acute cystitis
Introduction
Introduction to acute cystitis Acute cystitis (acutecystitis) is an acute inflammatory disease of the bladder wall caused by non-specific bacterial infection, which is a common disease of the urinary system. Sudden onset, often overworked, cold, prolonged urinary retention, sexual life after the onset, the course of the disease usually lasts for 1 to 2 weeks to resolve or resolve after treatment. It is characterized by "acute" onset, "heavy" inflammatory response, and "shallow" lesions. Common symptoms are frequent urination, urgency, dysuria, pyuria and terminal hematuria, and even gross hematuria. basic knowledge The proportion of illness: 0.02--0.05% Susceptible people: no specific people Mode of infection: non-infectious Complications: vesicoureteral reflux acute pyelonephritis diabetes gas cystitis
Cause
Cause of acute cystitis
Urinary tract infection (45%):
Cystitis is a common urinary tract infection, accounting for about 50% to 70% of the total number of urinary tract infections. Caused by bacterial infection. Most of the pathogenic bacteria are Escherichia coli. It usually occurs in women because the female urethra is shorter than the male urethra and close to the anus. E. coli is easy to invade.
Diarrhea (15%):
Diarrhea is medically known as "compulsory urine retention." Long-term urinary urination will accumulate more urine in the bladder. If urine containing bacteria and toxic substances is not discharged in time, it may cause cystitis, urethritis, dysuria, hematuria or enuresis. In severe cases, urinary tract infections can spread up to the kidneys.
E. coli (15%):
Acute cystitis is mainly caused by Escherichia coli (usually Escherichia), but is rarely caused by Gram-positive aerobic bacteria (S. parasitica and Enterococcus). The infection is often caused by the urethra going up to the bladder. Girls and women are more susceptible to cystitis than boys and adult men. In children, adenovirus infection can cause hemorrhagic cystitis, but it is rare in adults with viral cystitis.(1) Causes of the disease
Cystitis is caused by a variety of factors:
1 Intrinsic factors of the bladder, such as stones in the bladder, foreign bodies, tumors and indwelling catheters, etc., destroy the bladder mucosal defense ability, which is conducive to bacterial invasion.
2 urinary tract obstruction below the bladder neck, causing dysuria, loss of urine washing, residual urine becomes a good medium for bacterial growth.
3 nervous system damage, such as nervous system diseases or extensive pelvic surgery (uterine or rectal resection), the injury dominates the nerves of the bladder, causing dysuria and causing infection.
(two) pathogenesis
The route of bladder infection is the most common. The incidence rate is higher than that of males. Because female urethra is short and the urethral orifice is abnormally dissected, it is often contaminated by the contents of the adjacent vagina and anus, that is, the fecal-perine-urinary tract infection route. Friction damage to the urethra during sexual intercourse, bacteria in the distal 1/3 of the urethra are squeezed into the bladder: may also cause cystitis due to changes in sex hormones, causing vaginal and urethral mucosal defense mechanisms, and the use of spermicide in the vagina will change the vagina The environment causes the bacteria to grow and reproduce easily, becoming a pathogen of urinary tract infections. Male prostate seminal vesiculitis, female paraurethral gland inflammation can also cause cystitis. When the urethra is applied for examination or treatment, bacteria can enter the bladder. Recently, adolescent males The incidence of cystitis has an increasing trend. The main risk factors are excessive foreskin, sexual partners with vaginal inflammation, and male homosexuals. Downward infection refers to cystitis secondary to kidney infection. Bladder infection can also be infected by adjacent organs. Caused by spread or direct spread, but less common.
Prevention
Acute cystitis prevention
1, drink plenty of water to increase urination, can prevent or even treat the infection.
2, wash the hot water bath, can reduce pain.
3, taking anti-inflammatory drugs such as aspirin, can reduce the burning sensation caused by inflammation.
4, taking vitamin C, you can acidify the urine, interfere with bacterial growth.
5, after defecation, wipe the anus from front to back, can prevent recurrence of infection.
6, go to the toilet before sexual intercourse, so as to avoid the cells being brought into the bladder by sexual intercourse, after going to the toilet after sexual intercourse, the bacteria in the female urethra can be sent to the bladder, and then sent out by the urine.
7, consider whether the use of uterine sleeve contraceptive device, factor palace condoms can easily cause recurrent bladder infection, if there is infection, should consider changing to other methods of contraception,
8. Try to replace the tampon with sanitary napkins.
9, pay attention to personal hygiene, wearing cotton underwear, it is easier to keep dry and clean, but do not clean too much.
10. Patients with bladder infection should see a doctor once they have hematuria, pain in the lower back and waist, fever, nausea or vomiting.
Complication
Acute cystitis complications Complications vesicoureteral reflux acute pyelonephritis diabetic gas cystitis
The main complication of acute cystitis is infection involving the kidneys, and children with vesicoureteral reflux are prone to this complication.
A small number of girls with acute cystitis associated with vesicoureteral reflux, infection can rise and cause acute pyelonephritis, rare in adults.
A small number of diabetic patients cause cystitis due to indwelling of the urinary catheter, sometimes with gas cystitis, and the gas in the bladder is mostly caused by gas-producing bacteria.
Symptom
Acute symptoms of bladder inflammation Common symptoms Urinary tract burning sensation Urinary pain Urinary urgency Hyperthermia Prostatic hyperplasia Urinary incontinence Hematuria Urine turbidity
Review
Acute cystitis can occur suddenly or slowly. When urinating, there is burning pain in the urethra, frequent urination, often accompanied by urgency. In severe cases, it is similar to urinary incontinence. Urinary urgency is often very obvious. It can reach 5-6 times per hour. Not much, even a few drops, there may be lower abdominal pain at the end of urination. Urine turbidity, stinky smell, pus cells, sometimes hematuria, often evident in the terminal phase. Mild tenderness in the suprapubic bladder area. Some patients have mild low back pain. When the inflammatory lesions are confined to the bladder mucosa, there is often no fever and leukocytosis in the blood. The systemic symptoms are mild or absent, and some patients have fatigue. Acute cystitis has a short course of disease. If it is treated promptly, the symptoms will disappear in about 1 week.
symptom
There are obvious bladder irritation: frequent urination, urgency, nocturia, urinary burning or dysuria. There is often pain in the lumbosacral or suprapubic area. And common urinary interruption and hematuria, fever is rare. Women often cause seizures after sexual intercourse (honeymoon cystitis). With its unique therapeutic advantages, Chinese medicine Diurea Anti-inflammatory Pill has not only the rapid antibacterial and anti-inflammatory ability of similar Chinese medicines, but also the diuretic effect of antibiotics to clean the environment of the bladder, and can nourish the liver and kidney stimulated and injured by antibiotics. Self-immunity. Therefore, Chinese medicine diuretic anti-inflammatory pills have become the best drug for the treatment of cystitis.
Sign
There is sometimes tenderness on the pubic bone, but there is no specific signs. Relevant possible pathogenic factors should be examined, such as vaginal, urethral orifice, abnormal urethra (such as urethral diverticulum), vaginal secretions, urethral secretions, swollen anterior fissure gland or epididymis.
Examine
Examination of acute cystitis
Laboratory examination: blood is normal, or white blood cells are slightly elevated, urine analysis often has pyuria or bacteriuria, sometimes visible hematuria or microscopic hematuria, urine culture can find pathogenic bacteria, such as no other urinary diseases Serum creatinine and blood urea nitrogen were normal.
Urine check:
1 Urine routine white blood cell count (or platelet count) 10 / HP, may have red blood cells, but no cast.
2 urinary smear smear Gram stain, WBC 15 ~ 20 / HP; 3 middle urinary culture, colony 108 / L.
If there is urinary purulent discharge, smear examination should be performed to exclude Neisseria gonorrhoeae infection. If necessary, cystoscopy should be performed after acute infection or infection control, or B-ultrasound after onset, X-ray examination excluded Etiology or induced and concurrent factors such as urinary tract stones.
X-ray examination: If kidney infection or other genitourinary tract abnormalities are suspected, X-ray examination should be performed at this time. For patients with Proteus infection, if the treatment effect is poor or no effect at all, X-ray examination should be performed to determine whether to merge. There are urinary stones.
Device examination: cystoscopy should be performed when bleeding is obvious, but it must be done after the acute phase of infection or after the infection has been adequately treated.
Diagnosis
Diagnosis and diagnosis of acute cystitis
Diagnosis can be based on medical history, clinical symptoms, and laboratory tests.
Differential diagnosis
1, acute pyelonephritis is also mainly urinary frequency, urgency, dysuria and other urinary tract irritation symptoms, urine test may have pus cells and red blood cells, but often accompanied by fever and other systemic infection symptoms, low back pain and kidney area tenderness.
2, trichomonas cystitis also mainly manifested as urinary frequency, urgency, dysuria and other urinary tract irritation symptoms, but patients often have a history of unclean sexual intercourse, urethra has more secretions, and secretion examination can find trichomoniasis.
3, acute prostatitis also mainly manifested as frequent urination, urgency, dysuria and other urinary tract irritation, and pubic pain, patients often have varying degrees of dysuria, and rectal examination can be found with enlarged prostate with tenderness.
4, interstitial cystitis also mainly manifested as frequent urination, urgency, dysuria and other urinary tract irritation, and pubic pain, pain and tenderness in the suprapubic bladder area is particularly obvious, increased bladder filling, most routine urine examination Very few pus cells.
5, glandular cystitis clinical manifestations of frequent urination, urgency, dysuria, dysuria and hematuria, B-ultrasound can be shown as intravesical space-occupying lesions or thickening of the bladder wall and other non-specific signs, cystoscopy and mucosal activity Tissue inspection can help with identification.
6, the lower ureteral calculi ureteral stones can also produce bladder irritation when the ureteral stones fall to the interstitial wall of the bladder. If the infection is combined, it is not easy to identify with cystitis. The KUB plain film and IVU can show the location of the stones and determine whether there is a combined obstruction. .
