What is cystitis?

        Cystitis is the medical definition of inflammation in the bladder. Bacteria are the common cause. It causes painful and distressing urination. Mortal danger occurs in rare cases where it spreads to the kidneys. Cystitis may be a side effect of some drugs used. Cystitis can occur after radiotherapy applied on the cancerous organs around the bladder. Bacterial cystitis can be treated easily with antibiotics. Cystitis, which owes to different reasons, is treated according to the type of such causes.

Symptoms of Cystitis

        Symptoms of cystitis is urgent need for urination or even urine leakage, burning sensation while urinating, frequent urination in small volumes, bloody urine, pressure feeling in the lower abdomen and low fever. One should pay attention if it occurs in children especially with urinary incontinence during the day. This situation may indicate inflammation in the kidneys.

Causes of Cystitis

        One should possess knowledge of the discharge system in order to better understand cystitis. The discharge system is comprised of the kidneys, the ureter that carries urine from the kidney to the bladder, the bladder that stores the urine and the urethra channel (urinary channel) that ejaculates the urine from the body. Waste materials in the blood are filtered in the kidneys and stored in the bladder. The bladder drives these wastes away from the body by urination.

        Sexual activity. Tools that are placed inside the cervix and the womb for birth control, pregnancy, menopause, strictures in the urinary channel, disorders such as diabetes and AIDS that disrupt the immune system are amongst the risk factors.

Bacterial Cystitis;

        The female urethra (urinary channel) is a 4-5 cm channel located right above the vagina. Vagina is an organ that hosts benign and malignant bacteria. Owing the movements by the penis during sexual intercourse, such bacteria reach the nearby urinary tracts and from there, to the bladder. Such bacteria cause inflammation in the bladder. Chronic constipation is an auxiliary factor for the occurrence of cystitis.

Cystitis Not Caused by Bacteria;

        Cystitides not caused by bacteria have many causes. Interstitial Cystitis is one type not caused by bacteria. This also called painful bladder syndrome. Its cause is unknown. Although its diagnosis is partially easy, its treatment is very difficult. After we touch upon other cystitides not caused by bacteria, we touch upon the diagnosis and treatment of Interstitial Cystitis in detail.

        Cystitides as a side effect of drug use; when chemotherapy drugs are discharged by urine, they irritate the bladder and cause cystitis. Cystitides may occur due to radiotherapy, catheter applications to the bladder and allergic causes. As diabetes facilitate the generation of microbes in urine, inflammations may easily occur in the urine. This causes cystitis. Bladder inflammations (cystitis) may also occur due to kidney stones, prostate enlargement and spinal injuries.

Diagnosis of Cystitis

        Taking the medical history of the patient and his/her family, which we call anamnesis, is the easiest diagnosis method. Urine examination and antibiotic sensitivity test are important. If the disorder repeats frequently, one should enter and examine the bladder from the urinary channel with telescopic tools and camera, and also use radiologic and ultrasonography imaging methods. These clarify the causes of cystitis.

Treatment of Cystitis

        If the disease is seen for the first time, 3 or 7 days’ antibiotic treatment is sufficient for bacteria caused cystitis. But for repetitive cystitis, one should examine into long-term antibiotic treatment and the presence of other causes for cystitis. After necessary examinations are made and no other cause is identified, antibiotics of certain group should be used as a protector prior to or after sexual intercourse in a single dose. The patient is further advised to urinate after each sexual intercourse.

        On the other hand, treating cystitis that was transmitted under hospital environment is more difficult. Diseases caused by hospital infection are more resistant against antibiotics.

        In addition to antibiotics prescribed for cystitis in the menopause period, estrogen creams applied to the female organ are also beneficial. During the pregnancy period however, urinary tracts become more sensible against microbes due to disruption in the hormonal balance associated with pregnancy. It requires special treatment and regular follow-up.

Diagnosis and Treatment of Interstitial Cystitis;

        Interstitial Cystitis is also known as painful bladder syndrome. It occurs with intense pain in the bladder, womb and other inter-pelvic organs. It is a chronic disease that gives a pressure feeling. In a normal discharge system, nerve impulses go to the brain after bladder is filled up to a certain level and the bladder is discharged. But in this disease, the patient feels the urge to urinate with intense pain even there is a very low urine volume in the bladder. It is usually seen in women over 30 years of age. It is rarely seen in men. If research isn’t made into similar complaints in men, the disease may be skipped, as it is rare. Even interstitial cystitis (painful bladder syndrome) doesn’t have a conclusive treatment, we try to relieve the patient with some treatment methods. The disease exacerbates when the patient sits for long time during the menstrual period, or after intense stress, excessive physical activity or sexual intercourse. In addition to the vagina and anus region, the pain is also felt in the inter-pelvic organs (such as bladder and womb). The patient feels a continual urge for urinating. There are cases that need to urinate 60-70 days a day. Sexual intercourse triggers pain and this may cause problems between spouses.

        The disorder distorts the elasticity of the bladder muscle, smalls down the organ and considerably lowers the organ’s urine capacity. Frequent urination detaches the patient from social life. Cystoscopy (observing the bladder with camera) and other diagnosis method are sufficient for diagnosing the patient. But in suspicious cases, one should examine other intraabdominal organs with telescopic tools with call laparoscope and seek into other causes. One seeks into whether the tissue called endometriosis, which coats the interior of female womb, is present in different regions of the body at birth. That is because when it is present in other organs of the body, this tissue called endometriosis can lead to similar pains. This probability should be considered especially in case of complaints that increase during the menstrual period. Oral drugs taken from treatment only provide temporary healing for interstitial cystitis. Antidepressants and antihistamines used for allergy treatment can be beneficial. Drug treatment administered inside the bladder can be efficient. The patient’s bladder can be relieved by applying electric current to nerves though some electrodes that are placed in the nerve endings reaching to the bladder. These treatments provide pain control. The patients are asked to refrain from tea, coffee, chocolate, acidic foods, tomato, eggplant (aubergine), canned foods, sweeteners, alcohol and smoking.

        As a last resort, we fully remove the bladder, construct a new bladder from the intestines, and anastomose the urinary channels coming from the kidneys to this newly constructed bladder. This procedure relieves the patient. In some cases however, pains may persist even a new bladder has been constructed from the intestines. This is explained by the phantom pain theory. Although the cause of pain has been eliminated by the new bladder, the brain still senses the imaginary pain.