The inflammatory process in the bladder in most cases is recorded 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 predisposed to the development of cystitis.
Cystitis is a rare disease among men. Due to the elongated urethra, it is difficult for the infection to enter the bladder. A stream of urine washes away the pathogen that has entered the urethra, but if it manages to linger 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 agent infectious.
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, cocci, or urogenital infections enter the bladder. This process is facilitated by changes such as:
- decreased immunity under the influence of radiation, development of diabetes mellitus, blood diseases;
- development of a negative response by 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 due to sexually transmitted infections;
- reverse flow of urine;
- bladder injuries, including following surgery in the pelvic area;
- penetration of protozoan viruses into the blood and lymph.
Prolonged hypothermia of the body, which causes a sharp decrease in immunity, can also provoke the development of pathologies.
Types of cystitis
Depending on how vividly the symptoms manifest themselves, 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 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 treatment regimen 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 arise following exposure to a medicinal, toxic, infectious or chemical factor. Infection with parasites can also cause pathologies. The chronic form can be infectious, traumatic, neurotrophic or radioinduced.
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 presents rare periods of exacerbations, which coincide in symptoms with acute cystitis.
- Persistent.Exacerbation is recorded approximately 2 times a year. Symptoms of the disease are moderate.
- Interstitial.This form is characterized by frequent flare-ups 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 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 organ wall, the severity of symptoms, and not the frequency of relapses.
In medical practice, a classification is also used that allows the pathology to be divided 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 faces the problem of frequent urination and urinary incontinence. The process of emptying the bladder itself becomes painful.
- Trigonite.The inflammatory process begins 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 urine returns, the infectious agent is able to penetrate the kidneys, contributing to the appearance of pyelonephritis. The man has urinary problems, including incontinence of urine containing blood or pus.
- Spread.Its defining feature is damage to the bladder wall.
When damage to the mucosa and underlying structures is identified, it is not enough for the urologist to diagnose diffuse cystitis; it is also necessary to clarify the subtype of the disease, which characterizes the characteristics of the course of the inflammatory process and the damage caused by it.
To determine the characteristics of damage to the walls of the bladder during cystitis, methods of endoscopic examination by biopsy are used. The study of biological material and the analysis of associated symptoms allows us to further classify the pathology as:
- catarrhal, which only causes redness and irritation of the mucosa;
- hemorrhagic, causing the development of bleeding;
- cystic, in which cysts form on the damaged wall;
- ulcerative, whose name is due to the appearance of ulcers;
- phlegmon, 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 extremely rarely recorded, for example, in 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 the cystitis is defined as malacoplakia.
Characteristic symptoms of cystitis in men
The signs of the disease may vary slightly depending on whether it occurs in 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 urination disorders, which become painful and difficult, with frequent urges, even at night. Patients often complain of a false urge to urinate and a sensation 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 causes 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 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 can be completely absent, 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 and 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
To make a diagnosis, a visit to a urologist is necessary, who carries out a personal examination of the patient and studies a number of disorders. The patient must undergo a rectal examination procedure. The doctor inserts a finger into the rectum to examine the condition of the prostate gland. This method allows you to determine whether the symptoms are associated with prostatitis or prostatic hyperplasia.
The next stage is the sending of laboratory tests, which will not only confirm the presence of an inflammatory process, but also determine the type of infectious agent in order to select a drug to which it will have maximum sensitivity. 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 tests.Changes in indicators indicate the severity of the pathology. This list includes the detection of leukocytosis, increased concentration of eosinophils.
- Seeding trayThe study of pathogens contained in the urine or on the walls of the urethra makes it possible to evaluate their sensitivity to the action of various antibacterial drugs.
- Test for infectionsSexually transmitted diseases.
If the results obtained give a blurry picture, not allowing to unambiguously determine the patient's condition, additional studies can be prescribed, including a biochemical blood test, an immunogram and an assessment of the concentration of prostate specific antigen.
Also, during a comprehensive examination, instrumental diagnostic methods are used:
- cystography and cystoscopy;
- Ultrasound of the kidneys, prostate;
- uroflowmetry.
Ultrasound of the bladder can provide the most detailed picture of the condition 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 precludes 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 the disease, outpatient treatment is possible, which includes regular check-ups 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 prostatic adenoma. In other cases, conservative therapy methods are used.
When diagnosing acute cystitis, a man is recommended to stay in bed for 3-5 days. He needs to follow a diet that excludes foods or drinks that irritate the bladder walls:
- 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, antiseptic and antispasmodic drugs. In addition, herbal decoctions with a pronounced mild anti-inflammatory and 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 tuberculous forms of the pathology, this method is contraindicated. Microenemas with anesthetic can relieve acute pain, but can only be used 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 the factors that support and provoke the inflammatory process. In the presence of congestion, massages and appropriate medications are prescribed; 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 using not only medications, but also physical therapy. The second group includes inserting a catheter into the bladder for rinsing with an antibacterial or antiseptic solution, for example, based on sea buckthorn oil. Furthermore, electrophoresis, mud therapy and inductothermy are used.
For tuberculous cystitis, drugs capable of suppressing the activity of the pathogen and instillations based on fish oil are prescribed.
In the treatment of the radiating form of the pathology, instillations with regenerating agents are also used, but in 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. To prepare the herbal tea you can use dried flowers or leaves of chamomile, St. John's wort, nettle and eucalyptus. 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 attention in a timely manner, there is a risk that the infection will enter the kidneys, causing the development of pyelonephritis or reversal of urine flow. In some forms of pathology, the formation of a fistula can become a complication. Damage to the bladder sphincter 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 needs to monitor the general state of his immunity, which requires timely treatment of all infectious diseases, the fight against prostatitis and passing 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 due to natural aging (after 40 years), the risk of developing pathologies 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.