Inflammatory processes in the bladder in most cases are registered in men over the age of 40, which is associated with a natural decrease in immunity. Men with 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 an infection to penetrate the bladder. The flow of urine washes away pathogens that have entered the urethra, but if they manage to survive on the walls of the urethra, then the movement through them is so slow that the cells of the immune system have time to kill the infectious agent.
This explains that pathological diagnosis 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 significant decrease in immunity. Often such conditions create congestion in the bladder.
Causes of cystitis in men
This disease develops when E. coli, coccal or urogenital infections penetrate the 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 reaction from the immune system;
- inflammatory process in the prostate gland, kidney, ureter;
- bladder compression due to prostate cancer or benign hyperplasia;
- fistula formation in the rectum;
- sepsis;
- damage to the body by sexual infection;
- reverse flow of urine;
- bladder injury, including as a result of surgical intervention in the pelvic area;
- penetration of protozoan viruses into the blood and lymph.
Prolonged hypothermia of the body, which causes a sudden decrease in immunity, can also trigger the development of pathology.
Types of cystitis
Depending on how clearly 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, those that appear no more than once a year, or those that are registered at least twice a year. After completion of all therapeutic measures, no inflammatory process was detected in the bladder, and control laboratory tests confirmed the normalization of all indicators.
When prescribing treatment, amendments are made to the standard therapeutic regimen taking into account whether the disease is primary or secondary. Primary cystitis is one that occurs independently and is not a complication of other pathologies. Acute pathological forms can arise as a result of exposure to medical, toxic, infectious, or chemical factors. Infection with parasites can also trigger pathology. The chronic form can be infectious, traumatic, neurotrophic or due to radiation.
Chronic cystitis is characterized by a course in which periods of rest are replaced by exacerbations. There are 3 types of chronic forms:
- Latent.This disease occurs without the appearance of obvious symptoms and is detected during a routine medical examination. Pathology has a rare exacerbation period, which coincides with symptoms with acute cystitis.
- Continuously.Exacerbations are recorded about 2 times a year. Symptoms of the disease are simple.
- 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, causing rapid progressive destruction of the bladder wall.
In most cases, when classifying chronic diseases, urologists focus on the severity of damage to the organ walls, the severity of symptoms, and not the frequency of relapses.
In medical practice, a classification is also used that allows pathologies to be divided according to the criteria of the part of the bladder affected. In this case, it is customary to distinguish cystitis:
- Cervix.The inflammatory process is localized in the neck of the bladder, affecting its sphincter. A man has problems with frequent urination and frequent urination. The process of emptying the bladder itself 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 urine flows back, infectious agents can penetrate the kidneys, contributing to the occurrence of pyelonephritis. The man has urinary problems, including urinary incontinence that contains blood or pus.
- Permeating.Its distinguishing feature is damage to the bladder wall.
When identifying damage to the mucous membrane and the structures located under it, the urologist is not enough to diagnose diffuse cystitis; he also needs to explain the subtype of the disease, which characterizes the course of the inflammatory process and the damage caused. by him.
To determine the characteristics of damage to the bladder wall during cystitis, an endoscopic examination method using a biopsy is used. The study of the biological material and the analysis of accompanying symptoms allowed us to further classify the pathology as:
- catarrhal, which only causes redness and irritation of the mucous membrane;
- bleeding, provoke the development of bleeding;
- cystic, where cysts form on damaged walls;
- ulcerative, whose name is due to the appearance of an ulcer;
- 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 very rarely recorded, for example, with urogenital schistosomiasis or caused by fungal infections. The inflammatory process may 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
Pathological signs may vary slightly depending on whether they occur 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 impaired urination, which becomes painful and difficult, with frequent urges, including at night. Patients often complain of a false urge to urinate and a sense of incomplete bladder emptying. The urine itself becomes dark and cloudy, may acquire a certain 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. Body poisoning leads to general weakness, lethargy, and decreased concentration. In some pathological forms, urinary incontinence is recorded. With a long course of the disease, urination begins to be accompanied by a noticeable burning sensation.
In the chronic form of the disease, the intensity of symptoms is less significant, and high temperature is rarely recorded. With latent cystitis, pathological signs 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 desire to urinate, accompanied by constant and constant pain in the suprapubic area. General changes in the body lead to the development of progressive anxiety, irritability, and depression.
Diagnosis of cystitis
Making a diagnosis requires a visit to a urologist, who conducts a personal examination of the patient and reviews various complaints. The patient should undergo a rectal examination procedure. 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 associated with prostatitis or prostatic hyperplasia.
The next stage is a referral for laboratory tests, which will not only confirm the presence of the inflammatory process, but also determine the type of infectious agent to choose the drug that will have maximum sensitivity. The list of laboratory tests includes:
- General urine analysis.The development of cystitis is indicated by an increase in the 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.
- Breeding 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.
- Test for infectionvenereal disease.
If the results obtained give a vague picture, not allowing one to clearly determine the patient's condition, it is possible to prescribe additional studies, including biochemical blood tests, immunograms, and assessment of prostate-specific antigen concentrations.
In addition, during the comprehensive examination, instrumental diagnostic methods are used:
- cystography and cystoscopy;
- Ultrasound of the kidney, prostate gland;
- uroflowmetry.
Ultrasound of the bladder can provide the most detailed picture of the state of the bladder, but during the acute course of the pathology, filling the organ with urine to the required limit is impossible, which prevents 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, including 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; Indications for surgery are acute urinary retention in the presence of tissue necrosis or prostate adenoma. In other cases, conservative treatment 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 from the diet foods or drinks that irritate the bladder wall:
- alcohol;
- strong tea, coffee;
- salty or smoked foods;
- hot spices.
Patients should increase the amount of fluid used to 3 liters a day, while 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 clear anti-inflammatory and antiseptic effect, for example, based on chamomile and calendula, can be used.
To combat moderate pain, you can also use a heating pad in the lower abdomen, but for forms of hemorrhagic pathology or tuberculosis, this method is contraindicated. Microenemas with anesthetics can relieve acute pain, but they 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 factors that support and trigger the inflammatory process. If there is congestion, appropriate massages and medications 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 using not only drugs, but also physical therapy. The second group includes inserting a catheter into the bladder to rinse with an antibacterial or antiseptic solution, for example, based on sea buckthorn oil. In addition, electrophoresis, mud therapy, and inductothermy are used.
For tuberculous cystitis, drugs that can block the activity of pathogens and instillations based on fish oil are prescribed.
In the treatment of pathological forms of radiation, injections with regeneration agents are also 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, hormones, antimicrobials, anti-inflammatories and antihistamines.
Herbal decoction is used as an additional treatment. To prepare herbal tea, dried flowers or chamomile leaves, St. John's wort, nettle, and eucalyptus can be used. These agents act gently, have no significant 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 kidney, which causes the development of pyelonephritis or reverse urine flow. In some forms of pathology, fistula formation can be 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 this disease can be prevented by maintaining intimate relationships, including the prevention of sexual infections. A man needs to monitor the general state of his immunity, which requires timely treatment for all infectious diseases, fight prostatitis, and undergo an annual medical examination. Quitting smoking, living 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 not dangerous. With reduced immunity and changes occurring in the body due to natural aging (after 40 years), the risk of developing pathology increases significantly.
Keep in mind that this disease can be asymptomatic for some time, so men should not refuse preventive medical examinations that can detect inflammation in the early stages.