Which are the symptoms?
Symptomatology of cystitis varies from individual to individual. Usually, it manifests itself by difficulty in urinating, pain on urination and postictal burning, presence of blood in the urine, feeling of heavy bladder and having to urinate even immediately after urination (bladder tenesmus). More rarely, these symptoms may be associated with fever and chills.
- difficulty in urinating
- pain on urination
- burning afterwards
- presence of blood in the urine
- feeling of a heavy bladder
- feeling of having to urinate even immediately after urination (bladder tenesmus)
How is it diagnosed?
The diagnosis of cystitis is primarily clinical. However, urinalysis with urine culture (and eventual antibiogram) may be useful. Sample collection must be adequate so that it is not contaminated with genital bacterial flora. Urinalysis will detect increased white blood cell count, the presence of blood in the urine, nitrites, and increased pH. The urine culture is also useful to isolate the type of bacterium responsible for the infection, and based on the antibiogram you can then set up targeted therapy. Urine culture is indicated in all cases of urinary tract infections, however in cases of first episode of uncomplicated cystitis in premenopausal women, the presence of leukocyte esterase or nitrite in a test strip (positive strip) can be considered sufficient for the diagnosis to start an empirical treatment of short duration (3-5 days).
How is it treated?
The therapy of choice for cystitis is in fact antibiotic therapy. In particular, empirical therapy can be set up before having the report of the urine culture and antibiogram, and then it will be possible to set up antibiotic therapy targeted to specific pathogen. The most commonly used drugs are fluoroquinolones, trimethoprim-sulfamethoxazole, and nitrofurantoin. It should be noted that cystitis is a condition that tends to recur (it is estimated that about 25% of women who have cystitis will have a new episode within a year). Recurrence may be the result of reinfection or relapse. Reinfection is the cause of 95% of recurrent infections in women. They are caused by germs other than those previously treated, and the period of occurrence is usually more than two weeks after the previous infection. Recurrence, on the other hand, is more common in men and may involve anatomic or functional abnormalities of the urinary tract. It is usually due to the same microorganism as previously treated and usually appears in a shorter time interval (less than two weeks). To reduce the risk of the disease recurring, small lifestyle changes that reduce the risk of such infections may be helpful. In particular, preventive measures include adequate hydration (drink about 1.5-2 liters of water per day), accurate intimate hygiene, avoiding unprotected sexual intercourse, regular urination, urinate immediately after sexual intercourse, complete emptying the bladder with urination and limitation of alcohol use. In addition, drinking cranberry juice may reduce the incidence of new episodes due to its antibacterial and purifying abilities. In recurrent forms of cystitis, continuous or postcoital antibiotic prophylaxis may be necessary.