Infection urinary tract(UTI) - the growth of microorganisms in various parts of the kidneys and urinary tract (UT), capable of causing an inflammatory process, localized corresponding to the disease (pyelonephritis, cystitis, urethritis, etc.).

UTI in children occurs in Russia with a frequency of about 1000 cases per 100,000 population. Quite often, UTIs tend to be chronic and recurrent. This is explained by the peculiarities of the structure, blood circulation, innervation of the MP and age-related dysfunction immune system the child's growing body. In this regard, it is customary to identify a number of factors contributing to the development of UTI:

• disturbance of urodynamics;
• neurogenic bladder dysfunction;
• severity of pathogenic properties of microorganisms (adhesion, release of urease);
• features of the patient’s immune response (decreased cell-mediated immunity, insufficient production of antibodies to the pathogen, production of autoantibodies);
• functional and organic disorders of the distal parts of the colon (constipation, imbalance of intestinal microflora).

In childhood, UTIs in 80% of cases develop against the background congenital anomalies upper and lower MPs, in which there are urodynamic disturbances. In such cases, they speak of complicated UTI. In an uncomplicated form, anatomical disorders and urodynamic disorders are not determined.

Among the most common malformations of the urinary tract, vesicoureteral reflux occurs in 30-40% of cases. Second place goes to megaureter, neurogenic bladder dysfunction. With hydronephrosis, kidney infection occurs less frequently.

Diagnosis of UTI is based on many principles. It must be remembered that the symptoms of a UTI depend on the age of the child. For example, newborns do not have specific symptoms of UTI and the infection is rarely generalized.

For children younger age Symptoms such as lethargy, restlessness, periodic rises in temperature, anorexia, vomiting and jaundice are typical.

Older children are characterized by fever, back pain, abdominal pain and dysuria.

The list of questions when collecting anamnesis includes the following items:

• heredity;
• complaints when urinating (frequency, pain);
• previous episodes of infection;
• unexplained rises in temperature;
• presence of thirst;
• amount of urine excreted;
• in detail: straining during urination, diameter and intermittency of the stream, imperative urges, rhythm of urination, daytime urinary incontinence, nocturnal enuresis, frequency of bowel movements.

The doctor should always strive to more accurately determine the location of a possible source of infection: the type of treatment and prognosis of the disease depend on this. To clarify the topic of urinary tract lesions, it is necessary to know well clinical symptoms lower and upper urinary tract infections. In case of upper urinary tract infection, pyelonephritis is significant, which accounts for up to 60% of all cases of hospitalization of children in hospital ( ).

However, the basis for diagnosing UTIs is the data of urine tests, in which microbiological methods are of primary importance. Isolation of the microorganism in urine culture serves as the basis for diagnosis. There are several ways to collect urine:

• intake from the middle portion of the stream;
• urine collection into a urinal (in 10% healthy children up to 50,000 CFU/ml, at 100,000 CFU/ml the analysis should be repeated);
• catheterization through the urethra;
• suprapubic aspiration (not used in Russia).

Common indirect method bacteriuria is assessed by testing for nitrites (nitrates, normally found in urine, are converted to nitrites in the presence of bacteria). Diagnostic value This method reaches 99%, but in young children, due to the short stay of urine in the bladder, it is significantly reduced and reaches 30-50%. It is important to remember that little boys may have false positive result due to the accumulation of nitrites in the preputial sac.

Most UTIs are caused by one type of microorganism. The detection of several types of bacteria in samples is most often explained by violations of the technique for collecting and transporting the material.

At chronic course In some cases, UTI may reveal microbial associations.

Other methods for examining urine include collecting a general urine test, the Nechiporenko and Addis-Kakovsky tests. Leukocyturia is observed in all cases of UTI, but it must be remembered that it can also occur, for example, with vulvitis. Gross hematuria occurs in 20-25% of children with cystitis. In the presence of symptoms of infection, proteinuria confirms the diagnosis of pyelonephritis.

Instrumental examinations are carried out for children during the period of remission of the process. Their purpose is to clarify the location of the infection, the cause and extent of kidney damage. Examination of children with UTIs today includes:

• ultrasound scanning;
• voiding cystography;
• cystoscopy;
• excretory urography (obstruction in girls - 2%, in boys - 10%);
• radioisotope renography;
• nephroscintigraphy with DMSA (scar forms within 1-2 years);
• urodynamic studies.

Instrumental and x-ray examinations should be performed according to the following indications:

• pyelonephritis;
• bacteriuria under 1 year of age;
• increased blood pressure;
• palpable mass in the abdomen;
• spinal abnormalities;
• decreased urine concentrating function;
• asymptomatic bacteriuria;
• recurrence of cystitis in boys.

Bacterial etiology of UTI in urological diseases has distinctive features depending on the severity of the process, the frequency of complicated forms, the patient’s age and the state of his immune status, the conditions of the infection (outpatient or in a hospital).

Research results (data from the Scientific Center for Children's Diseases of the Russian Academy of Medical Sciences, 2005) show that in outpatients with UTI in 50% of cases there are E. coli, in 10% - Proteus spp., in 13% - Klebsiella spp., at 3% - Enterobacter spp., in 2% - Morganella morg. and with a frequency of 11% - Enterococcus fac. ( ). Other microorganisms, accounting for 7% of the isolation and occurring at a frequency of less than 1%, were as follows: S. epidermidis — 0,8%, S. pneumoniae — 0,6%, Acinetobacter spp. — 0,6%, Citrobacter spp. — 0,3%, S. pyogenes — 0,3%, Serratia spp. — 0,3%.

In structure nosocomial infections UTIs rank second after infections respiratory tract. It should be noted that 5% of children in a urological hospital develop infectious complications caused by surgical or diagnostic intervention.

In inpatients, the etiological significance of E. coli is significantly reduced (up to 29%) due to the increase and/or addition of such “problematic” pathogens as Pseudomonas aeruginosa (29%), Enterococcus faec.(4%), coagulase-negative staphylococci (2.6%), non-fermenting gram-negative bacteria ( Acinetobacter spp. — 1,6%, Stenotrophomonas maltophilia- 1.2%), etc. The sensitivity of these pathogens to antibacterial drugs is often unpredictable, as it depends on a number of factors, including the characteristics of nosocomial strains circulating in a given hospital.

There is no doubt that the main goals in the treatment of patients with UTIs are the elimination or reduction of the inflammatory process in renal tissue and MP, while the success of treatment is largely determined by rational antimicrobial therapy.

Naturally, when choosing a drug, the urologist is guided primarily by information about the causative agent of the infection and the spectrum of the antimicrobial action of the drug. An antibiotic may be safe, capable of creating high concentrations in the kidney parenchyma and urine, but if its spectrum does not have activity against a specific pathogen, prescribing such a drug is pointless.

A global problem in prescribing antibacterial drugs is the increasing resistance of microorganisms to them. Moreover, resistance most often develops in community-acquired and nosocomial patients. Those microorganisms that are not included in antibacterial spectrum of any antibiotic are naturally considered resistant. Acquired resistance means that a microorganism that was initially sensitive to a particular antibiotic becomes resistant to its action.

In practice, people are often mistaken about acquired resistance, believing that its occurrence is inevitable. But science has facts that refute this opinion. Clinical significance These facts are that antibiotics that do not cause resistance can be used without fear of its subsequent development. But if the development of resistance is potentially possible, then it appears quite quickly. Another misconception is that the development of resistance is associated with the use of antibiotics in large quantities. Examples of the world's most commonly prescribed antibiotic, ceftriaxone, as well as cefoxitin and cefuroxime, support the concept that the use of antibiotics with a low resistance potential in any volume will not lead to subsequent increases in resistance.

Many people believe that the emergence of antibiotic resistance is typical for some classes of antibiotics (this opinion applies to cephalosporins III generation), but for others - no. However, the development of resistance is not related to the class of antibiotic, but to the specific drug.

If an antibiotic has the potential to develop resistance, signs of resistance to it appear within the first 2 years of use or even at the stage clinical trials. Based on this, we can confidently predict problems of resistance: among aminoglycosides - gentamicin, among second generation cephalosporins - cefamandole, third generation - ceftazidime, among fluoroquinolones - trovofloxacin, among carbapenems - imipenem. The introduction of imipenem into practice was accompanied by the rapid development of resistance to it in P. aeruginosa strains; this process continues today (the appearance of meropenem was not associated with such a problem, and it can be argued that it will not arise in the near future). Among the glycopeptides is vancomycin.

As already indicated, 5% of hospitalized patients develop infectious complications. Hence the severity of the condition, and the increase in recovery time, hospital stay, and increase in the cost of treatment. In the structure of nosocomial infections, UTIs occupy first place, followed by surgical ones (wound infections of the skin and soft tissues, abdominal infections).

The difficulties of treating hospital-acquired infections are determined by the severity of the patient’s condition. Often there is an association of pathogens (two or more, with a wound or catheter-associated infection). Also of great importance is the increased recent years resistance of microorganisms to traditional antibacterial drugs (penicillins, cephalosporins, aminoglycosides) used for infections genitourinary system.

To date, the sensitivity of hospital strains of Enterobacter spp. to Amoxiclav (amoxicillin + clavulanic acid) is 40%, to cefuroxime - 30%, to gentamicin - 50%, the sensitivity of S. aureus to oxacillin is 67%, to lincomycin - 56%, to ciprofloxacin - 50%, to gentamicin - 50 %. The sensitivity of P. aeruginosa strains to ceftazidime in different departments does not exceed 80%, to gentamicin - 50%.

There are two potential approaches to overcome antibiotic resistance. The first is to prevent resistance, for example by limiting the use of antibiotics that have a high potential for its development; Equally important are effective epidemiological control programs to prevent spread in medical institution hospital infections caused by highly resistant microorganisms (inpatient monitoring). The second approach is to eliminate or correct existing problems. For example, if resistant strains are common in the intensive care unit (or in the hospital in general) P. aeruginosa or Enterobacter spp., That complete replacement in antibiotic formularies with a high potential for the development of resistance to “cleaner” antibiotics (amikacin instead of gentamicin, meropenem instead of imipenem, etc.) will eliminate or minimize antibiotic resistance of gram-negative aerobic microorganisms.

In the treatment of UTIs, the following are currently used: inhibitor-protected penicillins, cephalosporins, aminoglycosides, carbapenems, fluoroquinolones (limited in pediatrics), uroantiseptics (nitrofuran derivatives - Furagin).

Let us dwell on antibacterial drugs in the treatment of UTIs in more detail.

1. Inhibitor-protected aminopenicillins: amoxicillin + clavulanic acid (Amoxiclav, Augmentin, Flemoklav Solutab), ampicillin + sulbactam (Sulbacin, Unazin).
2. II generation cephalosporins: cefuroxime, cefaclor.
3. Fosfomycin.
4. Nitrofuran derivatives: furazolidone, furaltadone (Furazolin), nitrofural (Furacilin).

For upper urinary tract infection.

1. Inhibitor-protected aminopenicillins: amoxicillin + clavulanic acid, ampicillin + sulbactam.
2. II generation cephalosporins: cefuroxime, cefamandole.
3. III generation cephalosporins: cefotaxime, ceftazidime, ceftriaxone.
4. IV generation cephalosporins: cefepime.
5. Aminoglycosides: netilmicin, amikacin.

For hospital infection.

1. Cephalosporins of the III and IV generations - ceftazidime, cefoperazone, cefepime.
2. Ureidopenicillins: piperacillin.
3. Fluoroquinolones: according to indications.
4. Aminoglycosides: amikacin.
5. Carbapenems: imipenem, meropenem.

For perioperative antibacterial prophylaxis.

1. Inhibitor-protected aminopenicillins: amoxicillin + clavulanic acid, ticarcillin/clavulanate.
2. Cephalosporins of the II and III generations: cefuroxime, cefotaxime, ceftriaxone, ceftazidime, cefoperazone.

For antibacterial prophylaxis during invasive procedures: inhibitor-protected aminopenicillins - amoxicillin + clavulanic acid.

It is generally accepted that antibiotic therapy in outpatients with UTI can be administered empirically, based on the antibiotic susceptibility data of the main uropathogens circulating in a particular region during a given observation period and the clinical status of the patient.

The strategic principle of antibiotic therapy in outpatient setting is the principle of minimum sufficiency. First-line drugs are:

• inhibitor-protected aminopenicillins: amoxicillin + clavulanic acid (Amoxiclav);
• cephalosporins: oral cephalosporins of II and III generations;
• derivatives of the nitrofuran series: nitrofurantoin (Furadonin), furazidin (Furagin).

It is erroneous to use ampicillin and co-trimoxazole in outpatient settings due to increased resistance to them E. coli. The use of first generation cephalosporins (cephalexin, cefradine, cefazolin) is not justified. Derivatives of the nitrofuran series (Furagin) do not create therapeutic concentrations in the renal parenchyma, so they are prescribed only for cystitis. In order to reduce the growth of resistance of microorganisms, the use of third-generation cephalosporins should be sharply limited and the use of aminoglycosides in outpatient practice should be completely eliminated.

Analysis of the resistance of strains of pathogens of complicated urinary infections shows that the activity of drugs from the group of semisynthetic penicillins and protected penicillins can be quite high against Escherichia coli and Proteus, but against enterobacteria and Pseudomonas aeruginosa their activity is up to 42 and 39%, respectively. Therefore, drugs in this group cannot be drugs empirical therapy severe purulent inflammatory processes urinary organs.

The activity of cephalosporins of the first and second generations against Enterobacter and Proteus also turns out to be very low and ranges from 15-24%; against Escherichia coli it is slightly higher, but does not exceed the activity of semisynthetic penicillins.

The activity of cephalosporins of the III and IV generations is significantly higher than that of penicillins and cephalosporins of the I and II generations. The highest activity was observed against E. coli - from 67 (cefoperazone) to 91% (cefepime). Activity against Enterobacter ranges from 51 (ceftriaxone) to 70% (cefepime); high activity of drugs in this group is also noted against Proteus (65-69%). The activity of this group of drugs against Pseudomonas aeruginosa is low (15% for ceftriaxone, 62% for cefepime). The spectrum of antibacterial activity of ceftazidime is the highest against all current gram-negative pathogens of complicated infections (from 80 to 99%). The activity of carbapenems remains high - from 84 to 100% (for imipenem).

The activity of aminoglycosides is somewhat lower, especially against enterococci, but amikacin retains high activity against enterobacteria and Proteus.

For this reason, antibacterial therapy for UTIs in urological patients in a hospital should be based on data from microbiological diagnostics of the infectious agent in each patient and his sensitivity to antibacterial drugs. Initial empiric antimicrobial therapy in urological patients can be prescribed only until results are available bacteriological research, after which it must be changed according to the antibiotic sensitivity of the isolated microorganism.

When using antibiotic therapy in a hospital, a different principle should be followed - from simple to powerful (minimum use, maximum intensity). The range of groups of antibacterial drugs used here has been significantly expanded:

• inhibitor-protected aminopenicillins;
• cephalosporins of III and IV generations;
• aminoglycosides;
• carbapenems;
• fluoroquinolones (in severe cases and in the presence of microbiological confirmation of sensitivity to these drugs).

Perioperative antibiotic prophylaxis (pre-, intra- and post-operative) is important in the work of a pediatric urologist. Of course, one should not neglect the influence of other factors that reduce the likelihood of developing infection (reducing hospital stay, quality of processing of instruments, catheters, use of closed systems for urine diversion, staff training).

Major studies show that postoperative complications are prevented if a high concentration of antibacterial drug in the blood serum (and tissues) is created before the start of treatment. surgical intervention. IN clinical practice optimal time for antibiotic prophylaxis - 30-60 minutes before the start of surgery (provided intravenous administration antibiotic), i.e. at the beginning of anesthesia. There was a significant increase in the incidence of postoperative infections if the prophylactic dose of antibiotic was not prescribed within 1 hour before surgery. Any antibacterial drug administered after closing the surgical wound will not affect the likelihood of complications.

Thus, a single administration of an adequate antibacterial drug for prophylactic purposes is no less effective than repeated administration. Only with long-term surgery (more than 3 hours) an additional dose is required. Antibiotic prophylaxis cannot last more than 24 hours, since in this case the use of an antibiotic is considered as therapy, and not as prevention.

An ideal antibiotic, including for perioperative prophylaxis, should be highly effective, well tolerated by patients, and have low toxicity. Its antibacterial spectrum should include probable microflora. For patients staying in hospital for a long time before surgery, it is necessary to take into account the spectrum of nosocomial microorganisms, taking into account their antibiotic sensitivity.

For antibiotic prophylaxis during urological operations, it is advisable to use drugs that create high concentration in urine. Many antibiotics meet these requirements and can be used, such as second-generation cephalosporins and inhibitor-protected penicillins. Aminoglycosides should be reserved for patients at risk or allergic to b-lactams. Third and fourth generation cephalosporins, inhibitor-protected aminopenicillins and carbapenems should be used in isolated cases when the surgical site is contaminated with multi-resistant nosocomial microorganisms. Still, it is desirable that the use of these drugs be limited to the treatment of infections with a severe clinical course.

There are general principles antibacterial therapy UTI in children, which includes the following rules.

In case of febrile UTI, therapy should be started with a parenteral antibiotic. wide range(inhibitor-protected penicillins, cephalosporins of II, III generations, aminoglycosides).

It is necessary to take into account the sensitivity of urine microflora.

The duration of treatment for pyelonephritis is 14 days, cystitis - 7 days.

In children with vesicoureteral reflux, antimicrobial prophylaxis should be long-term.

Antibacterial therapy is not indicated for asymptomatic bacteriuria.

In the concept " rational antibiotic therapy» should include not only the correct choice of drug, but also the choice of its administration. It is necessary to strive for gentle and at the same time the most effective methods of prescribing antibacterial drugs. When using step therapy, which consists of changing the use of parenteral antibiotics to oral ones after the temperature has normalized, the doctor should remember the following.

• The oral route is preferable for cystitis and acute pyelonephritis in older children, in the absence of intoxication.
• The parenteral route is recommended for acute pyelonephritis with intoxication in infancy.

Antibacterial drugs are presented below depending on the route of their administration.

Oral medications for the treatment of UTIs.

1. Penicillins: amoxicillin + clavulanic acid.
2. Cephalosporins:

   II generation: cefuroxime;

   III generation: cefixime, ceftibuten, cefpodoxime.

Drugs for parenteral treatment of UTI.

1. Penicillins: ampicillin/sulbactam, amoxicillin + clavulanic acid.
2. Cephalosporins:

   II generation: cefuroxime (Cefu-rabol).

   III generation: cefotaxime, ceftriaxone, ceftazidime.

   IV generation: cefepime (Maxi-pim).

Despite the presence modern antibiotics and chemotherapy drugs that allow you to quickly and effectively cope with infection and reduce the frequency of relapses by prescribing long period drugs in low prophylactic doses, treatment of recurrent UTIs is still quite challenging difficult task. This is due to:

• increased resistance of microorganisms, especially when repeated courses are used;
• side effects of drugs;
• the ability of antibiotics to cause immunosuppression of the body;
• decreased compliance due to long courses of taking the drug.

As is known, up to 30% of girls have a recurrent UTI within 1 year, 50% within 5 years. In boys under 1 year of age, relapses occur in 15-20%; in boys older than 1 year, there are fewer relapses.

Let us list the indications for antibiotic prophylaxis.

• Absolute:

  a) vesicoureteral reflux;

  B) early age; c) frequent exacerbations of pyelonephritis (three or more per year), regardless of the presence or absence of vesicoureteral reflux.

• Relative: frequent exacerbations of cystitis.

The duration of antibiotic prophylaxis is most often determined individually. The drug is discontinued in the absence of exacerbations during prophylaxis, but if an exacerbation occurs after discontinuation, a new course is required.

IN lately appeared on the domestic market new drug to prevent recurrent UTIs. This preparation is a lyophilized protein extract obtained by fractionating an alkaline hydrolyzate of certain strains E. coli and is called Uro-Vaxom. The tests carried out confirmed its high efficiency with the absence of pronounced side effects, which places hope on its widespread use.

An important place in the treatment of patients with UTI occupies dispensary observation, which is as follows.

• Monitor urine tests monthly.
• Functional tests for pyelonephritis annually (Zimnitsky test), creatinine level.
• Urine culture - according to indications.
• Measure blood pressure regularly.
• For vesicoureteral reflux - cystography and nephroscintigraphy once every 1-2 years.
• Sanitation of foci of infection, prevention of constipation, correction of intestinal dysbiosis, regular bladder emptying.

Literature

1. Strachunsky L. S. Urinary tract infections in outpatients // Proceedings of the international symposium. M., 1999. pp. 29-32.
2. Korovina N. A., Zakharova I. N., Strachunsky L. S. et al. Practical recommendations on antibacterial therapy of infections urinary system community-acquired origin in children // Clinical microbiology and antimicrobial chemotherapy, 2002. T. 4. No. 4. P. 337-346.
3. Lopatkin N. A., Derevyanko I. I. Antibacterial therapy program for acute cystitis and pyelonephritis in adults // Infections and antimicrobial therapy. 1999. T. 1. No. 2. P. 57-58.
4. Naber KG, Bergman B, Bishop MK, et al. European Association of Urology guidelines for the treatment of urinary tract infections and infections reproductive system in men // Clinical microbiology and antimicrobial chemotherapy. 2002. T. 4. No. 4. P. 347-63.
5. Pereverzev A. S., Rossikhin V. V., Adamenko A. N. Clinical effectiveness of nitrofurans in urological practice// Men's health. 2002. No. 3. pp. 1-3.
6. Goodman and Gilman's The Pharmacological Basis of Therapeutics, Eds. J. C. Hardman, L. E. Limbird., 10th ed., New York, London, Madrid, 2001.

S. N. Zorkin, Doctor of Medical Sciences, Professor
SCCD RAMS, Moscow

The risk of developing urinary tract infections in women depends on the age of the patient and the presence of concomitant diseases. In young and middle age, women get UTIs much more often than men, but then the likelihood of developing pathologies decreases.

The high frequency of such ailments as cystitis and pyelonephritis is explained by the structural features female body. It is not only the specific anatomy of the urethra that facilitates the penetration of microbes inside, but also a number of other factors, including hormonal disorders and increased adhesion (sticking) pathogenic bacteria to the cells of the mucous membrane of the urinary tract.

• Show all

  Reasons for development

  The causes of urinary tract infections in women are very diverse. Most often, these diseases are bacterial in nature. Normally, the kidneys produce urine, which can be called sterile - it contains salts, water and metabolic products. When pathogenic bacteria enter urethra, an inflammatory process called urethritis develops. Some bacteria move higher and enter bladder and provokes the occurrence of cystitis.

  The most common pathogens are:

  • staphylococci;
  • enterococci;
  • Klebsiella;
  • coli.

  If inflammation in this organ is asymptomatic in the early stages and does not receive adequate treatment, the infection continues to spread higher, and after some time the risk of infection of the kidneys, or more precisely their tubular system, increases. This disease is called pyelonephritis, and the entire process described above is called an ascending infection of the genitourinary system.

  Diseases of the urinary system occur in both children and adults, more often at a young age.

  In order for bacteria to enter the ureters and other organs, appropriate conditions are necessary. Factors that provoke the development of UTI include:

  • inflammatory processes in the vagina;
  • hormonal disorders, due to which dysbiosis of the intestines and vagina develops (typical for pregnant women, but can also occur during other periods of a woman’s life, in particular during postmenopause);
  • genetic predisposition to such diseases;
  • too much long-term use oral contraceptives;
  • hypothermia and the presence of lesions chronic infection in the body (tonsillitis, tonsillitis).

  Types of UTIs

  All types of ailments of this type can be divided into two groups - complicated and uncomplicated UTIs. The first are observed in the presence of factors contributing to ascending infection:

  • congenital anomalies of the genitourinary system;
  • surgical interventions;
  • the formation of stones that impede the normal flow of urine;
  • insufficient emptying of the bladder (often observed in pregnant women).

  Complicated UTIs require elimination of the cause, that is, treatment of the underlying disease.

  Uncomplicated infections occur in young women who have unprotected sex, as well as in patients who neglect hygiene rules. Sometimes such pathologies develop in patients diabetes mellitus.

  

  Main symptoms

  Although each type of disease has certain symptoms, there are common symptoms that apply to absolutely all UTIs. These include:

  • increased temperature due to the inflammatory process;
  • urinary disturbance;
  • increased sweating;
  • signs of general intoxication - weakness, dizziness, malaise;
  • pain in the affected organ, which can be sharp, dull, or bursting;
  • frequent urge to empty the bladder.

  Signs of a UTI are expressed with greater or lesser intensity depending on the severity of the disease in each individual patient.

  

  Cystitis and urethritis

  One of the most common infections urinary system is cystitis. About 25% of women experience this disease in an acute form, and every eighth of them suffers from a chronic form.

  Characteristic signs of acute cystitis are frequent urge to urinate (up to 50 times a day or even more), microhematuria, that is, the microscopic content of red blood cells in the urine. When the disease is advanced, it becomes cloudy. If the urine at the end of the process is stained with blood, this condition is called terminal macrohematuria. These manifestations are observed for 7-10 days, then the patient feels an improvement in her condition.

  Symptoms of cystitis are similar to urethritis. Moreover, in women, these diseases usually develop simultaneously and require the same therapy.

  Pyelonephritis

  Pyelonephritis is an inflammatory process in the kidneys, characterized by severe pain in the lumbar region. The acute form of the disease is dangerous due to the development of complications, which include carbuncle and kidney abscess.

  At purulent pyelonephritis Possible death.

  Diagnostics

  The patients' complaints and symptoms are nonspecific, so it is necessary to isolate the specific pathogen and determine in which organ the inflammatory process develops.

  Methods such as bacterioscopic examination of vaginal microflora and general urine analysis are used. In addition, the degrees of bacteriuria, proteinuria and leukocyturia need to be assessed. A urine test is performed according to Nechiporenko, an Amburger study, etc.

  Sometimes UTIs develop against the background of gonorrhea, herpesvirus or mycoplasma infection. In this case, the doctor resorts to another test - the so-called polymerase chain reaction (PCR). Based on the identified pathogen, the specialist makes a diagnosis and gives appropriate recommendations regarding drug treatment, diet, etc.

  Drug treatment

  Treatment of UTIs in women mainly requires the use of antibiotics, which affect both gram-positive and gram-negative microflora. In most cases, it can be done at home, but severe pyelonephritis requires hospitalization. Antibiotics for illness are administered intravenously.

  If an analysis of the sensitivity of pathogenic microbes to drugs cannot be done for some reason, treatment is carried out with broad-spectrum agents. Mostly medications from the cephalosporin group are used - ceftriaxone (it is prescribed even during pregnancy, but only if the potential benefit outweighs the possible harm), cephalexin, cefuroxime and others.

  
  

  Medications that may be prescribed include:

  • semisynthetic penicillins (ampicillin, oxacillin, amoxicillin, Augmentin);
  • macrolides latest generation(clarithromycin, roxithromycin, azithromycin);
  • fluoroquinolones (ofloxacin, ciprofloxacin, levofloxacin).
  
  

  Not all broad-spectrum drugs are suitable for treating UTIs. For example, gentamicin, polymyxin and streptomycin have nephrotoxic properties, so if the infection is combined with kidney disease, these tablets are contraindicated.

  IN modern conditions the frequency of resistance of pathogenic microflora to antibiotics is constantly increasing. If treatment with one formulation does not give the desired effect, another medicine is used. For example, there are strains of E. coli that are resistant to ampicillin. In such cases, nitrofurans (Furadonin, furazolidone) are prescribed. Positive result can give the drug nalidixic acid - nitroxoline.

  
  

  Phytolysin paste based on more than ten medicinal plants has proven itself positively. It has anti-inflammatory and antispasmodic properties. The drug is able to activate the process of dissolution of mineral salts, which helps prevent the formation of stones.

  Strengthening the body's natural immunity plays an important role. For this purpose, not only immunomodulators are prescribed, but also multivitamin complexes.

  Cystitis and pyelonephritis

  For cystitis, anti-inflammatory drugs are prescribed along with antibiotics, for example Cyston, which contains extracts of medicinal plants. It has diuretic properties, relieves inflammation in the urinary tract, and enhances the effect of antibiotic therapy. Designed for long-term use.

  For pyelonephritis, anti-inflammatory drugs are also prescribed plant origin- for example, Canephron, containing extracts of rose hips, lovage, rosemary and centaury. It has a mild diuretic effect and increases the effectiveness of antibiotic use.

  

  Traditional therapy

  It is also possible to treat UTIs with folk remedies. These include:

  1. 1. Cranberry juice. He has antiseptic properties, flushes the urinary tract, suppresses the proliferation of pathogenic microbes, and promotes the removal of toxic substances from the body. You should drink at least a glass of juice or cranberry juice a day.
  2. 2. Echinacea root infusion. It is brewed like tea (1 tablespoon per glass of boiling water) and drunk at least three cups per day.
  3. 3. Bearberry infusion. Also has antiseptic properties. The leaves of the plant are brewed in the standard way - 1 tbsp. l. per glass of boiling water. Take the medicine 1/3 cup three times a day in the acute period.
  4. 4. Nettle infusion. The product has a mild diuretic effect and helps eliminate bacteria along with urine. Prepare it once a day - 1 tsp. dry herbs are poured into a glass of boiling water, infused for 20-30 minutes, filtered and drunk after eating.

  Pharmacies sell milk thistle preparations, which contain ascorbic acid, tocopherol, retinol and B vitamins. They increase immunity and promote speedy recovery patient.

The genitourinary system is at high risk due to poor lifestyle choices and infectious diseases.

With age, these risks increase significantly, so the condition of the organs responsible for sexual and urinary function should be given more and more attention.

Since the organs in the system are connected, the deterioration of the condition of one leads to risks for the other, therefore, in order to avoid serious consequences, treatment of diseases of the genitourinary system should be as fast and high-quality as possible.

Infectious diseases are the most common pathology of the genitourinary system. Modern medicine There are many similar diseases, most often caused by bacteria or fungi.

Inflammations are often diagnosed with a delay, since they usually occur unnoticed by the patient, sometimes they can only be recognized by complications in other organs.

The structure of the male genitourinary system

Most often, inflammatory processes that begin in the genitourinary system can be found out by the following:

• external manifestations on the genitals;
• lack of erection.

Prostatitis

Of all the disorders of the genitourinary system greatest number cases account for, which, in essence, is an inflammation of the prostate gland caused by bacteria (most often chlamydia).

Diagnosis is complicated by hidden diseases that are common to many other diseases.

Symptoms:

• painful urination;
• weak;
• discomfort in the lower abdomen;
• slight pressure of urine.

Urethritis

The disease is characterized by an inflammatory process inside the urethra. It may not appear for a long time, and later make itself felt under, or another disease. Main source infection - unprotected sexual intercourse.

Symptoms:

• burning when urinating;
• pain and itching;
• discharge;
• There is pain and cramping in the lower abdomen.

If not treated in a timely manner, inflammation of other organs may occur.

Prostate adenoma

• frequent urination (sometimes with interruption of sleep);
• weak intermittent stream of urine;
• feeling of incomplete emptying of the bladder;
• inability to urinate without straining;
• urinary incontinence.

Cystitis

For complex therapy Ursulfan or is used. Of the herbal uroantiseptics, Phytolysin is also most often used. Antispasmodics are used to relieve pain:, etc.

Diuretics or Furosemide are used as diuretics. Multivitamin complexes Alvittil, Milgamma, Tetrafolevit are excellent for stimulating the immune system; in addition, medications containing selenium and.

Diet

Diets are most often prescribed for kidney diseases:

• diet number 6. Helps limit salt intake, increase the proportion of dairy products, liquids, vegetables and fruits in the diet;
• diet No. 7a. Allows you to remove metabolic products from the body, reduce blood pressure and swelling.
• diet No. 7b. Increases the amount of proteins compared to 7a.

Depending on the type of disease, there are many types of prescribed diets; they are prescribed only by the attending physician based on test results.

Physiotherapy

The main purpose of physiotherapy for urological diseases is to enhance drug treatment. It is also used to directly eliminate certain diseases or is used in cases where medications are contraindicated for the patient.

Main types of procedures used:

• EHF therapy;
• ultrasound treatment;
• electrophoresis;
• inductothermy.

Therapy with folk remedies

In parallel with drug treatment apply . Eliminates urinary tract infections coconut oil(used internally), asparagus and celery help relieve inflammation.

Coconut oil works great against infections

An infusion of boiled onions and basil is used as an antibacterial and diuretic. Garlic is beneficial for kidney diseases.

For maximum effectiveness, drugs folk remedies and physiotherapy are used in combination.

Prevention of inflammatory diseases

The main element in the prevention of diseases of the genitourinary system is hygiene, which includes both regular washing and protected sex.

Despite their simplicity, many people ignore these measures. The absence of hypothermia, which leads, for example, to cystitis, is guaranteed by correct clothing for the season. To help the body get rid of harmful bacteria, you need to drink 1.5 to 2.5 liters of fluid per day.

They will help normalize the functioning of the body. Proper nutrition, activity, and giving up bad habits will help significantly reduce your risk.

At proper prevention and paying attention to your health can greatly reduce the risk of developing urological diseases.

Video on the topic

About the principles of treatment of diseases of the genitourinary system in the video:

Pathologies of the genitourinary system pose a huge threat to the body, including death. But it is not difficult to prevent these diseases by following a series of simple recommendations. A timely visit to a doctor will help prevent complications and make treatment as simple, fast and painless as possible.

With infections that enter the body sexually (see about sexually transmitted infections), both the reproductive and urinary organs are simultaneously affected, since they are functionally connected. A course of antibiotics, which is necessarily prescribed in such cases, can be carried out both in a hospital and at home.

Features of antibacterial therapy

The main goal of antibiotic treatment is to destroy certain pathogens identified during diagnosis.

After such diagnostic studies, such as polymerase chain reaction, bacteriological culture, DNA and antigens to pathogenic bacteria are detected. During the examinations, the sensitivity of the pathogen to various antibacterial drugs is also recognized, which determines the course of treatment.

Antibiotic therapy makes sense for inflammatory processes characterized by urination disorders, purulent discharge, and redness of the genital mucous tissues. Their use helps relieve inflammation, pain syndrome and prevents further spread of infection to nearby organs and systems of the body. A noticeable and fairly rapid result of antibacterial therapy depends on the early treatment of the patient, when the disease is at the initial stage.

Types of antibiotics and their main properties

Antibacterial agents are substances that are used to slow down growth and reproduction pathogenic microorganisms, to destroy them. They can be organic, that is, produced on the basis of bacteria, but, at the same time, they are fatal to pathogenic viruses. Today there are also combined and synthetic drugs.

These medications are classified:

• by type of exposure and chemical composition;
• by spectrum of action (narrow and broad).

Bactericidal drugs cause disturbances in the vital activity of the pathogen, leading to its death. Bacteriostatic – slow down growth processes, reduce viability, stop the impact of pathogenic organisms on the body.

There are several main types of antibiotics:

Penicillins (a class of beta-lactam drugs)

Properties– pronounced bactericidal effect, consisting in suppression of synthesis cell wall microbe, leading to its death. Chemical composition This group is active against gram-positive and gram-negative bacteria - enterococci, spirochetes, nesseria, actinomycetes, and most corynebacteria.

Drugs– Penicillin, Benzylpenicillin, Phenoxymethylpenicillin, from the compositions broad action– Ampicillin, Hiconcil, Flemoxin Solutab. Long-acting agents – Extensillin, Bicillin, Retarpen. Of the semi-synthetics - Oxacillin, active against staphylococci.

In the treatment of genitourinary inflammatory processes, antipseudomonal penicillins are often used - Pipracil, Carbenicillin, Securopen.

Cephalosporins

Properties– antimicrobial drugs are considered less toxic substances, but are also destructive for pathogens. Active substances act directly on the DNA of bacteria and viruses.

Drugs I generation - Cephalexin, Cefazolin, effective against gram-positive bacteria. Cefuroxime axetil, Cefaclor, Cefuroxime and other stage II derivatives are almost never used, as they are inferior to later cephalosporins - Cefixime, Ceftibuten (tablet forms), Cefotaxime, Ceftazidime (parenteral drugs). Compositions of this series, including Cefepime, are used mainly in hospital settings for complicated infections.

Aminoglycosides

Properties– the peculiarity of the drugs is the effectiveness of suppressing the viability of gram-negative bacteria. However, pyogenic bacteria and enterococci are resistant to their active ingredients.

Drugs– Gentamicin, Amikacin, Tobramycin, Netilmicin, Streptomycin. Against the background of safer fluoroquinolones and new generation cephalosporins, these drugs have recently been almost never prescribed for urinary infections.

Tetracyclines

Properties– have a bacteriostatic, inhibitory effect on chlamydia, mycoplasma, gonococci, gram-positive cocci. Inhibits microbial protein synthesis.

Drugs, most often prescribed for genitourinary infectious diseases - Tetracycline, Doxycycline, Minocycline, Limecycline. These are broad-spectrum antibiotics that are effective against infections of various etiologies.

Fluoroquinolones

Properties – fluoroquinolones cause the death of pathogenic bacteria and viruses, since they suppress the DNA synthesis of the pathogen’s cellular protein. They behave actively towards gonococci, chlamydia, mycoplasmas, pyogenic bacteria - streptococci and staphylococci.

Drugs - Lomefloxacin, Ofloxacin, Ciprofloxacin, Norfloxacin, Enoxacin, Ofloxacin are used to treat gonorrhea, mycoplasmosis, infectious prostatitis, cystitis, chlamydia. Today, there are 4 generations of broad-spectrum fluoroquinolones that are effective for various types of infections of the genital and urinary organs.

Nitrofurans

Properties– have a pronounced bactericidal effect, spectrum of activity – Trichomonas, Giardia, gram-negative, gram-positive bacteria, streptococci.

Drugs– Nitrofurantoin, Furazolidone, Furazidin, Nifuroxazide. They are used most often for uncomplicated urogenital infections, among the requirements is a low dosage due to toxicity, and also due to side effects.

In addition to the main groups of antibiotics, medical practice are used macrolides. They are active against staphylococci, streptococci, legionella, chlamydia, mycoplasma. These medications are especially effective for non-gonococcal urethritis.

The main effect is bacteriostatic, although with increasing dosage a bactericidal effect can be achieved.

Some drugs are Clarithromycin, Erythromycin, Azithromycin, Roxithromycin. For genitourinary infections, Azithromycin is mainly used. It is significant that resistance of viruses and bacteria to these drugs develops very slowly.

Incorrect, uncontrolled use of antibiotics can lead to resistance of pathogenic agents to a particular drug.

How to choose antibacterial agents for the treatment of genitourinary tract infections?

Despite the differences in the structure of the urinary organs in men and women, the infection can affect the kidneys, bladder, urethral canal, and ureters. In parallel, foci of inflammation develop in neighboring organs. Various microbes entering the body in different ways, cause a number of diseases:

• cystitis - inflammation of the bladder;
• urethritis affects the urethra;
• pyelonephritis and others, characterized by changes in the tubular system, tissues of the cups and pelvis, glomerular apparatus of the paired organ.

Of course, for treatment, the doctor prescribes a medicine that causes minimal harm to the patient’s health, based on the individual characteristics of his body.

During antibacterial therapy at home, it is extremely important to regularly donate blood and urine for research. This allows you to monitor the results of treatment and, if necessary, adjust it by replacing drugs with more effective ones.

All these ailments require treatment a certain type antibiotics, which are selected taking into account the sensitivity of pathogenic bacteria to them:

• For cystitis– penicillins (Amosin, Cephalexin, Ecoclave), fluoroquinolones (Nolitsin, Levofloxacin, Norfloxacin, Tsiprolet), cephalosporins (Cefotaxime, Azaran, Zinnat). Of the tetracyclines, Unidox can be used. Acute cystitis is treated with antibacterial agents for 5 days, with chronic form a course of 7 to 10 days will be required.
• For urethritis– fluoroquinolones (Pefloxabol, Pefloxacin), used for no more than 10 days. Tetracyclines, mainly Doxycycline, up to 7 days. If the disease occurs in mild form, macrolides are used - Azithromycin, Hemomycin for up to 3 days. If well tolerated, penicillins are prescribed - Amoxiclav, Timentin for a course of up to 14 days.
• For pyelonephritis and other diseases of the renal system - cephalosporins (Ceforal Solutab, Claforan, Cephalexin), they are effective for purulent inflammation, used for 3-5 days. In case of damage to E. coli and enterococci - penicillins (Amoxicillin and Penicillin), no more than 12 days. For complications, fluoroquinolones - Levofloxacin, Moxifloxacin. At an advanced stage, Amikacin and Gentamicin are prescribed for a short time.

In addition to these diseases, men and women, against the background of infectious infection, can develop other ailments that are unique to the male and female body.

Antibiotic treatment of genitourinary infections in men

Male infectious diseases, like female ones, are treated according to a strictly established scheme.

The rules of antibiotic therapy are as follows:

• Identification of the culprit of infection and its sensitivity to antibacterial agents through hardware and laboratory diagnostics.
• Prescribing the most effective medication that is gentle in its toxicity.
• Choosing the form of the drug, its dosage, duration of treatment.
• If necessary, a combination of different means.
• Monitoring and monitoring the progress of treatment using tests.

In men, in addition to common diseases urinary organs, other pathologies unique to the male half may be observed. It is important to know what antibiotics and other drugs are used to eliminate the pathogenic environment for these diseases.

Vesiculitis

Seminal vesicle disease. For the treatment of vesiculitis the following are used:

• Antibiotics - Erythromycin, Macropen, Sumamed (macrolides), Metacycline and Doxycycline (tetracyclines).
• Anti-inflammatory drugs - Ketonal, Indomethacin.
• Antiseptics – Furamag, Furadonin.
• Antispasmodic and analgesic suppositories - Ibuprofen, Anestezol, Diclofenac.

The use of immunostimulating agents (Pyrogenal, Taktivin, ginseng tincture) is indicated. To improve blood circulation - Venoruton, Dartilin, Aescusan. In some cases, mud therapy, physiotherapeutic procedures, and sedative medications are prescribed to correct the condition of the nervous system.

Epididymitis

Disease of the epididymis caused by infection. Epididymitis is treated using the following medications:

• Antibiotics – Minocycline, Doxycycline, Levofloxacin.
• Antipyretics – Paracetamol, Aspirin.
• Anti-inflammatory medications – Ibuprofen or Diclofenac are usually prescribed.
• Painkillers – Ketoprofen, Drotaverine, Papaverine.

During the acute phase of the disease, cold compresses are recommended. During remission chronic stage– warm-up sessions. In severe conditions of the patient, hospitalization is recommended.

Balanoposthitis

Inflammation of the head and foreskin infectious nature. For balanoposthitis, antibiotics are selected depending on the type of pathogen. The main local antifungal agents are Clotrimazole, Micogal, Candide. Broad-spectrum antibacterial drugs can also be used, in particular Levomekol based on chloramphenicol and methyluracil. Anti-inflammatory drugs are prescribed: Lorinden, Locacorten.

Additionally appointed antihistamines, relieving swelling and eliminating allergic reactions.

Treatment of genitourinary infections in women

Among the purely women's diseases caused by infectious agents, we can distinguish 3 most frequent illnesses, which we will consider next.

Salpingo-oophoritis (adnexitis) – pathologies of the ovaries and appendages in women

Adnexitis can be triggered by chlamydia, trichomonas, gonococci and other microbes, so antibiotics of different groups can be prescribed - Tetracycline, Metronidazole, Co-trimoxazole. They are often combined with each other - Gentamicin with Cefotaxime, Tetracycline and Norsulfazole. Monotherapy, in fact, is not used. Administration can be by injection, but oral administration (orally) is also possible.

Besides antibacterial agents, antiseptics, absorbable and painkillers are used - Furadonin, Aspirin, Sulfadimezin. Vaginal and rectal suppositories with painkiller and antimicrobial effect– Macmiror, Polygynax, Hexicon, etc. In the chronic course of the disease, baths, compresses, and paraffin applications, which are carried out at home as prescribed by a doctor, are advisable.

Infectious and inflammatory diseases of the urinary tract include urethritis, cystitis, ureteritis and pyelitis. The occurrence of all these diseases is based on the penetration of pathogenic microorganisms and activation of opportunistic flora in the urinary tract. A urinary tract infection develops because the body's own immune system cannot cope with the invading bacteria.

Therefore, it is necessary to treat urinary tract infections with the mandatory use of antibacterial drugs.

The most common bacteria that affect the genitourinary tract are: Escherichia coli, chlamydia, Pseudomonas aeruginosa, mycoplasma and streptococcus.

90% of all infections are associated with E. coli entering the urethra. And pathogens such as chlamydia and mycoplasma, in addition to the urinary tract, also affect the genitals. Many sexually transmitted diseases are accompanied by inflammation of the urinary tract. In this case, therapy is based on eliminating the underlying disease.

What groups of antibiotics can cope with the disease?

The selection of antibiotics depends on the pathogen. In addition, many drugs have a toxic effect on kidney tissue. Therefore, they are not used in the treatment of urinary tract infections. Since it takes time to determine the pathogen and its sensitivity to antibiotics, the selection of the drug is based on the use of broad-spectrum antibiotics. After all, the sooner treatment begins, the easier it is to get rid of the disease.

Treatment of urinary tract infections is carried out with cephalosporins, macrolides, fluoroquinolones, sulfonamide, nitrofuran drugs and pipemidic acid:

• Cephalosporins (Ceftriaxone, Cefuroxime) are broad-spectrum antibacterial drugs that effectively destroy almost all groups of pathogenic bacteria in the urinary tract.
• Macrolides, in addition to their antimicrobial effect, have moderate anti-inflammatory and immunomodulatory effects. Their use is accompanied low risk development of side effects. However, these medications are not the first choice for urinary tract infections and should be prescribed by a doctor.
• Sulfonamide drugs also have high efficiency with bacterial inflammation. Due to the fact that some people use them unjustifiably for the slightest cold, bacteria develop resistance and the drug turns out to be ineffective. However, people who do not abuse self-medication quickly cope with the disease when using it. A contraindication to their use is renal failure.
• Nitrofuran drugs (Furazolidone, Furadonin) are often used in elderly people with chronic, indolent diseases of the urinary tract. A contraindication to their use is renal failure.
• Antibacterial drugs pipemidic acid are used in men with urinary tract infections associated with prostate adenoma. Such drugs include Palin, Pimidel and Urotractin.

Absolutely all medications have their own indications and contraindications. You should not select the drug yourself. Questions about how and how to treat pathology should be dealt with exclusively by the doctor. In addition, each person is shown different doses and course of admission. On average, antibiotics are prescribed for 10-14 days.

Early cancellation of this type of treatment or complete refusal to use antibiotics leads to the development of latent, chronic inflammation, which is more difficult to treat than an acute process.

Antibiotics are discontinued when the urine test shows no bacteria or signs of inflammation. Otherwise, if the antibiotic is removed, the remaining bacteria will develop sensitivity to the previously used drug. And then, during an exacerbation, you will have to prescribe a stronger drug that can cope with the infection.

The use of herbal uroseptics in the treatment of urinary tract infections

Auxiliary treatment for urinary tract infections is carried out using herbal uroseptics. These drugs are also indicated for prophylactic use in patients with chronic infectious and inflammatory diseases of the urinary system.

Herbal preparations disinfect urine, promote the removal of pathological agents from the urinary tract and improve the function of the urinary system.

Uroseptics on plant based Available in the form of tablets or drops. They are taken in long courses as prescribed by the attending physician. The most commonly used drugs are Canephron, Urolesin, Urolesan, Fitolysin.

Symptomatic therapy for urinary tract infections

Infection of the bladder, urethra, urinary canal and renal collecting system is manifested by the following symptoms:

• Discomfort and burning when urinating
• Frequent urination in small portions, up to the urge to appear every 10-15 minutes
• The appearance of pathological impurities in the urine (mucus, pus, blood)
• Increased frequency of nighttime urination
• Slight increase in temperature
• Pain in the lumbar and suprapubic region.

Symptomatic treatment of urinary tract infection is used to eliminate all of the above clinical manifestations. Depending on severe symptoms One or more of the following drugs are prescribed:

• Painkillers that are not nephrotoxic
• Diuretics to increase urine output and prevent fluid accumulation in the urinary tract
• Antispasmodics also have an analgesic effect and prevent urinary retention.

It should be noted that it is unsafe to take the medications described above without a doctor’s prescription. Because they exist various shapes diseases for which a particular drug is a contraindication. For example, with cervical cystitis, urinary retention is observed due to sphincter spasm. And the use of a diuretic will lead to even greater accumulation of fluid in the bladder and increased pain.

What medications are taken to boost immunity?

Normally, immune reactivity is provided by special cells - macrophages. In order to quickly get rid of a urinary tract infection and prevent recurrence, immune correction should be carried out.

Patients are prescribed multivitamin tablets. You can use a complex of vitamins and microelements. Moreover, you should not choose the most expensive drug - after all, expensive does not mean quality. Many domestic medicines have the same properties as expensive imported multivitamins.

In addition to vitamin therapy, immunomodulatory treatment can be used.

However, if vitamins do not harm anyone, then the prescription of an immunomodulatory drug should be taken more seriously and in no case should you take the drug without consulting a doctor.

Treatment of the disease using traditional methods

Non-medical treatment of the disease is carried out using various herbal baths, teas, juices, etc. The following methods can be noted, which, according to reviews, have good effectiveness:

• Cranberry juice can inhibit the growth of bacteria and prevent them from attaching to the walls of the urinary tract. It improves the excretion of pathogenic microorganisms in the urine. It is recommended to drink a glass of cranberry juice per day. It should be noted that many other juices, in particular citrus fruits, are contraindicated for genitourinary infections.
• Echinacea strengthens the immune system. By taking Echinacea tea, the patient simultaneously increases the amount of fluid entering the body. And for genitourinary diseases it is very important drinking plenty of fluids. You should drink 3 cups of Echinacea root tea per day.
• Milk thistle also has a number of beneficial effects. This plant is a storehouse of vitamins A, B, C, E, K and many others. The use of milk thistle increases the body’s immune reactivity and promotes quick recovery. And in case of chronic cystitis, the use of this plant helps prevent relapse of the pathology.
• Bearberry has an antiseptic effect, but is contraindicated for long-term use. It is recommended to use an extract from the leaves of this plant while symptoms of the disease are present. In addition, bearberry should not be taken at the same time as vitamin C, as there will be no effect from such treatment.
• To alkalize the environment in the bladder, urethra and ureters, it is recommended to drink a soda drink at the first signs of illness. To do this, dissolve a quarter teaspoon of baking soda in half a glass of water. Drink 2 glasses before drinking it ordinary water. Alkaline environment does not irritate the bladder, which helps reduce inflammation.

Treatments only folk ways will not bring the desired effect. It must be remembered that a genitourinary infection will go away without a trace only after using antibiotics.

The video talks about the benefits of cranberries:

How to prevent the transition of acute pathology to chronic

In order to get rid of it once and for all genitourinary infections The following recommendations should be followed:

• Strictly adhere to medical prescriptions and do not self-medicate
• Do not stop taking the drug yourself
• It is better to spend the acute period of illness in bed
• Maintain hygiene of the genitourinary organs
• Avoid sexual intercourse during treatment
• Follow a diet excluding extractive and irritating substances
• Drink enough liquid, preferably in the form of warm compotes
• Avoid alcohol, coffee and carbonated drinks
• Avoid hypothermia.

By following simple rules and strictly following the doctor’s instructions, the patient will safely get rid of the pathology and return to the usual rhythm of life.