slightly depending on whether it appears 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 desire to urinate and a feeling of incomplete emptying of the bladder. The urine itself becomes dark and cloudy, may have 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 localized pain in the groin, scrotum and urethra. Intoxication of the body leads to general weakness, lethargy and decreased concentration. In some forms of pathology, urinary incontinence is recorded. 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 temperatures are rarely recorded. With 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 associated with a significant increase in the desire to urinate, accompanied by constant and constant pain in the suprapubic area. General changes in the body lead to the development of anxiety, nervousness and progressive depression.
Diagnosis of cystitis
Establishing 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 procedure. The doctor inserts a finger into the rectum to examine the state of the prostate gland. This method allows you to determine whether the symptoms are associated with prostatitis or prostatic hyperplasia.
The next stage is a referral for 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 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.
- Planting tankThe study of pathogens contained in the urine or in the walls of the urethra makes it possible to evaluate their sensitivity to the action of various antibacterial drugs.
- Testing for infectionssexually transmitted diseases.
If the obtained results give an unclear picture, not allowing one 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, during a comprehensive examination, instrumental diagnostic methods are used:
- cystography and cystoscopy;
- Ultrasound of the 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 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 follow-up 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 methods of therapy 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 increase the volume of fluids consumed to 3 liters per 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 a mild anti-inflammatory and pronounced antiseptic effect can be used, for example, based on chamomile and calendula.
To combat moderate pain, you can also use a heating pad on the lower abdomen, but for hemorrhagic or tubercular forms of the pathology, this method is contraindicated. Microclyses 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 involves taking measures to eliminate factors that support and provoke the inflammatory process. In the presence of congestion, appropriate massages and medications 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 using not only medications, but also physical therapy. The second group involves inserting a catheter into the bladder for rinsing with an antibacterial or antiseptic solution, for example, based on sea oil. In addition, electrophoresis, mud therapy 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 regenerative agents are also used, but in case of extensive lesions, plastic surgery is recommended. For the treatment of interstitial cystitis, a complex of medications is prescribed, including pain relievers, hormonal, antimicrobial, anti-inflammatory and antihistamines.
Herbal decoctions are used as an auxiliary treatment. St. John's wort, nettle and eucalyptus can be used to prepare herbal tea, dried flowers or chamomile leaves. These agents act gently, do not have a 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 flow of urine. In some forms of pathology, the formation of a fistula 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 relations, 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, combating prostatitis and conducting annual medical examinations. Quitting smoking, 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.