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Cystitis: infection of the bladder
 This is a very common infection or irritation of the bladder that results in an
urgent desire to urinate frequently, regardless of whether your bladder is full.
Passing urine is usually painful and the urine may be cloudy or even contain
blood. You may feel discomfort after passing urine or have abdominal pain. It is
important to treat cystitis as soon as it is detected; otherwise it can lead to
kidney infection and possibly cause permanent kidney damage. Women seem to be
more at risk of getting cystitis than men because their urethras are much
shorter and therefore more vulnerable to irritation and infection.
Many women get cystitis when they first become sexually active of after
frequent sexual intercourse. This is because when the penis is inside the vagina
it can irritate the urethra, which lies next to the vagina. This is what first
gave the condition in young women the name of “honey-moon cystitis.”
Symptoms
Symptoms of cystitis can include:
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a stinging or burning sensation when you pass urine
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the need to urinate more often than you usually do
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feeling the need to urinate urgently, even if you pass very little
or no urine
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urine that is cloudy or dark coloured, and may have a strong smell
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blood in your urine
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pain or tenderness in your lower back or lower abdomen
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a general feeling of being unwell
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How does a doctor diagnose cystitis?
 The diagnosis of cystitis is primarily based on symptoms and signs. Visual
appearance of the urine is not helpful. The most important examination of urine
is done by chemical testing (dipstick test), which is very quick, and by urine
culture where the specimen is sent to a hospital laboratory to grow and examine
the bacteria. The specimen must be fresh. It is also important that the woman
has separated her labia (lips) during urination, to avoid bacteria from the
skin
and vagina contaminating the specimen. If there is inflammation, the doctor will
identify bacteria and red and white blood cells in the urine using the dipstick
test. If this is positive, your doctor can prescribe antibiotics immediately
while waiting for further confirmation from the urine culture. This will also
indicate whether the antibiotic is sensitive to the bacteria or whether there is
any resistant bacteria which is not going to respond to the antibiotic.
In the case of repeated, inexplicable, infections of the urinary system, a
referral should be made to a hospital for tests such as ultrasound scanning or
X-rays of the urinary system and cystoscopy (telescopic examination of the
bladder).
The effects on your fertility
Cystitis should present no obstacle to
conceiving – apart from the fact that
you should abstain from intercourse until the infection has cleared up. However,
it is particularly common in
pregnancy because the expanding uterus places more
pressure on your urethra, making it more difficult to completely empty your
bladder. Increased amounts of progesterone in your body during pregnancy also
make the urethra more lax, and this allows infections to travel up the urethra
to the bladder more easily. If left untreated, cystitis can progress to kidney
infection and cause premature
labor.
Treatment
If a urine test shows you have cystitis, you will most likely be prescribed a
course of antibiotics to treat the bacterial infection effectively. If you are
planning to conceive, check with your doctor that these are safe.
Self-help measures to prevent cystitis
The following will help to prevent cystitis:
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 Drink lots of water, herbal teas, and other clear fluids,
so the bladder is flushed thoroughly. .
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Drink plenty of cranberry juice (it has a natural antibiotic effect).
There is no doubt that this simple and natural
treatment may help to reduce the frequency of recurrent infections. It is
thought that the cranberry juice works by preventing common bacteria from
‘sticking’ to the walls of the bladder and so preventing infection taking hold.
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Always completely empty your bladder – infections develop more easily in urine
that becomes concentrated or stagnant. Empty your bladder before intercourse and
again afterward. Remember, it is a bad habit to sit on
the toilet bent forward and reading while urinating.
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Try to avoid vaginal deodorants, douches, bubble baths, and perfumed soaps, as
these all irritate the urethra.
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Wear loose clothes and cotton-lined underwear to help prevent irritations and
infections in the vaginal area.
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If you are using a diaphragm, make sure it fits properly or change to a
cervical cap, which fits snugly over the cervix and does not press on the
urethra.
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If you suffer from vaginal dryness use some lubrication.
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When you breast-feed, your body secretes protective carbohydrates, known as
oligosaccharides, in both your breast milk and urine. Oligosaccharides prevent
bacteria from sticking to the wall of your bladder and that of your baby’s. This
will protect you both from cystitis – another benefit to breast-feeding your
baby.
If you get three or more attacks a year, your GP may give you a course of
antibiotics to keep at home so you can use them as soon as you know you are
getting a bout of cystitis. Alternatively, women who get repeated attacks may
need to take a low dose of antibiotics for six to 12 months. If you get cystitis
after sexual intercourse, your GP may advise you to take a single dose of
antibiotics immediately after you have had intercourse to prevent an attack.
Curing Cystitis
The following will help to cure an attack of cystitis:
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As soon as symptoms start, drink at least a pint of water with a teaspoon of
sodium bicarbonate (baking soda) dissolved in it. This may help to prevent any
bacteria from reproducing. Continue to drink a pint of this mixture every hour
until symptoms stop.
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Use a hot water bottle to relieve the pain.
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Drink lots of cranberry juice, hot yarrow tea, and vegetable broth containing
barley. These all help to ward off infection.
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