The impact of high doses of radiation on the bladder does not pass without a trace for the patient. Today, radiation cystitis is one of the most common complications of radiation therapy in oncological urology.
It often causes an accompanying infectious complication in the form of infectious infections by various bacteria (protea, Klebsiella, enteroviruses). Most often, this disease occurs in women who take intravaginal rays, but men are no exception.
Therefore, even at the stage of exposure to radiation, it is important to take measures to minimize the manifestation of this side effect. The development of this type of cystitis takes mainly a long time: from 2-5 weeks to several years.
What are the changes in the bladder
As you know, any kind of radiation aimed at treating oncology destroys not only atypical cells, but also healthy ones. The weak point is any mucous membrane. The bladder has an increased sensitivity to this kind of exposure. First of all, in the urinary tissue structure is disturbed. In connection with damage to microvessels, there is a deterioration in blood circulation in the irradiation zone. As a result of all this, erosion and ulcers occur.
The most dangerous and unfavorable is the direct exposure of the rays directly to the area of the bladder. Post-radiation cystitis mainly appears in the treatment of tumors located in the pelvic organs. This is due to the fact that doctors are not always able to prevent the direct exposure of the rays to the bladder due to the proximity of organs. In the treatment of other parts of the body, this problem is overcome by covering such weak areas with various protective agents.
Cystitis after radiation therapy is divided into 2 subspecies: infectious and non-infectious. With this method of treatment of cancer, the likelihood of infection joins in connection with a decrease in overall immunity in humans. In addition, various pathogens can enter the bladder both from above - from the kidneys and from below.
Features of the course of the disease in men and women
It is worth noting that men are not so often affected by cystitis. This is due to the fact that they have a long urinary canal, which prevents infections from entering from the outside. The bactericidal substance secreted in men by the secreted periurethral gland provides reliable protection to the body from the penetration of any pathogens. But, in the treatment of cancer, they often get this disease.
Treatment of radiation cystitis in women will be the same as in men. Untimely adoption of measures by a woman can lead to extremely unfavorable consequences: purulent focal inflammation occurs in the uterine cavity, appendages, which in turn leads to infertility.
A feature of radiation cystitis is that the disease occurs in connection with a violation of the natural environment in the bladder. The course of the disease will be different from gender. In men, this leads to the appearance of prostatitis and prostate adenoma, unfortunately, mainly in severe form.
Causes of the disease
Structural changes in the tissues of the mucous membranes, a sharp decrease in the human immune system in the treatment of cancer by radiation lead to the appearance of this disease. Inhibition of both local and general immunity leads to the activation of pathogenic microorganisms. A patient who is undergoing radiation therapy is repeatedly exposed to radiation, while the break between the sessions is small. In this regard, the affected tissues do not physically have time to recover, and structural changes also accumulate, which leads to the irreversibility of the process.
Possible changes in the bladder:
- volume reduction;
- stenotic sclerosis;
- fistula formation;
- stagnation.
Radiation cystitis in women who receive x-rays to fight cancer in the genital area is far from a rare occurrence. It is important to follow all the doctor’s recommendations, observe the established regimen in order not to amplify the negative impact of this therapy.
Symptoms of the disease
The main sign of radiation cystitis is constant urge to urinate, the number of which reaches from 40 to 45 times per day, including at night. The characteristic manifestations of the disease include pain, burning and pain during urination. Blood may be present in the urine, as well as white flakes, sand, small stones. The general condition of a person and the severity of symptoms will depend on the severity of the course of the disease. A mild degree is characterized by an almost asymptomatic course of pathology. With an average degree of damage, the signs will be more pronounced, but adequate competent treatment allows you to quickly cope with the disease.
In severe form, the patient needs inpatient treatment, it is characterized by the presence of severe pain and possible complications. Extremely severe form of radiation cystitis occurs against the background of organ damage, which is diffuse. At the same time, the acute and chronic nature of the course of the disease is distinguished.
The degree of post-radiation cystitis:
- Catarrhal. Its signs: the presence of small impurities of blood in the urine, increased urination (22-24 times a day). A urinalysis shows the presence of protein, white blood cells, and red blood cells. A biochemical blood test does not reveal significant changes.
- A pathology develops in which vasodilation occurs inside the organ. Signs: low hemoglobin, blood impurities appear in the urine in the form of clots, frequent urination (up to 30 times a day).
- Inlaid degree. Signs: in urine there are many different impurities, urination is increased up to 45 times a day. The biochemical composition of the blood shows characteristic changes (the presence of creatinine, nitrogen, urea). Reduction of the bladder in volume.
Diagnosis of the disease
Diagnosis begins with the delivery of urine and blood tests to the patient for laboratory tests. Signs of radiation cystitis are the presence in the blood and urine of an elevated level of red blood cells, white blood cells, bacteria, calcium salts. Biochemical analysis is aimed at identifying residual nitrogen, creatinine, and also urea. Also, the doctor gives a referral to the urine bacterial culture to determine the exact type of infection and prescribe medications based on this.
To clarify the diagnosis, instrumental research methods are used:
- urography;
- cystoscopy (determines the presence of changes in the bladder);
- renography (to determine the health of the kidneys).
Disease treatment
The treatment is comprehensive. It all depends on the severity of the course of the disease, the characteristics of the body, the type of lesion. In any case, the patient is prescribed conservative therapy for a long period. If the form is evaluated by the doctor as “severe”, then surgery is performed. A competent doctor will always pay special attention to eliminating the possible risk of secondary infection and preventing the spread of inflammation to other vital organs.
Diet
Treatment of radiation cystitis begins with the appointment of a special diet for the patient. This kind of food contains high-calorie foods with a high protein content. The following foods are not allowed:
- fried;
- sharp;
- salty;
- spicy;
- canned.
This diet is aimed at restoring the natural processes in the bladder.
What kind of drugs are prescribed to the patient
The disease is also treated with medical and conservative methods. Medicines are aimed at restoring the patient’s immune system, enhancing the nutrition of body cells, as well as the antibacterial and anti-inflammatory effect. Often, the doctor prescribes additional drugs that help stimulate the human circulatory system. Medicines that promote the healing of body tissues find their application here. To improve the general condition of a person, it is also necessary to use painkillers.
Efficacy of Intravesical Administration
In severe cases of the disease, the patient may be prescribed intravesical administration of the drug. This method often shows good results because the introduction of the drug directly into the affected area makes it possible to favorably influence the course of the disease. In no case should you stop using the drugs after eliminating the pain unpleasant symptoms, otherwise, the disease may return again. Treatment after radiation cystitis must be continued as prescribed by the doctor.