What men need to know about cystitis symptoms, causes and treatment of disease

Cystitis in men the inflammatory process in the bladder wall that occurs for various reasons. Often the signs appear after the age of 40 and are complications due to diseases in the body, infection of the urinary organs, or stagnation.

According to statistics, due to the structure of the urethra men suffer less than women. The symptoms of male cystitis are recorded at 6-8 out of 1000 male patients. To treat the disease is easiest when the primary sign, prevented the transfer of disease into a chronic form.

Etiology and taxonomy

Why the symptoms of cystitis in men are extremely rare? The reason – the unusual structure of the lower divisions of the urine-diverting paths, particularly long and convoluted canal, which prevents the penetration of any infectious factor in the urinary bladder (vesica urinaria). Even when the penetration of pathogenic microorganisms in the initial parts of the urethra it is washed out by the flow of urine partially, and the rest of the microorganisms are attacked by cells of the immune system.

But that doesn't mean to treat the disease need timely treatment with antibiotics (mostly) helps to stop the process in its initial stages. To cure pathology easier in the beginning, than then for years to use maintenance therapy or to get on the table to the surgeon.

But in the case when an immune response is very weak and the few symptoms manifest in the bladder develop congestion and infectious agents develop in huge quantities. In this case, it is manifest the primary symptoms of acute cystitis. Ignoring symptoms or improper treatment, when the microorganisms are not destroyed completely, but only unaffected by antibiotics, develop chronic cystitis in men.

Often the disease progresses because of infravesical obstruction, when there is podozrenie compression of the urinary tract. There is an obstacle at the level of the cervix or urethra that does not allow the flow of urine to pass freely when urinating. The symptoms in this case are very characteristic, indicate the violation of the outflow of urine, treatment needs to be immediate.

Sistematizirovat cystitis as follows:

• Primary

Causes: acute and chronic processes in the vesica urinaria, infectious, chemical, pharmaceutical, thermal, toxic or nutritional in nature. Primary chronic process is more often due to exposure to an infectious agent, parasite or develop after injury.

• Secondary

Reason: it happens in the background of any urological pathology (most often occur inmen).

The popularity of cystitis are distinguished: diffuse, cervical and focal, against the background of the clinical picture are:

• Hemorrhagic, polypoid, granulation.
• Catarrhal, gangrenous.
• Abscess, necrotic.
• Interstitial, fibrinous, cystic.
• Encrusting and ulcerative.

All of these forms are diagnosed with the accounting endoscopic picture, symptoms and morphological changes in the vesica urinaria.

Causes of cystitis in men are different, but the basis almost always lays one factor is infection. The catalysts of the inflammatory process are Neisseria gonorrhoeae, Chlamydia trachomatis, Pseudomonas aeruginosa and E. coli, staphylococci and pathogenic fungi. Pathogens fall into the cavity of the vesica urinaria with blood flow from the surrounding inflammatory foci. Secondary infection can act if to the end is not fixed the diseases of the genitourinary system (prostatitis, pyelonephritis, urethritis, etc.).

A rising path microflora penetrates very rarely, structure of the urinary tract and inaccessibility of the bladder to bacteria can be protected, at least in this case. But do not relax: there are many "paths" by which pathogenic flora can easily penetrate into the vesica urinaria, because any infectious foci should be treated promptly. Drugs (antibiotics, etc) prescribed by a doctor depending on the kind of the pathological focus.

The cause of the inflammatory process may be due to the following non-infectious factors:

• Decrease in immunity.
• Hypothermia, frequent stress.
• Lack of exercise, rare trips to the bathroom (suffering).
• Commitment to sharp and salty, alcoholic beverages.

Against this background, in men, reduces the overall resistance of the organism, including the bladder, microorganisms are the easiest to infiltrate into the mucosa and cause inflammation.

Infectious cystitis develops:

• By ascending paths. From the urethra, prostate, testicle or epididymis, seminal vesicles,
• Descending pathways (kidney disease).
• By hematogenous routes (for the blood of the purulent foci remote).
• Direct way. Often, by direct manipulation in the bladder (catheterization, abscess in the prostate, cystoscopy, fistula in the bladder).

Among the probable causes in men that can trigger the disease include: diabetes, TOUR, injuries to the spinal column and stress.

A separate item, experts distinguish cystitis tuberculous etiology. It appears as erased chronic process, the symptoms smoothed, visible only subfebrile temperature, General weakness, a slight "hints" on cystitis, pyelonephritis, urethritis, andother problems in the urogenital system. The massive spread of tuberculosis on the planet (according to statistics, up to 90% of the adult population) gives a high probability of transition from its latent state into an active phase. Deceit and extrapulmonary forms is much worse, as the tubercle Bacillus can penetrate all organs, including the genitourinary system. Often the pathological process is disguised as a banal infection, bacterial seeding is not carried out, moreover, the result is often false negative, especially in the case of treatment with fluoroquinolones (antibiotics).

Classification of the disease

Knowledge of all the causes, forms and types of disease helps to make the right diagnosis even when the manifestation of the pathology is not entirely typical or cystitis similar manifestations (symptoms) with other diseases.

Types of cystitis in men:

I. On the nature of the flow

a) sharp. Although it first appeared, manifested rare 1 R/year, with frequent manifestations until 2 p./year and more. After treatment of the acute forms all laboratory parameters return to normal.

b) chronic:

1. Leaking latent (hidden):

• Having a stable latent period, this form can be detected only by endoscopy.
• Manifested rarely stable.
• Have periods of exacerbation twice a year and more often.

In acute cystitis in the latent period appears as a subacute or acute cystitis.

1. Persistent. In men often manifests itself twice a year, while laboratory findings show an inflammatory process in the body.
2. Interstitial. One of the most severe forms of cystitis in men chronic course, is manifested in almost constant pain in the region of the vesica urinaria, the changes in its walls, frequent exacerbations.

It is noteworthy that when talking about acute or chronic form, the flow of cystitis, it more determines the presence of characteristic changes in the lining of the bladder wall than the number of relapses occurring during the year.

II. Secondary and primary cystitis.

a) Primary. Manifested by itself and not associated with any pathology in the body:

• The acute course, such as medical, infectious, toxic, chemical, nutritional, neurogenic, heat reasons).
• Parasitic cystitis.
• Chronic (radiation, infectious, neurotrophic ulcer, incrusting, post-traumatic, involutional and other causes).

b) Secondary. Is a consequence of any disease developed in the body of a man:

• The cystic form (foreign body, trauma, stones, malformations, tumors, and surgical interventions).
• Neuzina form (injuries to the spinal column, adenoma, urethral strictureetc.).

III. Diffuse cervical cystitis.

The following types of cystitis depends on what part of the bladder is inflamed:

• Cervical cystitis. The inflammatory process affects only the neck of the bladder, the symptoms are incontinence of urine, frequent urination, pain when urinating.
• Will trigonic. Inflammation affects the vesical triangle, located between the mouth of the ureter and the orifice of the urethra. This often creates vesicoureteral reflux occurs when the reflux of urine back into the ureter to reach the kidneys and develop pyelonephritis and congestive phenomena. When will trigonica is urination disorder, noted blood and pus in urine.
• Diffuse cystitis. Inflammatory process is spread throughout the bladder wall.

IV. Ulcer, catarrhal and other.

The following types of cystitis that develops in men, characterized by changes in the mucosa and lower structures:

• Catarrhal (redness).
• Hemorrhagic (bleeding).
• Cystic (inflammatory process with formation of cysts).
• Ulcer (ulceration).
• Abscess (in the urine there are a large number of pus).
• Gangrene (necrosis of the tissues of the bladder).
• Other (other) types (interstitial, granulomatous, etc.).

In General, the form of inflammatory process in case of cystitis depends on the strength of the immune system in men, the pathogenic properties of the pathogen.

V. Rare forms of cystitis:

• Cystitis with actinomycosis (fungi).
• When bilharzia (urogenital schistosomiasis).
• Malakoplakia (the appearance of the characteristic plaques on the mucosa of the bladder or other organs, accompanied by inflammation).
• Cystitis in purple.

Many of the forms requires a thorough examination of men with suspected cystitis urologist, it will only allow the correct diagnosis and provide adequate treatment. It is not necessary to treat the illness independently on a single symptoms, prescribing yourself antibiotics or other medication on the advice of a neighbor." It should be remembered that any drugs can cure or permanently harm the body. Tablet is a powerful synthetic or vegetable "weapon" in the fight against various infections.

The characteristic clinical picture of the disease

The symptoms of cystitis in men are different, but the leading symptoms of acute cystitis are: urinary frequency (including nocturia), strangury (difficult and painful), imperative urination, cloudy urine, terminal hematuria. As concomitant symptoms may be chills, fever, reduced quality of life and health.

Painis a constant symptom, especially early in the urine and in the end of the process, accompanied by burning and stinging in the urethra. Out of miccai (urination) pain felt in the groin, suprapubic region, scrotum, penis. One-time urine volume is reduced to 10-20 ml, in some cases, there is leakage (incontinence) of urine.

Table 1. The main symptoms of cystitis, diagnosed in men

Acute cystitis symptoms		Chronic cystitis, symptoms
Miccia	Hampered. Painful. At night often. With painful urgency.	There is a slight violation of urination. Symptoms are less pronounced. Overall health is generally OK.
urine	Terminal hematuria (blood). Pyuria (with pus). Turbidity. Often with an unpleasant odor.
Other symptoms	General weakness and low performance. The increase in temperature. Pain in penis, groin, suprapubic region. Burning in the urethra. Urinary incontinence (trigona, the cervical form). Pain, aching muscles and joints due to high temperature.

Latent (hidden) period of cystitis can occur for men unnoticed. The discouraging diagnosis, he "gets" only after passing of urine analysis or according cystoscopy.

Interstitial cystitis is characterized by a particularly frequent urging to miccai (every hour), and persistent and stubborn pain cause the man attacks constant irritability, anxiety, depressive symptoms and General decrease in quality of life. Often patients suffering from this form of cystitis for a long time, but to no avail courses of antibiotics as long as the diagnosis will not be delivered accurately.

Typical signs of cystitis: pyuria, leukocyturia, macro - or microscopic hematuria. They can be found in the study of urine. A severe form of cystitis in men (abscess, hemorrhagic, gangrenous) cause intoxication, oliguria with a rise in body temperature. Urine turbid, with admixtures of pus and blood, often with an unpleasant odor, when examination revealed fibrin layers and mucosa.

The symptoms of chronic cystitis in men are manifested poorly, have undulating or continuous stable flow. Urination less painful, persists in urine, proteinuria, pyuria, mucus, recurrent microhematuria.

When complication develops parasitic (inflammation paravesical fiber), sclerosis of the walls of the urinarybladder, pyelonephritis. The bladder is sharply reduced in volume.

Diagnosis when the disease

Diagnostic activities – it's not just a one-time visit to the urologist, a man with symptoms of cystitis will have to prepare mentally and get a full examination, to establish a form of cystitis.

Diagnosis includes:

1. Medical examination.
2. Laboratory and instrumental research.

Each of these stages is of great clinical value in subsequent treatment. Diagnosis includes:

I. examination of a doctor (urologist)

This is the preliminary diagnosis phase involves the collection of anamnestic data (patient complaints), urological examination, palpation of penis and examination of the prostate through the rectum. It allows you to determine whether the symptoms of cystitis with prostatitis, adenoma, orhiepididimita or not.

II. Laboratory and instrumental research.

As prescribed by the physician to identify the causative agent of cystitis and to clarify the nature of the inflammatory process. It includes the following:

1. The General analysis of urine (cystitis reveals leukocyturia, hematuria, bacteria, protozoa, mucus, and epithelial cells).
2. General analysis of blood. According to the results it is possible to understand the nature and severity of cystitis (for example: allergic cystitis – an increase of eosinophils, with fever leukocytosis and increased ESR).
3. The cultures of urine and urethral content. Allows to identify the causative agent of cystitis and to determine its sensitivity to antibiotics.
4. The PCR technique, scraping. Held for suspected sexual infections.

If necessary, the doctor will prescribe a more in-depth study, which includes: blood tests, immunogram, the level of prostate specific antigen and others.

• Instrumental study

Carried out to clarify the causes, triggering cystitis. Are assigned:

1. Comprehensive urodynamic study.
2. Cystography, and cystoscopy.
3. Uroflowmetry.
4. Ultrasound of the kidneys and prostate.

In the period of exacerbation of chronic or acute cystitis ultrasound of the bladder is expedient, so as to fill the urine in this period impossible.

All about treatment of the disease

Treatment of cystitis in women, especially in the acute form, is only carried out in hospital under medical supervision. Any pills (antibiotics, antispasmodics, analgesics, etc.) are issued only after final diagnosis. General treatment recommendations:

• Bed rest. Drinking plenty of fluids, antipyretics, diet.
• Antibiotics. Administered after allocation of the causative agent and determine its sensitivity to drugs. This is usually pills: nitrofurans (Furadonin), fluoroquinolones(Normaks, Tsiprolet And, Nolitsin), cephalosporins.
• Herbal medicine. Shown diuretic and anti-inflammatory herbal preparations (field horsetail, bearberry, cowberry). Well help pills plant-based: Zistan, Kanefron, Vitalizing.
• Painkillers. Effectively relieve pain drugs-antispasmodics (Papaverine, no-Spa) and NSAIDs (Nimesil, Diclofenac).
• Tablets STI treatment. In identifying STDs use certain treatment regimens of each of the detected diseases, which could trigger the development of cystitis in men.
• Irrigation of the bladder. If necessary, I do wash antiseptic (antibiotics) solutions.
• Physiotherapy. Treatment with UHF, ultrasound, mud and magnetolaserotherapy is only possible after removing the acute symptoms.
• The Spa treatment. Good results are tracked after visiting a patient of the resorts of the Stavropol and Krasnodar edges.

Most forms of cystitis treated successfully with conservative methods (pills), but in the following cases only require surgical intervention:

• Chronic cystitis, which developed as a result of BPH. Is excision of part of the prostate gland or in full, after which the flow of urine is restored, and inflammation disappears.
• Gangrenous cystitis. The bladder is released from dead tissues, if you want to hold plastic fabrics.

Treatment of cystitis in men in acute and chronic form

With the development of acute cystitis is recommended:

• Drink plenty of liquids and bed rest in the first three days.
• The complete exclusion from the diet sharp, spicy, savoury dishes.
• The refusal of cigarettes, alcohol, coffee.
• The appointment of antispasmodics, herbal decoctions.
• Treatment with antibiotics (Blacks, Furagin, Tetracycline, Oletetrin etc.) for 1-2 weeks.

To reduce the pain in the urinary tract, you can use heat on the lower abdomen, microclysters with 2% procaine, a warm bath. Strictly excluded heat treatments for tuberculosis and hemorrhagic cystitis.

With the development of chronic cystitis recommended:

• The identification and elimination of reasons that support the inflammatory process (stones, blockage, prostatitis).
• To use antibiotics that are prescribed for the establishment of susceptibility to a particular drug.
• Local treatment. To do washing with silver nitrate solution, furatsilina within 10-14 days. Shown instillation into the bladder of sea buckthorn oil or emulsions of antibacterial agents.
• Physiotherapy. Mud, UHF, inductothermy, iontophoresis.

Some forms require special treatment:

• Radiation cystitis.In addition to local treatment, use of administration tools that stimulate tissue regeneration. With extensive lesions shown plastic surgery.
• Tuberculous cystitis. In addition to anti-TB drugs prescribed instillation saluted, fish oil and PAS.
• Interstitial cystitis. With the main treatment prescribed antibiotics, administration of hormonal drugs, painkillers. Indication – anti-allergic and anti-inflammatory pill.

Table 2. Antibiotics prescribed for cystitis in men

Tablets generation fluoroquinolone number	Cephalosporins third-generation	Hydroxyquinoline derivatives	Pill of plant origin
lomefloxacin; Gatifloxacin; ofloxacin; ciprofloxacin.	cefixime; cefuroxime. Effective will also nitrofurans: furadonin; furagin; furamag.	nevigramon; nitroksolin.	the kanefron; zistan; vitalizing; uronefron.

It should be remembered that the treatment of cystitis in the chronic form, can reach 1.5 years. It is because it is advisable to treat immediately upon detection of symptoms of cystitis. This will reduce the rate of up to several weeks and prevent complications.