The inflammatory process in the bladder is in most cases recorded in men over 40 years old, which is associated with a natural decrease in immunity. Men with concomitant pathologies of the genitourinary system of an infectious nature are prone to developing cystitis.
Cystitis is a rare disease in men. Because the urethra is elongated, it is difficult for infections to enter the bladder. A stream of urine washes away the pathogen that has entered the urethra. However, if it manages to linger on the walls of the urethra, the movement through the urethra is so slow that the cells of the immune system have time to kill the infectious agent.
This explains that the diagnosis of pathology occurs ten times less often in men than in women. The disease develops only if there are factors that favor the massive development of pathogenic microflora against the background of a pronounced decrease in immunity. Such diseases often lead to bladder congestion.
Causes of cystitis in men
The disease occurs when E. coli, cocci or urogenital infections invade the bladder. This process is facilitated by the following changes:
- reduced immunity under the influence of radiation, development of diabetes mellitus, blood diseases;
- Development of a negative immune system reaction;
- inflammatory process in the prostate, kidneys and ureters;
- compression of the bladder due to prostate cancer or benign hyperplasia;
- Formation of fistulas in the rectum;
- Sepsis;
- Damage to the body caused by sexually transmitted infections;
- reverse urine flow;
- Bladder injury, including as a result of pelvic surgery;
- Penetration of protozoal viruses into blood and lymph.
Prolonged hypothermia of the body, leading to a sharp decrease in immunity, can also lead to 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 appear for the first time, occur no more than once a year, or are recorded at least twice a year. After completing 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 occurs independently and is not a complication of another pathology. An acute form of pathology can arise as a result of the action of a medical, 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 progresses 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.
- Stubborn.An exacerbation is recorded about twice a year. The symptoms of the disease are moderate.
- 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 form of cystitis and leads to rapidly progressive destruction of the bladder walls.
In most cases, when classifying a chronic disease, the urologist is guided by the severity of the damage to the organ wall, the severity of the symptoms, and not the frequency of relapses.
In medical practice, a classification is also used that allows dividing 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 bladder neck and affects 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 at the sphincter of the affected organ and spreads to the opening of the ureter. This form often leads to the development of urinary reflux. When urine flows back, the infectious agent can penetrate the kidneys and contribute to the development of pyelonephritis. The man has urinary problems, including incontinence of urine that contains blood or pus.
- Diffuse.Its characteristic feature is damage to the bladder wall.
When detecting damage to the mucous membrane and underlying structures, it is not enough for the urologist to diagnose diffuse cystitis, he also needs to clarify the subtype of the disease that characterizes the course of the inflammatory process and the damage caused to it.
To determine the features 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 allow us to further classify the pathology as:
- catarrhal, which only provokes redness and irritation of the mucous membrane;
- hemorrhagic, which provokes 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, recorded in the presence of tissue necrosis.
There are also some types of diseases that occur extremely rarely, such as urogenital schistosomiasis or caused by a fungal infection. 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 malacoplakia.
Characteristic symptoms of cystitis in men
Signs of pathology may vary slightly depending on the acute or chronic form, the type of pathogen and the type of lesion. The severity of the disease is determined by the intensity of symptoms and the degree of bladder damage.
Acute cystitis is characterized by impaired urination that becomes painful, difficult, and involves frequent urge to urinate, including at night. Patients often complain of a false urge to urinate and the feeling of incomplete bladder emptying. The urine itself becomes dark and cloudy, may acquire a specific pungent odor or contain pus or blood impurities.
The inflammatory process in most cases leads to an increase in body temperature and the appearance of severe pain in the groin, scrotum and urethra. Intoxication of the body leads to general weakness, lethargy and reduced 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 the symptoms is less pronounced and high temperatures are rarely measured. With latent cystitis, signs of pathology may be completely absent; the presence of an inflammatory process can only be determined through laboratory tests.
With interstitial cystitis, there is a significant increase in the urge to urinate, accompanied by persistent, persistent pain in the suprapubic area. General changes in the body boil down to the development of anxiety, irritability and progressive depression.
Diagnosis of cystitis
To make a diagnosis, a visit to a urologist is required, who will personally examine the patient and examine a number of complaints. The patient must undergo a rectal examination. The doctor inserts a finger into the rectum to examine the condition of the prostate. This method allows you to determine whether the symptoms are associated with prostatitis or prostatic hyperplasia.
The next step is a referral for laboratory tests that 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 has the greatest 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 analysis.Changes in indicators indicate the severity of the pathology. This list includes the detection of leukocytosis and an increased concentration of eosinophils.
- seed tankThe study of pathogens contained in the urine or on the walls of the urethra makes it possible to assess their sensitivity to the effects of various antibacterial drugs.
- Tests for infectionssexually transmitted diseases.
If the results obtained give a blurry picture and do not allow to clearly determine the patient's condition, additional examinations may be prescribed, 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 the kidneys, prostate;
- Uroflowmetry.
Ultrasound of the bladder can provide the most detailed picture of the condition of the bladder, but in 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 bladder infections in men
The therapeutic course should only be prescribed by a doctor. For mild to moderate forms of the disease, outpatient treatment is possible, which includes regular follow-up examinations by a urologist. In severe cases with acute urinary retention, severe pain or bleeding, inpatient treatment is prescribed.
Surgical treatment is rarely performed; The indication for surgery is acute urinary retention in the presence of tissue necrosis or prostate 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 must follow a diet that excludes from the diet foods or drinks that irritate the bladder walls:
- Alcohol;
- strong tea, coffee;
- salted or smoked foods;
- hot spices.
The patient must increase the amount of fluid 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, for example based on chamomile and calendula, can be used.
To combat moderate pain, you can additionally use a heating pad on the lower abdomen, but this method is contraindicated in hemorrhagic or tuberculous forms of pathology. Microenemas containing an anesthetic can relieve acute pain, but they should only be used with the permission of the attending physician. The duration of therapy for acute cystitis is rarely more than 14 days.
When treating chronic cystitis, measures are taken to eliminate factors that support and provoke the inflammatory process. In case of congestion, massage 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 not only with medication, but also with physiotherapy. 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. Electrophoresis, mud therapy and inductothermy are also used.
For tuberculous cystitis, drugs are prescribed that can suppress the activity of the pathogen, as well as instillations based on fish oil.
In the treatment of the radiation form of pathology, instillations with regenerating agents are additionally used, but plastic surgery is recommended for extensive lesions. To treat interstitial cystitis, a complex of medications 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 and eucalyptus can be used to prepare herbal tea. These active ingredients have a gentle effect, have no pronounced influence on the immune system and stimulate the body's natural protective functions. The duration of therapy can be up to 1 year, although 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 of infection entering the kidneys, leading to 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; the development of acute retention is also possible.
Prevention of bladder infections
The development of the disease can be prevented by maintaining intimate relationships, including preventing sexually transmitted infections. A man needs to monitor the general state of his immunity, which requires timely treatment of all infectious diseases, combating prostatitis and conducting annual medical examinations. Quitting smoking, leading an active lifestyle, and avoiding hypothermia can help prevent cystitis.
Cystitis is rarely diagnosed in men, but this does not mean that the pathology is harmless. With reduced immunity and changes 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 examinations that can detect inflammation in the early stages.