We will understand for what reasons cystitis with blood appears in women. What kind of ailment is this? Common inflammation differs from hemorrhagic cystitis in that, with such a disease, blood impurities are present in the urine. This is the same cystitis, but blood in the urine indicates a significant depth of damage to the multilayer epithelium of the mucous membrane of the bladder, as well as the spread of the pathological process to the capillary endothelium of its microvasculature.
The disease has a code according to ICD-10 N 30. The causes of cystitis with blood in the urine of women must be clarified.
Epidemiology
About 150 million people are affected by urinary tract infections each year. According to scientific studies, hemorrhagic infectious cystitis occurs much more often in women than in men. This happens especially often during menopause, since due to a decrease in the concentration of estrogen in the blood, the protective properties of the mucous membranes begin to decrease. To date, the causes of cystitis with blood in women, which determine its varieties, are divided into non-infectious and infectious.
Infectious causes of the disease
In most cases, acute hemorrhagic cystitis of bacterial etiology occurs due to infection of the inner surface of the bladder with Escherichia coli Escherichia coli, uropathogenic strains, Proteus coli, saprophytic staphylococcus or conditionally pathogenic microorganisms Klebsiella oxytoca.
The pathogenesis of the lesion is due to the ability of Escherichia (they represent synanthropic intestinal flora, but with cystitis appear in the urinary tract) to act as intracellular opportunistic pathogens. Using adhesive organelles, these microbes penetrate the cells and colonize the mucous membrane of the bladder and urethra. Here they consume iron compounds extracted from the cells and produce toxins that destroy red blood cells, which causes inflammatory reactions and the response of the urothelium effector cells. What are the other causes of cystitis with blood in women? Symptoms of the disease are discussed below.
Often this pathology is caused by ureaplasma, mycoplasmas, trichomonads, chlamydia, gardnerella, gonococcus. Primary fungal cystitis is rare and this disease is caused by the treatment of bacterial cystitis: suppression of the commensal microflora of the vagina by antibiotics allows lactobacilli and Candida fungi to multiply freely.
Noncommunicable causes
According to urologists, blood cystitis in women of non-bacterial origin can develop due to the presence of calculi in the bladder - especially urate stones during the development of uric acid diathesis - when the mucous membrane of the bladder is injured and microdamage caused by excessively acidic urine becomes deeper. Such cystitis with blood in the urine, many domestic doctors call ulcerative.
In addition, such types of hemorrhagic cystitis as radiation (radiation) or chemically induced are not associated with infectious tissue damage. Radiation inflammation of the bladder mucosa often develops after the treatment of malignant neoplasms located in the pelvis. In this case, the pathogenesis of the disease is due to the fact that radiation provokes the breaking of DNA chains. In addition, radiation penetrates into the deep layers of the muscle fibers of the bladder, which reduces the impermeability of the vascular walls.
Chemically induced cystitis with blood in the urine in women is the result of intravenous administration of anti-cancer drugs - cytostatics, for example, ifosfamide, cyclophosphamide, doxorubicin and bleomycin.
Hemorrhagic cystitis in women can develop when agents enter the bladder through the lumen of the urethra for intravaginal use. This can happen, for example, when douching with the drug "Gentsianviolet", intended for the treatment of vaginal candidiasis, as well as spermicidal agents, for example, such as "Nonoxynol".
Hormonal disruption
Another non-infectious cause of the development of this pathology in women can be hormonal disruptions in the body, oral contraceptives. The mechanism of the development of the disease in this situation is due to the fact that when the hormones are imbalanced, the composition of the microflora of the mucous membranes changes, and this leads to a weakening of the natural barrier against the penetration of pathogenic bacteria into the body. So the causes of cystitis with blood in women are very diverse.
Risk factors
The main risk factors for hemorrhagic cystitis are due to:
- decreased immune defense;
- the presence in the body of a woman of latent urogenital infections or cancer;
- urolithiasis and stagnation of urine;
- thrombocytopenia (low platelet count in the blood);
- non-compliance with aseptic rules in urological and gynecological manipulations;
- violation of the hygiene of the genitals.
Symptoms of the disease
In most cases, the initial signs of the development of cystitis with blood in women are manifested in the form of pollakiuria - more frequent urge to urinate with a simultaneous decrease in the amount of fluid released. Almost simultaneously with this symptom, there is the attachment of such a characteristic sign of an early stage of inflammation as multiple urges to empty the bladder (usually at night), as well as acute pain and burning at the end of the urination act.
Other clinical manifestations
In addition, the following clinical manifestations of hemorrhagic cystitis are noted:
- pain in the pubic region;
- pains in the pelvis, giving in the groin and lower back;
- clouding and a change in the smell and color of the excreted urine (from pink to bright red);
- Uncontrolled urination (urinary incontinence) may occur.
The patient's general condition worsens significantly - she develops severe weakness, appetite decreases, febrile syndrome occurs, and temperature rises.
If at any stage of the pathological process the patient feels difficulties during urination, then this indicates tamponade - blocking the opening of the bladder with blood clots.
Diagnostics
Diagnosing cystitis with blood in women is usually easy. In this case, it is necessary to differentiate urethritis, acute cystitis and diverticulum of the bladder. Additional examinations include:
- general urine tests;
- Ultrasound of the bladder;
- cystoscopy;
- swabs from the vagina on the flora;
- Back sowing urine.
Pathology treatment
The main thing is to timely recognize the symptoms of cystitis with blood in women. Treatment should also be comprehensive. It is important to understand that the full restoration of the mucous membrane of the bladder is possible only with the use of potent medicines. It should be noted that the chances of a full recovery increase with the timely diagnosis of the diagnosis and the use of antibiotics of the corresponding sensitivity group. Later, the treatment of cystitis with blood in the urine of women and the administration of drugs that only eliminate the symptoms of the disease without affecting the pathogenic environment can lead to the transition of a hemorrhagic disease into a chronic form.
The main task facing the specialist is the destruction of pathogenic microorganisms that have penetrated into the cavity of the bladder and caused inflammation of the mucous layer.
Medications
The choice of funds for the antibacterial treatment of cystitis with blood in women is determined by such parameters as the severity of symptoms and the duration of the disease. In addition, the selection of drugs takes into account the likelihood of side effects, the presence of concomitant pathologies, etc.
In the acute form of cystitis, antibacterial drugs, antispasmodics, herbs with a diuretic are prescribed. With severe pain, it is recommended to take drugs that relieve spasm of the muscle fibers of the bladder ("Papaverin", "Drotaverin"). They can be used both in tablet form and in the form of rectal suppositories. The elimination of severe pain contributes to the application of a heating pad on the lower abdomen.
Diuretic herbs such as bearberry, kidney tea, and lingonberry leaf are widely used in acute cystitis with blood in women. There are also ready-made phytopreparations - “Cyston”, “Kanefron”, “Phytolysin”. A prerequisite for a quick recovery is a plentiful warm drink.
One of the main means of combating the disease is the medicament fosfomycin, on the basis of which the popular Monural cystitis medication is produced. It is a broad-spectrum antibiotic that is a derivative of phosphonic acid. The medication has a bactericidal effect, the mechanism of which is due to the suppression of bacterial wall synthesis. The medicine can be used simultaneously with other antibiotics.
It is widely used in the treatment of cystitis with blood in the urine, the drug Metronidazole. It, along with the main antibiotic, can be prescribed drip intravenously or orally. The medicine is an effective antiprotozoal and antibacterial synthetic medicinal product with a wide range of effects. An antibiotic is selected as the main drug. Most often, they are given any medication of the cephalosporin series - Ceftriaxone, Cefotaxime, etc.
Fluoroquinolones are very effective in cystitis, for example, Norfloxacin (Nolitsin, Norbactin, Bactinor, Urobacil).
Norfloxacin is recommended to be taken within two weeks. It should be borne in mind that this drug for the treatment of cystitis with blood in women is contraindicated in diseases of the kidneys, pregnancy and epilepsy.
The consequences of this pathology
The main complications of hemorrhagic cystitis include:
- violation of the outflow of urine (as a result of the aforementioned tamponade through a blood clot), which can lead to the development of urosepsis, renal failure and rupture of the bladder;
- damaged areas of urothelium can become permeable to infections and cause them to enter the systemic circulation;
- violation of the integrity of the vessels of the bladder can threaten severe blood loss and the occurrence of iron deficiency anemia, especially if the patient is diagnosed with chronic hemorrhagic cystitis;
- open ulcers on the inner surface of the bladder gradually heal, but scars form in their place, provoking sclerotic changes in the walls, deformation of the bladder and a decrease in its size.
Surgical intervention for this pathology
Surgical treatment is required with a refractory form of hemorrhagic cystitis. In addition to cystoscopy with electrocoagulation, selective embolization of the hypogastric branch of the artery is possible. In some cases (with severe scarring of the walls and deformation of the bladder), a cystectomy (organ removal) is indicated. Surgical intervention is extremely rare, in most cases, cystitis with blood in women is cured with medication.
Folk methods
Alternative medicine methods are appropriate not only after radiation therapy, but also as an adjunct treatment of acute cystitis, which is prone to relapse. In the fight against blood in the composition of urine, decoctions of herbs that need to be taken in a full course effectively help. Here are proven folk recipes:
- Grind dried parsley. Pour 1 tbsp. l raw materials 2 tbsp. cold water. The composition is insisted for 8-10 hours, and then drink in several doses throughout the day.
- 1 tbsp. l lingonberry leaves pour 1 tbsp. boiling water, insist. Take orally in half a glass 3 times a day before meals.
- Pound fresh cranberries, thereby making mashed berry, which is required to be consumed daily during breakfast.