The inflammatory process in the bladder in most cases is recorded in men over 40 years old, 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. Thanks to the elongated urethra, it is difficult for the infection to penetrate the bladder. A stream of urine eliminates the pathogen that has entered the urethra, but if it manages to remain on the walls of the urethra, movement through it will be so slow that immune system cells will 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 pronounced decrease in immunity. Often, these conditions create bladder congestion.
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 immune system response;
- inflammatory process in the prostate, kidneys, ureters;
- bladder compression due to prostate cancer or benign hyperplasia;
- formation of fistulas in the rectum;
- sepsis;
- damage to the body from sexually transmitted infections;
- reverse flow of urine;
- bladder injury, including as a result of surgical interventions in the pelvic region;
- 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 the intensity with which the symptoms manifest, the disease is divided into acute and chronic forms. Acute cystitis is usually divided into those that occur for the first time, that appear at most once a year or that are recorded at least twice a year. After completing all therapeutic measures, no inflammatory processes are detected in the bladder and a control laboratory examination 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 occurs independently and is not a complication of another pathology. An acute form of pathology can arise as a result of exposure to a medicinal, toxic, infectious or chemical factor. Infection with parasites can also cause 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 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 about 2 times a year. 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 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 subdivided according to the criteria 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, affecting its sphincters. A man faces the problem of frequent urination and urinary incontinence. The bladder emptying process itself becomes painful.
- Trigonite.The inflammatory process begins in 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 returns, the infectious agent can penetrate the kidneys, contributing to the occurrence of pyelonephritis. The man has urinary problems, including incontinence of urine containing blood or pus.
- Diffuse.Its distinctive feature is damage to the bladder wall.
When identifying damage to the mucous membrane and structures located below, it is not enough for a urologist to diagnose diffuse cystitis, he also needs to clarify the subtype of the disease, which characterizes the features of the course of the inflammatory process and the damage caused by it.
To determine the features of damage to the walls of the bladder during cystitis, endoscopic examination methods using biopsy are used. The study of biological material and the analysis of accompanying symptoms make it possible to further classify the pathology as:
- catarrhal, which only causes redness and irritation of the mucous membrane;
- hemorrhagic, provoking the development of bleeding;
- cystic, in which cysts form in the damaged wall;
- ulcerative, whose name is due to the appearance of ulcers;
- phlegmatic, 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 may be accompanied by the appearance of a large number of plaques on the organ's mucosa, in this case cystitis is defined as malakoplakia.
Characteristic symptoms of cystitis in men
Signs of the pathology may vary slightly depending on whether it occurs acutely or chronically, the type of pathogen and the nature of the lesion. The severity of the disease is determined by the intensity of symptoms and the degree of damage to the bladder.
Acute cystitis is characterized by difficulty urinating, which becomes painful and difficult, with frequent urges, including at night. Patients often complain of a false urge to urinate and a feeling 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 located 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 accompanied by a significant increase in the urge to urinate, accompanied by persistent and constant pain in the suprapubic region. General changes in the body boil down to the development of anxiety, irritability and progressive depression.
Cystitis diagnosis
Making a diagnosis requires a visit to a urologist, who performs a personal examination of the patient and studies a range of complaints. The patient needs to undergo a rectal examination procedure. 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 stage is 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 select a drug to which it will have maximum sensitivity. The list of laboratory tests includes:
- General urine analysis.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, increased concentration of eosinophils.
- Seeding TankThe study of pathogens contained in urine or in the walls of the urethra makes it possible to assess their sensitivity to the action of various antibacterial drugs.
- Tests for infectionssexually transmitted diseases.
If the results obtained give a blurred picture, not allowing 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.
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 a more 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 limit, which precludes the use of this method.
Treatment of cystitis in men
The therapeutic course should only be prescribed 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 surgical indication 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 needs to follow a diet that excludes foods or drinks from the diet that irritate the walls of the bladder:
- alcohol;
- strong tea, coffee;
- salty or smoked foods;
- hot spices.
The patient needs to increase the volume of liquids consumed to 3 liters per day, avoiding soft drinks and energy drinks. To suppress the inflammatory process, the patient is prescribed a complex of antibacterial, antiseptic and antispasmodic drugs. Additionally, 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 in hemorrhagic or tuberculous forms of pathology this method is contraindicated. Microenemas with anesthetic can relieve acute pain, but can only be used with the authorization of the attending physician. The duration of therapy for acute cystitis rarely exceeds 14 days.
Therapy of chronic cystitis involves taking measures to eliminate 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 not only with medication but also with 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. Additionally, 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 pathology, instillations with regenerating agents are additionally used, but in case of extensive injuries, plastic surgery is recommended. For the treatment of interstitial cystitis, a complex of medications is prescribed, which includes analgesics, hormonal, antimicrobial, anti-inflammatory and antihistamines.
Herbal decoctions are used as an auxiliary treatment. To prepare herbal tea, dried flowers or leaves of chamomile, St. John's wort, nettle and eucalyptus can be used. 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 a timely manner, there is a risk of kidney infection, which causes the development of pyelonephritis or reverse flow of urine. In some forms of pathology, fistula formation 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.
Cystitis prevention
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, combating prostatitis and undergoing 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 the reduction of immunity and the changes that occur in the body as a result of natural aging (after the age of 40), the risk of developing pathology increases significantly.
It must be remembered 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.