Acute cystitis– a disease quite common in urology, which is one of the most frequent infections All in all. Because of physiological structure urinary system, acute inflammation occurs more often in women than in men.

The fact is that the urogenital canal in women is larger in diameter and smaller in length. It is these characteristics that create optimal conditions for the occurrence and development of infection in the bladder. In addition, the external exit of the canal is located next to the vagina and rectum, and these organs are often sources of various types of infections. Cases of detection of this problem in women exceed more than 5 times the number of tracking cases in men.

If the necessary measures are not taken in a timely manner, the acute form can easily turn into chronic!

Categories

The disease is divided into 2 categories:

• primary;
• secondary.

Primary is an independent disease that is more often observed in women. And the secondary form is a complication of other diseases, mostly in men. For example, this may be a consequence of an adenoma. Cystitis usually appears in people aged 20-40 years, because during this period the most active intimate life is observed.

Reasons

Doctors usually distinguish the following:

• improper care of body hygiene;

• peculiarities anatomical structure urinary system, which impede the correct outflow of fluid;
• diseases of structures and tissues that are located around urethra;
• impact chemicals and medications.

But, for the most part, acute cystitis becomes a consequence of the adverse effects of several factors at once.

An important factor may be decreased immunity and general hypothermia; microtraumas that, for example, occurred during sexual intercourse. But the predominant factor still remains infection, the causative agent of which can be a fungus, virus or bacteria.

Pathogen bacterial form Cystitis can be E. coli, staphylococcus, Proteus, or a combination of them. A urine test may reveal candida, fungal threads, and trichomonas in the vagina. Viral form often caused by adenoviruses, in this case the microbes penetrate the bladder with the bloodstream. It is observed in children and adult men.

Mucous membrane genitourinary system has good local protection, due to which a small number of microbes can be contained in the organ, but not develop cystitis. Weakening of the local immunity of an organ occurs due to stress, hypothermia, various pathological processes and postoperative period. In such conditions harmful microbes can actively grow, which leads to inflammation.

Another type is radiation cystitis, which can appear as a result of radiation therapy for the treatment of oncology.

Symptoms

With this disease, the following symptoms and their standard combination are observed: problems with urination, urine discharge with blood or pus. It is not necessary to have three symptoms at once; a doctor can suspect the likelihood of cystitis even if there are signs of inflammation in the patient’s urine tests.

One of the main dysuric symptoms is a frequent urge to urinate at intervals of 5-20 minutes, also at night. The volume of urine during one trip to the toilet may be small, because urine does not always have time to accumulate in the bladder. All this can be accompanied by imperative urges, which lead to urinary incontinence.

In acute cystitis, when fluid passes through the urethra, the patient feels a burning sensation, painful sensations and itching. This is especially pronounced at the end of the urination process. Symptoms also include pain in the genital area and lower abdomen.

Diagnostics

Acute cystitis is diagnosed as follows— a specialist studies the patient’s medical history and then conducts comprehensive study. It includes:

• urine and blood tests;
• carrying out urography, ultrasound examination in the pelvic area;
• excretory cystography;
• performing cystoscopy.

After studying the results of all tests and studies, the doctor determines the appropriate treatment option for a particular patient.

Treatment

Treatment of the described disease is not particularly different for women and men. It depends on the causes, symptoms, clinical picture and other factors.

A special diet is where you need to start. With proper nutrition, the human body receives vitamins, nutritional supplements and minerals that help restore damaged tissue. The diet must be followed mandatory, if you are suffering from diseases or metabolic disorders accompanying acute cystitis.

In any form, the patient must be provided with plenty of fluids; he must drink at least 2 liters of water per day. This helps rid the bladder of harmful substances by flushing it out. For this purpose, it is strictly prohibited to use sweetened soda, drinks and alcohol. It is allowed to drink water, tea, vegetable, berry or fruit juices. Lingonberry juice is very useful, since lingonberry is a natural uroseptic that rids the urinary canals of dangerous bacteria.

Plant foods. Fruits and vegetables alkalinize urine, changing the acidic environment favorable to bacteria. Salty, spicy and smoked foods should be removed from the patient’s menu, because they can increase urinary concentration and irritate the mucous membrane.

First aid

When you have acute cystitis, first aid is provided when an attack occurs sharp pain in the lower abdomen. To reduce pain, you need to take a painkiller. They also take analgesics of the antispasmodic category, since pain occurs due to spasms of the muscles of the genitourinary system.

Drugs such as No-shpa, Atropine, and Papaverine will help alleviate an attack of the acute form of the disease. But before taking them, be sure to study the recommendations and contraindications. Antibiotics should only be taken as prescribed by a specialized doctor.

Acute hemorrhagic cystitis is treated exclusively under medical supervision, on an inpatient basis. This form of the disease often causes severe complications. At the same time, without the intervention of doctors, it is very difficult for the patient to relieve himself. During treatment, antibiotics and anti-inflammatory drugs are prescribed.

Prevention

To prevent the occurrence of such an unpleasant disease, it is enough to follow a few recommendations below:

1. take responsibility for the rules of personal hygiene, keep your body clean and well-groomed;
2. dress according to weather conditions, do not allow your body to become hypothermic;
3. do not allow long delays in urination, try to empty the bladder as quickly as possible after the corresponding urge appears;
4. if you experience diseases or problems that concern you in the field of gynecology and urology, contact specialists in a timely manner and complete the prescribed treatment;
5. You should not self-medicate, or use drugs in treatment that were not prescribed by a doctor.

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Cystitis is one of the most common inflammatory pathologies affecting the functioning of the mucous membrane bladder. More often discomfort occur in women.

Features of the course of acute cystitis

Acute cystitis in the vast majority of cases is of an infectious nature, so the cause of inflammation is microorganisms that penetrate into the bladder through the urethra. Treatment in women is aimed primarily at eliminating opportunistic inflammatory agents and the consequences of their vital activity, since in some cases the disease is accompanied by unpleasant complications.

Activation of microorganisms that provoke inflammation occurs under the condition of one of the following factors:

• mechanical injury to the organs of the genitourinary system, creating favorable environment for the development of infection;
• hypothermia;
• reduced immunity;
• wearing tight underwear for a long time.

To properly treat acute cystitis in women, it is important to comprehensive diagnostics, during which a specific pathogen will be identified. The following options are possible.

1. Escherichia coli.
2. Staphylococcus saprophytic.
3. Various fungi.
4. Trichomonas.
5. Mycoplasma.
6. Viruses.
7. Chlamydia.

Treatment of cystitis in women is carried out based on what form of the disease is diagnosed in a particular case, since in addition to acute course inflammation, a recurrent variant can be observed, that is, a chronic form of the pathology.

If there is an exacerbation of cystitis or the disease occurs primarily, symptoms appear following symptoms:

• sudden deterioration of the condition a couple of hours after exposure to the provoking factor;
• frequent urge to urinate, which is accompanied by severe cutting pain, especially at the end of the process;
• pain in the bladder itself;
• appearance bloody discharge in the last portion of urine;
• the appearance of purulent contents in the urine;
• feeling of heaviness in the lower abdomen;
• urine becomes cloudy (due to the presence of exfoliated epithelium of the irritated mucosa, leukocytes, erythrocytes and bacteria themselves).

When diagnosing “acute cystitis,” it is important to select medications as soon as possible that will provide effective treatment and restoration of women’s health. Exacerbation of the process can provoke the following complications:

• increased pain that does not go away even after emptying the bladder;
• almost constant feeling of fullness of the bladder;
• inability to touch the abdomen in the area where inflammation develops;
• false urinary incontinence with urination before visiting the toilet (as a rule, such complications are typical for adolescents);
• the development of pyelonephritis, one of the first signs of which is an increase in temperature. With this variant of the course of the disease, it is necessary to additionally treat the inflamed kidneys.

How is therapy chosen?

It is advisable to treat acute cystitis under the supervision of a specialist who will conduct a comprehensive preliminary diagnosis in order to eliminate possible misunderstandings with the diagnosis. The necessary drugs are selected based on the results of macro- and microscopic examination of urine, bacteriological analysis, and cystoscopy. Also, treatment of cystitis in women is based on the results of ultrasound examination of the bladder, kidneys, reproductive system organs, and DNA diagnostics, the purpose of which is to identify infections present in the body.

Possible complications can be determined and treatment can be adjusted based on the results of a blood test (increased leukocytosis is significant) and a urine test (the doctor evaluates the presence of protein and an increased number of epithelial cells).

Considering that acute cystitis in women can occur against the background inflammatory process in the genitals (for research, not only urine is taken, but also the microflora of the vagina), it may be necessary to additionally treat inflammation of the appendages or other organs of the reproductive system.

Therapy for acute cystitis

Effective treatment of cystitis during an exacerbation implies mandatory compliance with bed rest, change usual diet and, of course, the reception medicines. The main drugs are antibiotics and agents that promote general strengthening body.

Antibacterial treatment

To effectively eliminate acute cystitis, use various groups antibiotics.

• Fluoroquinolones. These include drugs such as Avelox, Tsiprobay, Tavanik. Good effect Ciprofloxacin, Norfloxacin and Pefloxacin are given if they are taken simultaneously with antispasmodics that help relax smooth muscles.
• Cephalosporins are the drugs Clafaran and Rocephin.
• Fosfomycin-based Monural. Its purpose is to treat the bladder directly with the development of cystitis. You can immediately note a significant advantage this drug: Most microbes are not resistant to antibiotics.

Antibiotics are prescribed in a course to exclude possible complications. As a rule, when choosing drugs and the duration of their use, doctors proceed from the preservation clinical symptoms. To consolidate the result, it is important to continue treatment for at least three days from the moment the condition improves. After the specified period, a control urine test is performed. In most cases, an exacerbation of cystitis must be treated for a maximum of a week.

Drinking regime

To enhance therapeutic effect When treating cystitis in women, in addition to antibiotics, special diuretics may be prescribed. It is also important to adhere to increased drinking regime. In case of cystitis, it is necessary to do a kind of “washing” of the bladder, ensuring minimal daily norm drink liquid in an amount of at least two liters. This can be not only ordinary drinking water, but also fruit drinks made from cranberries or lingonberries that effectively relieve inflammation and eliminate infection.

Treatment of acute cystitis is preferably carried out with a complete abstinence from carbonated drinks, coffee, black tea and alcohol, which contribute to increased irritation of the bladder and aggravation of the condition, adding to the unpleasant symptoms sensation strong burning sensation. Helps reduce pain soda solution, which you can make yourself by dissolving in half a glass of warm boiled water a teaspoon of soda. You need to take this medicine every hour. As a result, the acidity of urine decreases, which cannot be achieved by the drugs indicated for cystitis.

Thermal treatments

Not only medications, but also heat can help effectively treat acute cystitis in women. Procedures can be carried out using plastic bottle or a heating pad filled warm water. A container with warming liquid is placed on the lower abdomen or placed between the legs.

Thermal treatment can also be carried out through sitz baths with infusion of chamomile, St. John's wort or oak bark. Take two tablespoons of herbs and pour half a liter of boiling water. After 20 minutes of infusion in a water bath, the broth is poured into a basin with warm water (the final temperature should not exceed 37.5 degrees) and warmed up.

Therapeutic diet

In addition to all the above measures, inflammation in acute cystitis must be treated with a diet based on dairy and plant food. During the treatment period, spices, spicy and salty foods, canned food, and marinades are completely excluded from the diet. In the daily menu, in addition to dairy and fermented milk products, fresh vegetables and fruits must be present, which will ensure that they enter the body essential vitamins. If you follow such a gentle diet, the drugs will act as effectively as possible.

If cystitis occurs without development serious complications, compliance with all the described therapeutic measures helps to maximize short terms eliminate inflammation and normalize the condition. The most dangerous course of the disease occurs if there is gangrenous form cystitis in women. In such a situation one cannot do without surgery(cystostomy).

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Cystitis is a consequence of the development of an inflammatory process in the bladder. If it manifests itself in acute form, it is impossible to ignore the symptoms without attention. Can the medical history of “acute cystitis” be the same for all patients with a similar diagnosis? What similar features of lifestyle and disease development do doctors observe in such patients?

Symptoms

The main thing that distinguishes this form of the disease is the imposition large quantity symptoms at the same time. All signs do not appear incrementally, but arise almost spontaneously, out of nowhere, at once. This is very frightening for patients experiencing the disease for the first time. So, what symptoms may appear:

1. Increased body temperature. Its values ​​can reach up to 38 and even 40 degrees. At the same time, the patient feels general weakness, chills, increased sweating. An increase in temperature during acute cystitis indicates a significant degree of intoxication of the body.
2. Frequent urination with acute cutting pains. If the frequency of urination itself occurs in many people, including after heavy salty food, then here the degree of the symptom is much higher. It is simply impossible not to suspect the infectious nature of such a condition.
3. The urine becomes cloudy, dark, and may contain droplets of blood. Typically, this symptom is noted by women, since blood particles remain on the toilet paper. A decrease in urine clarity occurs due to an increase in the level of white blood cells and epithelial cells.

Why does acute cystitis appear?

If this is inflammation, then the cause must be infection with bacteria, viruses or fungi of the genitourinary organs. But in the case of acute cystitis, there must be a combination of several provoking factors that significantly contribute to the development of the disease:

1. Working for long periods of time in a sitting position.
2. Improper genital hygiene, we're talking about even about a one-time violation of standards.
3. Eating hot, spicy, smoked foods or alcoholic drinks, as well as a combination of these products. That is why acute cystitis is very often recorded in patients after holidays, corporate events or friendly gatherings.
4. Severe hypothermia of the body.
5. Injury to the urethra and bladder. The patient needs to remember if he has recently fallen or hit his genitourinary organs.
6. Prolonged failure to go to the toilet to urinate. Thus, the diagnosis of acute cystitis can be made after a trip where the patient was not able to urinate normally when the bladder was full. In this case, the ureter expands, and bacteria easily rise up the genitourinary system.
7. Constipation. When the body is unable to perform a bowel movement, a huge mass of bacteria accumulates in the large intestine. Thin mucosa is not always able to protect organs in the immediate vicinity, and acute cystitis is the result of such a disruption in the functioning of the digestive tract.
8. Immunodeficiency conditions of the body, as well as other diseases of the patient. Any disease takes away part of the body’s own potential, and the body is no longer able to fight all illnesses at once. Even fungus on the nail undermines the immune system and can cause acute cystitis in the patient.

Diagnosis of acute cystitis: how to do it correctly

In case of acute pain in the lower abdomen, the patient should immediately call ambulance. You can see a therapist in a hospital only if there is no queue to see a doctor and the patient does not have a fever. In all other cases, heroism can turn out badly! Ideally, it is better to immediately go to see a urologist, but the medical histories of patients with acute cystitis usually describe a long walk from the general practitioner to other specialists - a gynecologist, a gastroenterologist.

What should the doctor do? First, fill out the patient’s medical history, namely, collect complaints, clarify the place of work and practiced lifestyle, the presence bad habits and other pathologies. This is necessary to compile a general clinical picture. Most likely, the patient will be a fan of sitting in front of a monitor or TV screen, undemanding in choosing the quality of food and body hygiene products, and also a rare visitor to hospital facilities, even when unpleasant symptoms and malaise appear.

Secondly, the doctor will examine the patient’s genitourinary organs. Now you can see swelling, redness, and local hyperemia. Thirdly, a qualified specialist will refer such a patient to undergo rapid urine tests - general, bacterial culture and the Nechiporenko method. Express tests are necessary to quickly determine the reasons, because in the couple of days that the result is usually prepared, the patient’s condition may worsen. Unfortunately, not every clinic has such capabilities, but when a patient is admitted by ambulance, such quick results of the patient’s condition are considered standard.

It is advisable to do ultrasound diagnostics genitourinary organs in order to understand their structure, see changes in the condition of the tissue and the size of the organs.

How is acute cystitis treated?

In the vast majority of cases, patients are immediately sent to hospital for treatment. The elevated temperature and increased symptoms of the disease do not allow him to take care of himself on his own. The main treatment is taking antibacterial and anti-inflammatory drugs. In the first days of a patient’s admission, they try to administer medications intravenously in order to speed up the process of the active components entering the blood and to prevent them from harming the stomach of patients who experience a decrease in appetite during this period.

Droppers with saline solution will help remove toxins from the body, but it is intoxication that causes a strong increase in temperature. Gradually the patient's condition improves. After 7-9 days of the patient’s stay in the hospital, he may be asked to continue treatment on an outpatient basis, under the supervision of the attending urologist.

After completing the main course of treatment, the doctor can close the sick leave. The patient coped with acute cystitis, but talk about full recovery forever is too early. After some time, it is necessary to take tests again and check the condition of the genitourinary organs in order to avoid the progression of the disease to chronic stage. If the results show the absence of bacteria, the medical history for the patient with acute cystitis can be considered closed.

Introduction………………………………………………………………………………..3
1. Causes of cystitis………………………………………………………...4
2. Etiology and pathogenesis……………………………………………………………..5
3. Symptoms and course…………………………………………………….7
4. Diagnostics……………………………………………………………...8
5. Treatment………………………………………………………………………………......9
6. Nursing process for cystitis……………………………………..11
Conclusion………………………………………………………………………………….14
Literature………………………………………………………………………………..15

Introduction
To infections urinary tract(UTI) are a group of diseases united by localization within the same anatomical and physiological system and characterized by a common feature - the presence of bacteria in the urine. Currently, UTIs are divided into complicated and uncomplicated. This is due to differences in their etiology, pathogenesis and different approaches to treatment, which is very important from a practical point of view. Uncomplicated UTI occurs in the absence of structural changes in the kidneys and urinary tract, as well as in patients without serious concomitant diseases.
Cystitis is an inflammation of the mucous membrane of the bladder caused by the penetration of infection into it. About 20-25 percent of women experience cystitis in one form or another, and 10 percent suffer from chronic cystitis, and these numbers are steadily growing every year. Men suffer from this disease much less frequently. The incidence of acute cystitis in adult men is 6-8 cases annually per 10 thousand men aged 21-50 years. About 30% of women have an episode of dysuria every year. The initial visit to a urologist in 47-60% of cases is associated with manifestations of acute or chronic cystitis.
UTIs are among the most common diseases in both outpatient and in-hospital practice. The most common presentation of uncomplicated UTI is acute cystitis (AC).
Primary cystitis occurs in an intact bladder, without any previous changes in it. It develops as independent disease. Secondary cystitis is a complication of other bladder diseases.

1. Causes of cystitis
Most often, the development of cystitis is preceded by the following circumstances: decreased immunity (hypovitaminosis, overwork)
hypothermia of the body; Hypothermia causes a decrease in the body's resistance, especially the local immune response, as a result of which the infection actively multiplies and enters the bladder, causing inflammatory reaction.
previous gynecological, urological or venereal diseases inflammatory diseases;
frequent and long-term constipation;
irregular urination (less than 5 times a day);
regular prolonged sitting in one place (more than 4 hours) during the working day; circulatory disorders in the wall of the bladder and pelvis,
constant lack of sleep, overwork, poor nutrition, stress;
abuse of hot, spicy and fried foods;
poor sexual hygiene (vaginal sex
after anal);
frequent wearing tight and dense clothing, shapewear.
The occurrence of cystitis is promoted by: pregnancy, childbirth, inflammation of the genital organs, the use of substances that irritate the mucous membrane of the bladder (hexamethylenetetramine - methenamine), irradiation of the bladder during radiation therapy for pelvic tumors.
Sometimes exacerbations of cystitis are associated with menstrual cycle.
The occurrence of cystitis in men can be caused by prostatitis (acute and chronic), the structure of the urethra, adenoma, stone or cancer prostate gland and other diseases of the genital organs. The cause of chronic cystitis in both men and women can be stones, tumors, leukoplakia and tuberculosis of the bladder, but such “chronic cystitis” is secondary, it is based on another disease of the bladder, which must be promptly recognized by a doctor.

2. Etiology and pathogenesis
Anatomically, women are more susceptible to this disease than men, since their urethra is shorter and wider, and is located close to the anus - the source of E. coli and other bacteria, so the microbial infection reaches the bladder faster. The mucous membrane of the bladder is most often affected. The result is an inflammatory process, also known as cystitis.
Another reason is considered hormonal. In men throughout life hormonal background more stable and only changes with age. And in women, due to the menstrual cycle, it fluctuates all the time.
Rarely there are toxic, allergic, non-infectious cystitis. In the vast majority of cases, cystitis is caused by one or another infection. Most often this is one of the representatives of opportunistic flora - E. coli, staphylococci, streptococci, etc. Often there are cystitis directly associated with sexually transmitted infections, for example, ureaplasma, mycoplasma, chlamydia, gonorrhea.
Etiological factors occurrence of acute cystitis are E.coli (from 70 to 95%), Staphylococcus saprophyticus (from 5 to 20%), Proteus mirabilis., Klebsiella spp.
Typically, the development of cystitis is associated with an infection in the vagina. Normally, a woman’s vagina is inhabited by microflora. It is based on the so-called lactobacilli, or Dederlein bacilli; there are also a small number of bifidobacteria and some other microorganisms. All these microbes are in ecological balance, their numbers are strictly controlled by each other, and they do not allow any other microorganism to appear in the vagina.
Under the influence of various factors, this balance may be disrupted. These factors range from stress and hypothermia to hormonal changes, pregnancy or withdrawal. oral contraceptives. An imbalance occurs when a colony of some microorganisms grows in large quantities and suppresses all others.
Some women show a correlation between sexual activity and the appearance of symptoms of acute cystitis within 24-48 hours after sexual intercourse.
According to the forms of clinical manifestations, it is necessary to distinguish between primary uncomplicated and recurrent cystitis.
Approximately 80-90% of recurrent cystitis is more likely to be a reinfection with the microflora of the perineal area than a relapse.
Acute cystitis usually represents serious inconvenience for the patient due to the unexpected onset, rapid course of the disease and social maladjustment due to dysuric phenomena.
In the etiology of cystitis in children, an important role is played by abnormalities in the development of the urethra, its narrowing, valves, etc. Hematogenous penetration of the infection into the bladder is also possible.

3. Symptoms and course
Inflammation of the bladder can develop suddenly, but most often the symptoms of cystitis increase gradually.
It manifests itself as a feeling of discomfort, a burning sensation and itching in the urethra and perineum during urination.
A feeling of discomfort and pain above the pubis or in the perineal area may remain after urination. Urination becomes frequent, painful, and the amount of urine with each urination decreases.
In this case, there may be a urge to urinate even with a small amount of fluid in the bladder, and after that there is still a feeling of its fullness.
At the end of urination, the urine is sometimes stained with blood.
The following symptoms of cystitis may also be present: bad smell urine; difficulty urinating; cloudy urine, change in color; purulent discharge; general nervous state; The urge to urinate may be imperative, and urinary incontinence is sometimes observed.
Pain appears in the lower abdomen, the back or sides ache. The more pronounced the inflammatory process in the bladder, the more frequent the urge to urinate and the more intense the pain. In severe forms of acute cystitis, patients are forced to urinate every 15-20 minutes. day and night.
In most cases with acute cystitis, the body temperature remains normal, rarely subfebrile. An increase in temperature during cystitis indicates that the infection has spread beyond the bladder, most often to the upper urinary tract.
Palpation and percussion in the suprapubic region with cystitis is sometimes accompanied by pain.
Urine in acute cystitis contains many leukocytes and red blood cells, which causes the presence of small amounts of protein in it.
4. Diagnostics
It is usually not difficult to diagnose cystitis - specific symptoms, abnormalities in urine tests, abundant growth of bacteria in the urine, signs of inflammation during ultrasound, cystoscopy, biopsy. But from everything said earlier, it follows that to diagnose cystitis, it is necessary to examine the condition of the woman’s genital organs.
Therefore, a routine examination of a woman with cystitis should include:
1. Examination by a gynecologist
2. General analysis urine
3. Urinalysis according to Nechiporenko
4. Bacteriological urine culture to identify opportunistic pathogens
5. DNA (PCR) diagnosis of major infections
6. Study of vaginal microflora for dysbacteriosis
7. Ultrasound of the genitourinary organs (allows us to exclude concomitant diseases)
8. Cystoscopy, biopsy (if indicated)
Bacteriuria is always detected in infectious cystitis. As with other forms of urinary tract infection, with cystitis it is important to determine the degree of bacteriuria. The detection of more than 100,000 microbial bodies in 1 ml of urine indicates an acute process. A laboratory examination of urine reveals a significant increase in the number of leukocytes per 1 ml. False proteinuria is also diagnosed.
With cystitis, only moderate leukocytosis and increased ESR are detected in the blood.

5. Treatment
In acute cases - bed rest, thermal procedures, antibiotics, uroantiseptics, UHF.
For chronic cases - treatment of pyelonephritis, courses of instillation of the bladder with protargol solution.
The main task of treating cystitis is to restore the natural protective antibacterial mechanisms of the urinary system.
The main areas of treatment are:
antibacterial therapy,
general and local anti-inflammatory therapy,
elimination of urodynamic disorders of the lower urinary tract.
The problem when choosing an antibacterial drug remains the prevalence of uropathogenic strains of Escherichia coli, the main causative agent of acute cystitis, resistant to previously used ones. First of all, we are talking about well-known antibacterial drugs - ampicillin, trimethoprim, nitroxoline.
The basis of treatment is antibacterial drugs; they should be prescribed without waiting for the results of urine culture and determination of microflora for sensitivity. Wide spectrum actions and high efficiency has Bactrim (Biseptol), which for cystitis can be prescribed 2 tablets 2 times a day. After obtaining data from a study of urine microflora and its sensitivity, the drug can be replaced. For the treatment of cystitis, Nevigramon 0.5 g 4 times a day, furadonin 0.1 g 4 times a day, furagin 0.1 g 3 times a day are used.
Treatment lasts 5-10 days. If the disease lasts longer and bacteriuria is detected (more than 100,000 microbial bodies in 1 ml of urine), antibiotics should be prescribed. It is most advisable in these cases to use ampicillin 500 mg 4 times a day.
An antibacterial drug used in the treatment of AC must at least correspond to the spectrum of antimicrobial activity against pathogens of acute cystitis; be characterized by pharmacokinetics that allow high concentrations in the urine when taking the drug 1-2 times a day; have high profile security.
Currently, a comparative evaluation of various antibiotic treatment regimens is being carried out, in particular single-dose, short-course and long-term treatment. A number of studies have shown that the effectiveness of treatment with a single dose of AC is comparable to the effectiveness of therapy over several days.
The advantages of this therapy are low frequency unwanted side effects, high guarantee of treatment, reduction of its cost, reduction of the risk of selection of resistant strains.
However, there are contraindications to short-course treatment of acute cystitis, which include: pregnancy, women over 65 years of age, acute cystitis in men, relapse of infection, diabetes mellitus, the duration of cystitis symptoms persisting for more than 7 days.
Patients with frequently recurring cystitis (more than two exacerbations in 6 months or more than three exacerbations in a year) should be offered preventive therapy.
Patients with rare exacerbations of AC, who are unable to see a doctor, can resort to self-administration of an antibacterial drug when clinical symptoms appear. After completing such treatment, it is advisable to bacteriological examination urine to confirm elimination of the pathogen.

6. Nursing process for cystitis
The nurse should know the main complaints and symptoms of diseases of the genitourinary system.
She should listen carefully to the patient and pay attention to the presence of pain in the lumbar region, change in urine color, urination disorder.
The nurse should have an understanding of instrumental and laboratory methods research. Her responsibilities include preparing patients for various types examinations, she must explain the rules for collecting urine according to Nechiporenko, preparing for an ultrasound.
The nurse must know the specific problems faced by patients with cystitis. They may be in a state of depression due to loss of independence in carrying out daily activities, irritability.
Nursing intervention in such cases it should be very delicate, you need to encourage the patient, teach him the self-care techniques that he is able to perform.
It is necessary to correctly carry out manipulations aimed at preventing the development of infection.
The nurse must promptly and correctly perform toileting in the perineal area, teach the patient the correct washing technique, and remind the patient of the need to drink enough liquid.
Psychological problems problems associated with physiological functions can be resolved by providing the patient with privacy during urination.
Nursing care will be much more effective if the patient has the opportunity to openly discuss his problems with the nurse. The nurse should familiarize the patient with the principles of diet therapy, methods of prevention, and explain what to watch out for, for example, hypothermia.
A patient with acute cystitis should remain calm, stay warm, and bed rest is advisable. Heating pad on the suprapubic area, sedentary warm baths reduce pain.
Diet with low content acids Food should be free of hot seasonings, marinades, and preservatives. With plenty of fluid intake.
Drink as much liquid as possible, at least 2 liters per day, but not tea, coffee, beer or soda, it’s best clean water, mineral water without gas, non-concentrated juices, fruit drinks, decoctions of medicinal herbs - (pour two tablespoons of hop cones with half a liter of boiling water, leave for 2 hours, strain and take half a glass 4 times a day before meals.
Bearberry leaves - 40 g, greater celandine grass - 10 g, garden parsley seeds - 10 g. Prepare and use as in the previous recipe.)
It is recommended to drink tea with milk. Diuretics should not be used, as this significantly reduces the concentration antibacterial drugs in urine.
Besides, local treatment- bladder lavage disinfectant solutions, introducing anti-inflammatory drugs into it.

Problem What the nurse does
Potential threat
health related
lack of information about
disease Conduct a conversation with the patient about his disease,
warning possible complications and prevention of exacerbations
Difficulty in acceptance
diet changes
in connection with the current
habits Have a conversation with the patient about the influence dietary nutrition on the course of the disease. Encourage the patient to follow the diet. Monitor transfers to relatives
Frequent urge to
urination,
need to visit
toilet at night
Provide the patient with a urinal bag and a bedpan.

Development risk
complications Promptly and correctly perform toileting in the perineal area.
Teach the patient or his relatives the correct washing technique (front to back), especially women.
Provide the patient with sufficient time to urinate.
Remind the patient to drink enough fluids.
Limited mobility
out of necessity
compliance with bedtime
mode. Self-care deficits and dependence due to limited mobility Perform daily hygienic care

Conclusion
In autumn, the number of patients increases, and this is due to the immune system, which weakens at this time of year, and breakdowns occur.
Kidney function in this disease, even in the case of a long course and multiple exacerbations during the year, remains unchanged.
However, with recurrent cystitis, therapy is necessary to quickly relieve the symptoms of acute cystitis, reduce morbidity and prevent exacerbations.
Acute primary cystitis is mainly a purely female disease. Its occurrence is associated with hypothermia, previous infection, instrumental examination, neglect of personal hygiene rules.
One of the predisposing factors for the development of cystitis is diabetes mellitus. The development of cystitis is also possible due to allergic reaction body.
Treating cystitis on your own is dangerous to your health.
Cystitis is the cause of urological, gynecological or sexually transmitted diseases (thrush, urethritis, gonorrhea, chlamydia, candidiasis, gardnerellosis, ureaplasmosis, trichomoniasis, mycoplasmosis, adnexitis, endometritis, etc.).
Treatment of cystitis will be much more difficult if it develops into hidden form, then, accordingly, the underlying disease will become chronic.
Cystitis will certainly resume as soon as a provoking factor appears, but then it will be much more difficult to cure it. Cystitis cannot be cured only with the help of folk remedies, which will only lengthen the treatment time.

Literature

1. Davlitsarova K.E. Fundamentals of nursing. First medical aid: Textbook. - M.: Forum: Infa - M, 2004 - 386 p.
2. Guide to nephrology: Trans. from English/Ed. J. A. Whitworth, M.:
Medicine, 2000 – 290 p.
3. Guide to urology in 3 volumes./ Ed. N. A. Lopatkina.
M.: Medicine, 2003- 683 p.
4. Doctor's Directory general practice. In 2 volumes. / Ed. Vorobyova N.S. –M.: Eksmo Publishing House, 2005.- 947 p.
5. Smoleva E.V. Nursing in therapy. – Rostov n/d: Phoenix, 2007 – M.: Eksmo Publishing House, 2007-308 p.

Cystitis is especially dangerous during gestation due to the risk of infection spreading through the placenta.

Acute cystitis is an inflammation of the mucous epithelium inside the bladder with a rapid spontaneous course and a gradual increase in pathological symptoms. Diagnosis of the disease is usually not difficult; women and men independently determine the unpleasant symptoms.

The duration of treatment takes 10-14 days, depending on the nature of the inflammation, but after 3-4 days the intensity of symptoms decreases significantly.

Predisposing factors

The main factor in the inflammatory process is infection with E. coli and other bacteria: coccus bacilli, Proteus, Klebsiella. Cystitis can be caused by a fungal infection of the genital organs. Pathogenic media penetrate into the bladder through descending (from the renal structures) and ascending routes (for example, the urethra, perianal space).

Acute cystitis in men occurs much less frequently, which is due to the anatomical nuances of the structure of the urinary organs. Women have a wide and short urethra, so the infection penetrates more quickly to the bladder cavity.

Others include:

• trauma to the bladder cavity;
• disturbance of the urodynamic background;
• metabolic disorders;
• decrease in the body's immune forces;
• vaginal dysbiosis;
• lack of hygienic discipline.

Pay attention! All factors that can in one way or another contribute to the penetration of infectious agents into the bladder and the exacerbation of cystitis can be direct and indirect. In women, acute cystitis is often an independent process, and in men it is usually secondary to prostatitis.

Symptomatic complex

All symptoms are associated with irritation of the inner epithelial layer of the urinary tract. Normally, a healthy bladder begins to signal the brain to empty when it is filled to half its capacity. Violation of this process is another sign of the disease.

With inflamed tissues, excitation begins when it is slightly filled. That's why common symptom- and urge when the bladder is slightly full. Other clinical symptoms include:

• nagging pain even at rest;
• cutting pain when emptying the urinary cavity;
• general malaise;
• increased body temperature;
• urinary incontinence.

Important! Acute cystitis is often accompanied by hematuria syndrome, when blood appears in the urine. Along with hematuria, the development of iron deficiency anemia is noted. Children are often diagnosed with nephritis and pyelonephritis, which arise through an ascending route of infection.

Therapeutic process

How to treat inflammation in the bladder? The treatment process involves drug intervention, minimally invasive medical procedures - instillation and douching. The main drugs for the treatment of cystitis are:

1. Antibiotics. The main treatment is the prescription of antibiotics to suppress pathogenic activity bacterial microflora. Popular drugs are Monural, Palin, Ceftriaxone, Ciprofloxacin, Suprax, Levomycetin.
2. Antiseptic drugs (uroantiseptics). Medications are prescribed to prevent the spread of bacterial media throughout the body. Among known means especially highlight, Furamag, Nitroxoline.
3. Antispasmodics. This group of drugs is necessary to reduce the tone of the smooth muscles of the bladder. Spastic drugs are prescribed with caution, since anti-inflammatory and antibacterial drugs have some doses of similar substances. Popular remedies are Drotaverine or No-shpa, Papaverine, Spazmalgon.
4. Iron-containing. The drugs are effective for minor bleeding to compensate for iron deficiency anemia. In acute cases, treatment is carried out in hospitalization. Together with them they are appointed vitamin complexes. Popular drugs consider Maltofer, Ferrum-Lek, Sorbifer, Ascorutin, Vikasol, calcium preparations, tranexamic and aminocaproic acids.
5. Painkillers. Medicines are required for relief pain syndrome against the background of acute cystitis. Methyluracil, Ibuprofen, Ketoprofen, Cystatin are usually prescribed.

Popular for symptomatic treatment cystitis are vaginal suppositories. This dosage form ensures instant penetration of active substances into the vagina and bladder cavity. Popular drugs are Diflucan, Hexicon, Polygynax, Betadine, Cystatin.

What to do if triggered by a fungal infection? If the cause of the inflammatory process is fungal infection, then treatment is first carried out antifungal drugs and only then are antibacterial agents prescribed.

Pay attention! Symptomatic therapy is always short-term and is used until atypical symptoms subside. General course treatment usually does not exceed 14 days.

Folk remedies

Clinicians do not recommend use traditional methods treatment for several reasons. Firstly, first therapeutic effect can be observed only after 5-7 days of regular use, which is not suitable for acute cystitis. Secondly, inadequate treatment (warming, douching) can aggravate infectious process, lead to serious complications.

The effectiveness of traditional medicine is noted as an auxiliary therapy against the background of primary treatment. Popular recipes at home are:

• a decoction of berries and leaves of cranberries, lingonberries (the product has a pronounced anti-inflammatory and diuretic effect);
• a decoction of chamomile and St. John's wort (an anti-inflammatory natural remedy);
• honey, water tincture of propolis, garlic (natural antibacterial agents).

Herbal decoctions can be used as warm douches on days 2-3 of traditional treatment of acute cystitis. Otherwise, the risk of infection spreading to neighboring organs increases. If there is active inflammation and an increase in body temperature, warming up or any thermal procedures are unacceptable.

However, an effective folk remedy associated with heat is hot stone. To do this, stones or one large stone are heated in the oven (on a stove), placed in a bucket, a towel is wrapped around the rim of the container and the patient is seated.

Pay attention! The duration of the procedure is 15-20 minutes 2 times a day. After the manipulation, you should administer antibacterial suppositories, warm underpants and go to bed. The very next day, women feel a significant improvement. Dry heat rarely leads to complications.

Diet features

Diet plays an important role in the treatment of acute cystitis. In some patients, irritation of the bladder walls occurs due to increased acidity of urine as a result of eating citrus fruits, sour and spicy foods, and spices. During cystitis, it is prohibited to eat the following foods:

• All sour fruits, berries;
• alcoholic drinks of any strength;
• black coffee, strong tea;
• strong spices.

At the same time, you should minimize the amount of fats, carbohydrates and proteins. This is useful for reducing the load on the urinary system. The diet can be followed throughout the course of treatment.

Be sure to follow a plentiful drinking regime. Unsweetened fruit drinks, compotes, clean water, green tea, a decoction of rose hips. Warm drinking accelerates the removal of pathogenic media from the body. An increase in daily fluid is possible in the absence of contraindications.

Pay attention! Constant adherence to the rules of food discipline can not only prevent the return of inflammation and chronicity of the disease, but also slightly reduce overweight patient.

The prognosis for acute cystitis is mostly favorable. In complicated cases, inflammation often becomes chronic and is accompanied by exacerbations when exposed to certain negative factors.

Prevention of acute cystitis is due to regular emptying of the bladder, personal hygiene, protective regime during respiratory infections. Prevention is based on the preservation of the anatomical and functional integrity of the urethral canal after surgical interventions and various manipulations.