Cystitis is inflammation of the lining of the bladder as a result of infection, irritation or damage. It can affect women and men, but is much more common in women. This is because women have a shorter urethra (the tube that goes from the bladder out of the body) and its opening is located nearer the anus, which means that infection can occur more easily.
Cystitis is more common in pregnant women, sexually active women and women after the menopause, but it can occur at any age.
Many women have at least one attack of cystitis in their lives, some women have frequent attacks. The first time you have cystitis you should see your GP for advice. If you go on to have cystitis more than three times in one year, you should see your GP again. Children and men should always see their GP if they have cystitis.
Cystitis is common in women, but it is less common and a potentially more serious condition for men. For men the cause can be an underlying bladder or prostate infection, an obstruction or tumour, or an enlarged prostate. It’s not usually serious if treated quickly, but the discomfort can be chronic and disabling. Untreated bladder infections can cause kidney or prostate infections and damage. Sexually active gay men are more likely to get cystitis than other males.
Symptoms
Symptoms of cystitis include:
- pain, burning or stinging sensations when passing urine,
- needing to urinate frequently and urgently, but only passing small amounts,
- urine which is dark, cloudy, strong smelling or contains traces of blood,
- pain directly above the pubic bone, or in the lower back or abdomen.
- Older women may have none of the above symptoms, but may feel generally unwell, weak and feverish.
Cystitis can also affect children. Their symptoms may include weakness, irritability, reduced appetite, vomiting, and pain when passing urine.
The symptoms described above may be caused by conditions other than cystitis, such as:
- sexually transmitted infections (STIs) such as gonorrhoea and chlamydia,
- being infected with a parasite such as E-coli,
- thrush (Candida),
- use of perfumed personal hygiene products,
- inflammation of the urethra (urethritis),
- urethral syndrome (women only), or
- inflammation of the prostate gland, known as prostatitis (men only).
Causes
Bacterial infection is the most common cause of cystitis. Bacterial infection of the bladder may be caused by:
Not emptying the bladder fully, this can cause bacteria to multiply, leaving bacteria (a cause of cystitis) in the bladder. This is especially common in pregnant women because of the pressure on the pelvic area.
Bacteria being pushed into the urethra in women, this can happen when you insert a tampon or when you are having sex.
Spreading germs from your anus to your urethra when you go to the toilet in women, this can happen if you wipe from back to front rather than front to back.
Damage caused to the area when changing a catheter.
A blockage somewhere in the urinary system that prevents complete emptying of the bladder.
An enlarged prostate gland in men, which can cause a blockage and bladder infections, this is because the prostate prevents the bladder from completely emptying.
Other bladder or kidney problems and diabetes.
In menopausal women, the lining of the urethra and the bladder become thinned due to a lack of the hormone oestrogen. This thin lining is more likely to become infected and damaged. Women also produce less mucus around the vagina after the menopause, and without this mucus, bacteria are more likely to multiply. Menopausal women taking hormone replacement therapy (HRT) may be less likely to get cystitis.
In women, physical damage or bruising often caused by vigorous or frequent sex can lead to cystitis. This is commonly known as honeymoon cystitis.
Women who use a diaphragm for contraception are also more likely to get cystitis.
Diagnosis
If you think you have cystitis and you go to see your GP theyll ask you about your symptoms and do a urine test. This will either be using a dipstick in your urine sample, or by sending your sample to a hospital laboratory. Here they will find out which bacterium is causing the infection so you can be prescribed the right antibiotics to treat it.
Your GP might also take this opportunity to make sure you dont have any STIs that might be causing similar symptoms. Tests are quick and painless and most STIs can be treated easily with antibiotics.
If you have recurrent cystitis (more then three times in 12 months) you may have to have further tests such as an ultrasound scan, X-ray or a fibre-optic camera examination of the bladder (cytoscopy).
Treatment
Mild cystitis will usually go away by itself in 2-4 days. If it doesnt, you should go to see your GP. In some cases (especially if you are pregnant), a short course (3 days) of antibiotics is given for cystitis. The symptoms should start to improve after the first day of treatment. If your symptoms do not improve, go back to your GP or call NHS Direct on 0845 4647.
Over-the-counter painkillers like paracetamol or ibuprofen can be taken to reduce discomfort (always read the label and ask your pharmacist first if you are pregnant).
Drinking plenty of water is often recommended as a treatment for cystitis. There is no evidence that this is helpful, although drinking at least two litres of fresh water per day is generally good for health. You should also avoid alcohol.
Taking sodium citrate or potassium citrate in sachets or solutions may be helpful in easing some of the symptoms. These are available from your pharmacist over-the-counter (without a prescription) but pregnant women should ask the pharmacist for advice.
Drinking cranberry juice may help prevent cystitis coming back, and some people use it to relieve the symptoms of an attack. Although there is little evidence to support this, it is thought that cranberry juice helps to stop bacteria sticking to the urinary tract.
Don’t have sex until your cystitis has cleared up.
Your GP may also arrange laboratory tests to rule out other causes or to identify the bacteria causing the cystitis. Once the bacteria are known, the most appropriate antibiotic can be prescribed.
Women who get cystitis frequently (more than three times in 12 months), should go and see their GP. It is also important that you see your GP initially rather than treating the condition yourself, because it is easy to mistake other conditions for cystitis.
Men and children with cystitis should always see their doctor.
Prevention
It is not always possible to prevent cystitis, but here are some tips to try and avoid it:
- make sure youre clean before and after sex, but avoid using perfumed bubble bath, soap and talc around your genitals,
- always empty your bladder fully when you go to the toilet,
- dont wait to go if you need to urinate,
- wear cotton underwear and avoid tight jeans and trousers,
- wipe from front to back, not back to front,
- use a lubricant when having sex to avoid damaging the area, and
- after having sex, make sure you empty your bladder as soon as possible to get rid of any germs.
- People who wear catheters need special advice on how to change them carefully to avoid damaging the area. Ask your doctor, carer or continence advisor.
This information is sourced from Sourced from NHS-CKS.