7 March 2019 Author : Pedro Soares Urinary tract infections are the second-most frequent cause of infectious disease in adults. Cystitis is the most common of these, and is more likely to affect women . Bacterial cystitis is the most frequent form of infectious cystitis and is defined as an inflammatory response of the urinary tract to the invasion and colonisation of the bladder by bacteria that normally live in the human intestine. Of these bacteria, Escherichia coli or E-coli, as is popularly known, is responsible for 75% to 90% of all infections. It should be noted that the invasion of the bladder by bacteria does not necessarily mean there will be an infection because, as a general rule, the balance will fall in favour of the body’s natural defences. Approximately 50% of women will suffer with cystitis at some point in their life. Women with an active sex life will have at least one episode of cystitis every two years. Why does cystitis affect women more than men? Women are more likely to be affected by urinary infections than men due to the anatomical differences between the two: in women’s bodies, the anus is closer to the urethra, and the urethra is much smaller. Symptoms are usually characteristic and include: Burning sensation when urinating; Increased urinary frequency; Strong and permanent need to urinate; Pain or sensation of weight in the lower part of the abdomen; Pink urine (in some situations, suggestive of the presence of blood). Fever, back pain, nausea and vomiting may indicate you are suffering with a kidney infection known as pyelonephritis . How can cystitis be prevented? In order to prevent cystitis, a woman should: Urinate immediately after sexual intercourse; Drink sufficient water to urinate about 5 times a day; Take showers rather than baths and avoid underwear made from synthetic materials. Wiping after urination should be done with soft paper , and always from front to back . This can help to avoid local trauma and the transportation of bacteria from the area around the anus to the vagina. Constipation is considered to be a predisposing factor for the onset of urinary infections, and as such its treatment is also important. Other preventive measures In clinical studies, the use of food supplements was found to be effective in the prevention of repeated urinary infections. The use of probiotics (substances that can restore normal vaginal bacterial flora) is recommended, as is cranberry extract - this is a red berry that makes it difficult for the bacteria causing urinary infections to fix to the surface of the vagina, urethra and bladder. Orally-administered vaccines are also available. These stimulate the development of specific immunity against the bacteria that usually cause urinary infections. In postmenopausal women, the use of topical oestrogens is recommended to prevent atrophy of the vaginal mucosa, which can help bacteria to fix. How is cystitis diagnosed and what is the best way to treat it? In 90% of cases, a diagnosis can be made by evaluating the patient’s complaints and carrying out a urine summary analysis (test strip or urine II). Where there is uncertainty with regard to diagnosis or repeated infection is taking place, a urine culture should be made for confirmation. In some cases of cystitis, spontaneous healing of the infection can occur with nothing more than increased water intake (repeated urination eliminates the bladder bacteria); however, in most cases patients require antibiotic treatment of varying duration depending on the drug and the severity of the infection. Be aware that: Bacterial cystitis is the most common form; Female anatomy is more susceptible to this infection; More than half of women will experience cystitis once in their lives; Sexually active women may experience cystitis every 2 years; Drinking a lot of water helps to get rid of the infection. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
