Cystitis (Bladder Infection) Symptoms and Treatment

Uncomfortable, embarrassing and common - cystitis (a bladder infection) is all three to many women. Cystitis is one of the most common conditions seen by general practitioners, but some women can barely get away from the toilet for long enough to visit the surgery!

The symptoms of burning pain on passing urine, pain in the pelvis, and the desire to pass urine every 10 minutes that are associated with cystitis are not limited entirely to women, but less than 10% of cases occur in men because the longer length of their urethra (the tube leading from the bladder to the outside) gives them considerable protection from infection. When it does affect males, it is often more serious and requires more aggressive investigation and treatment. Most women will have at least one bladder infection in their lives, and some have repeated attacks that require constant medication to prevent them.

Cystitis is due to bacteria that can reproduce rapidly in the warm urine. The bacteria can enter the bladder in one of two ways — by coming up the urethra from outside the body, or coming through the bloodstream to the kidneys and then the bladder. Entry of the bacteria from the outside is far more common, and is often due to sex. Because the urethra is very short in women (as little as 1 cm), bacteria on the skin can easily pass into the bladder with the massaging that area receives during intercourse. Passing urine immediately after sex can help to remove any bacteria that may have entered.

Slackness of the muscle ring that controls the release of urine from the bladder can also allow bacteria to enter the bladder. This damage may be caused by childbirth or prolapse of the womb, and may eventually cause incontinence with a cough or laugh. There are physiotherapy and surgical procedures available to correct this problem.

When a patient arrives at a surgery with symptoms of cystitis, a urine sample will be checked for infection. A plastic strip covered with spots that are sensitive to different constituents of the urine is used for this purpose. This can give a quite accurate picture of what is happening to cause the patient's symptoms. The sample is then sent to a laboratory for further testing to find out which bacteria are causing the infection, and which antibiotics will kill them. These tests may take a few days to complete, so the patient is usually started on an appropriate antibiotic immediately, which can be changed at a later date if the tests results indicate that this is necessary. Other medications (in the form of a powder that makes a fizzy drink) to alkalise the urine and remove the unpleasant burning sensation are also prescribed. Drinking extra fluid will help wash the infection out of the kidneys and bladder. If several infections occur, further investigations such as X-rays of the bladder and kidneys are performed, to exclude some of the rarer more serious causes of recurrent cystitis.

In most patients, cystitis is a considerable nuisance, not a serious disease, which can be easily and effectively treated provided the patient presents to a doctor at the first sign of trouble.

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