Cystitis in men: causes, types, symptoms, diagnosis, treatment, complications, prevention

Cystitis in men, with frequent urge to urinate and pain

In most cases, the inflammatory process of the bladder is registered in men over 40 years of age, which is associated with a natural decrease in immunity. Men who have concomitant pathologies of the urogenital system of an infectious nature are prone to the development of cystitis.

Cystitis is a rare disease among men. Thanks to the elongated urethra, it is difficult for the infection to enter the bladder. The stream of urine washes away the pathogen that has entered the urethra, but if it manages to remain on the wall of the urethra, its movement is so slow that the cells of the immune system have time to destroy the infectious pathogen.

This explains why the diagnosis of pathology occurs 10 times less often in men than in women. The disease develops only if there are factors that promote the mass development of pathogenic microflora against the background of a pronounced decrease in immunity. Such conditions often cause congestion in the bladder.

Causes of cystitis in men

The disease develops when E. coli, coccalis or urogenital infections penetrate the bladder. This process is facilitated by the following changes:

  • reduced immunity due to radiation, development of diabetes, blood diseases;
  • the development of a negative response of the immune system;
  • inflammatory process in the prostate gland, kidneys, ureters;
  • bladder compression due to prostate cancer or benign hyperplasia;
  • formation of fistulas in the rectum;
  • blood poisoning;
  • damage to the body by sexually transmitted infections;
  • reverse urine flow;
  • bladder injury, including as a result of surgical interventions in the pelvic area;
  • 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 pathology.

Types of cystitis

Depending on how vividly the symptoms appear, the disease is divided into acute and chronic forms. Acute cystitis is usually divided into first-time cases, which occur no more than once a year, or which are registered at least twice a year. After the completion of all therapeutic measures, no inflammatory process can be detected in the bladder, and the control laboratory test confirms the normalization of all indicators.

When prescribing treatment, the standard therapeutic regimen is modified, taking into account whether the disease is primary or secondary. Primary cystitis occurs independently and is not a complication of another pathology. The acute form of the pathology can develop as a result of exposure to a medicinal, 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 form:

  • Hidden.The disease occurs without the appearance of pronounced symptoms and is detected during a routine medical examination. The pathology has rare periods of exacerbation, the symptoms of which coincide with acute cystitis.
  • Persistent.Exacerbation is recorded about 2 times a year. The symptoms of the disease are mild.
  • Interposed.This form is characterized by frequent exacerbations and the presence of pain even during rest. This cystitis is the most dangerous and difficult to treat type of cystitis, which causes a 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 the symptoms, and not on the frequency of relapses.

In medical practice, a classification is also used that allows the pathology to be divided 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 neck of the bladder and affects the sphincter. A man faces the problem of frequent urination and urinary incontinence. 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 provokes the development of urinary reflux. When the urine flows back, the infectious agent can penetrate the kidneys, contributing to the occurrence of pyelonephritis. The man has problems passing urine, including incontinence of urine containing blood or pus.
  • Diffuse.Its distinguishing feature is damage to the bladder wall.

When identifying damage to the mucous membrane and the structures located under it, it is not enough for the urologist to diagnose diffuse cystitis, but also to clarify the subtype of the disease, which characterizes the specifics of the course of the inflammatory process and the damage caused. by some.

To determine the characteristics of damage to the walls of the bladder during cystitis, endoscopic examination methods with biopsy are used. The study of biological materials and the analysis of accompanying symptoms allow further classification of the pathology:

  • catarrhal, which only causes redness and irritation of the mucous membrane;
  • hemorrhagic, provokes the development of bleeding;
  • cystic, in which cysts form on the damaged wall;
  • ulcerated, whose name is due to the appearance of ulcers;
  • phlegmonosis, is diagnosed when pus forms in the problem area;
  • goiterrecorded in the presence of tissue necrosis.

There are also diseases that are extremely rarely registered, such as caused by urogenital schistosomiasis or fungal infection. The inflammatory process can be accompanied by the appearance of a large number of plaques on the mucous membrane of the organ, in which case cystitis is called malakoplakia.

Typical symptoms of cystitis in men

Signs of pathology may differ slightly, depending on whether it is in an acute or chronic form, depending on 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 a violation of urination, 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 bladder emptying. The urine itself becomes dark and cloudy, it may have a specific pungent smell, or it may contain impurities of pus or blood.

In most cases, the inflammatory process causes an increase in body temperature and severe pain localized in the groin, scrotum and urethra. Intoxication of the body leads to general weakness, lethargy and reduced concentration. Urinary incontinence is recorded in some forms of the pathology. In case of a long course of the disease, urination is 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 registered. In the case of latent cystitis, signs of pathology may be completely absent, the presence of the inflammatory process can only be detected by laboratory tests.

Interstitial cystitis is accompanied by a significant increase in the urge to urinate, accompanied by persistent, constant pain in the suprapubic area. General changes in the body lead to anxiety, irritability and progressive depression.

Diagnosis of cystitis

To make a diagnosis, you need to visit a urologist, who will personally examine the patient and examine a number of complaints. The patient should undergo a rectal examination. The doctor inserts a finger into the rectum to examine the condition of the prostate. This method makes it possible to determine whether the symptoms are related to prostatitis or prostatic hyperplasia.

The next stage is the reference to laboratory tests, which not only confirm the presence of the inflammatory process, but also determine the type of infectious agent in order to select the drug to which it has maximum 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 test.Changes in the indicators indicate the severity of the pathology. This list includes the detection of leukocytosis, an increased concentration of eosinophils.
  • Seed containerExamining pathogens in urine or on the wall of the urethra allows to assess their sensitivity to the effects of various antibacterial drugs.
  • Investigation of infectionssexually transmitted diseases.

If the obtained results give a vague picture that does not allow a clear determination of the patient's condition, additional tests 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 the comprehensive examination:

  • cystography and cystoscopy;
  • Ultrasound of the kidneys, prostate;
  • uroflowmetry.

Bladder ultrasound can provide the most 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 therapy course can only be prescribed by a doctor. In the case of mild or moderate forms of the pathology, an outpatient form of treatment is possible, which includes regular follow-up examinations by a urologist. In severe cases, acute urinary retention, severe pain or bleeding require hospitalization.

Surgical treatment is rarely used, the indication for surgery is acute urinary retention in the presence of tissue necrosis or prostate adenoma. In other cases, conservative therapeutic methods are used.

During the diagnosis of acute cystitis, the man is recommended to stay in bed for 3-5 days. You should follow a diet that excludes foods or drinks that irritate the bladder wall:

  • alcohol;
  • strong tea, coffee;
  • salted or smoked foods;
  • hot spices.

The patient should increase the amount of fluid consumed to 3 liters per day, while avoiding carbonated and energy drinks. In order 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, such as those based on chamomile and calendula, can also be used.

To overcome moderate pain, you can also use a heating pad on the lower abdomen, but this method is contraindicated in hemorrhagic or tubercular forms of the pathology. Microenemas with anesthetic can relieve acute pain, but they can only be used with the permission of the attending physician. The duration of treatment of acute cystitis rarely exceeds 14 days.

The therapy of chronic cystitis includes measures aimed at eliminating factors that support and provoke the inflammatory process. In case of congestion, massage and appropriate drugs are prescribed, if stones or prostatitis are detected, measures are taken to get rid of them. After determining the sensitivity of the pathogen, antibiotic therapy is selected.

Chronic cystitis is treated not only with drugs, but also with physical therapy. The second group includes inserting the catheter into the bladder with an antibacterial or antiseptic solution, such as sea buckthorn oil-based irrigation. In addition, electrophoresis, mud therapy and inductothermy are used.

In the case of tuberculous cystitis, drugs are prescribed that suppress the activity of the pathogen, and instillations based on dead oil.

In the treatment of the radiation form of the pathology, drips with regenerating agents are also used, but in case of extensive changes, plastic surgery is recommended. For the treatment of interstitial cystitis, a complex of drugs is prescribed, including pain relievers, hormonal, antimicrobial, anti-inflammatory and antihistamines.

Herbal decoctions are used as a complementary treatment. Dried chamomile flowers or leaves, St. John's wort, nettle and eucalyptus can be used to make medicinal tea. These agents have a gentle effect, have no pronounced effect on the immune system, and stimulate the body's natural defense functions. The duration of the 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 in the kidneys, which causes the development of pyelonephritis or reversal of the flow of urine. In some forms of the pathology, the formation of a fistula can cause a complication. Bladder sphincter damage does not always contribute to urinary incontinence, and acute retention is also possible.

Prevention of cystitis

The development of the disease can be prevented by maintaining intimate relationships, including the prevention of sexually transmitted infections. A person should monitor the general state of his immunity, which requires timely treatment of all infectious diseases, the fight against prostatitis and 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. Reduced immunity and changes occurring in the body as a result of natural aging (after 40 years) significantly increase the risk of developing pathology.

It should not be forgotten that the disease can be asymptomatic for some time, so men should not refuse preventive medical examinations, which allow the detection of inflammation at an early stage.