Symptoms
Symptoms and progression of cystitis
If bacteria settle in the bladder, a urinary tract infection can occur. Women are significantly more susceptible to cystitis than men.
Symptoms of an uncomplicated cystitis
In the case of an uncomplicated (acute) urinary tract infection, there are no complicating factors (such as pre-existing conditions, urinary stones, etc.) that could lead to a more severe course of the infection or consequential damage. Often, only the lower part of the urinary system – i.e., the urethra and bladder – is affected by the inflammation.
Typical complaints for such simple urinary tract infections include:
- Burning or pain during urination
- Frequent, sometimes sudden, urge to urinate with low urine output
- Cloudy urine, which may smell bad or contain visible blood admixtures
- Abdominal pain
- General feeling of illness
An uncomplicated cystitis usually heals without problems and is generally easy to treat.
Complicated urinary tract infection - possible symptoms
Good to know:
You should always take the symptoms of a complicated urinary tract infection and possible pyelonephritis seriously and see a doctor if you are in any doubt. In general, however, the infection very rarely spreads to the kidneys. This is because most types of cystitis are uncomplicated urinary tract infections that heal without consequences.
Other types of cystitis
In addition to the distinction between uncomplicated and complicated urinary tract infections, there are other classifications or types of cystitis. These include, among others:
- Asymptomatic bacteriuria: when bacteria are found in a urinalysis but there are no symptoms, experts call it asymptomatic bacteriuria. It is usually harmless.
- Recurrent cystitis: if urinary tract infections occur at least twice in 6 months or at least 3 times in a year, this is called recurrent (or chronic) cystitis.1 Up to 5 percent of all women are said to be affected by this.1
- Honeymoon cystitis: the term describes the occurrence of cystitis after frequent sexual intercourse (for example during the honeymoon period, hence the name). It is mainly used colloquially and usually refers to a simple, uncomplicated urinary tract infection.
- Interstitial cystitis (bladder pain syndrome): this is a chronic disease that involves inflammation of the bladder and can cause pain in the abdomen and/or pelvic area. Increased urge to urinate and sometimes urinary incontinence are also possible symptoms. Unlike common urinary tract infections, there is no infection with bacteria or other pathogens. The exact cause is still not known.
Important: determining the type of urinary tract infection is crucial for treatment, for example if cystitis is chronic.
Ttrigger
Causes and risk factors of a urinary tract infection
Uncomplicated cystitis is usually caused by bacteria entering the bladder through the urethra and causing an infection there. This can happen, for example, during sexual intercourse, but also when intestinal bacteria get into the genital area due to incorrect wiping after using the toilet.
Is cystitis contagious?
As cystitis is usually caused by bacteria, transmission of the pathogens is generally possible. But even people without an acute urinary tract infection can spread bacteria. Cystitis is therefore not necessarily contagious.
The following factors can increase the risk of cystitis:
- Use of diaphragms (barrier method of birth control for women) and birth control creams that kill sperm
- Diseases such as multiple sclerosis or diabetes mellitus
- Anatomical changes in the urinary tract area (for example, a narrowing of the urethra in men)
- Use of a bladder catheter (a type of artificial bladder outlet)
- Young age at first occurrence of cystitis (under 15 years)2
- Hypothermia, for example due to wet swimwear
- Excessive intimate hygiene, e.g., frequent use of intimate wash lotions
- Past use of antibiotics
Bladder infections are also more common in pregnant women and women going through menopause due to hormonal changes.
Cystitis in men and women - why one is more likely to be affected than the other
Urinary tract infections occur significantly more often in women than in men. The reason: the female urethra - which extends from the bladder to the vaginal opening - is relatively short. It is therefore easier for bacteria to enter the bladder. In men, on the other hand, the urethra extends from the bladder to the tip of the penis. It is significantly longer, making it more difficult for pathogens to enter the bladder.
Diagnosis
Diagnosis of urinary tract infections
Diagnosis begins with a consultation in which the doctor asks about the patient's symptoms. This often leads to the suspicion of either uncomplicated or complicated cystitis.
Subsequently, a urinalysis can be carried out to determine the presence of bacteria. Further analysis of the urine (such as precise pathogen detection) is usually not necessary if the symptoms are clear.
If the symptoms are severe and there are signs of a complicated urinary tract infection, the doctor may also use an ultrasound to examine the bladder and kidneys. Very rarely, an X-ray examination or cystoscopy is also carried out to detect changes in the bladder.
Good to know:
If you suspect you have cystitis, your GP is a good first port of call. However, specialists in gynaecology (women's health) or urology (diseases of the urogenital system) can also help.
Treatment
Cystitis - which treatment is the right one?
A simple, uncomplicated urinary tract infection usually heals on its own without any consequential damage. Therefore, medication is often not absolutely necessary for cystitis, especially if it is manageable. However, treatment may be useful if
- the duration of the illness is to be shortened or
- the symptoms are very severe and need to be alleviated.
In these cases, it is advisable to consult a doctor who can prescribe antibiotics or other medicines for cystitis if necessary.
Antibiotics for cystitis - when are they useful?
Antibiotics work against bacteria and can therefore help treat a bacterial urinary tract infection. They usually workrelatively quickly and reduce acute symptoms such as pain when urinating. Antibiotics are also often the treatment of choice for complicated urinary tract infections or recurrent (chronic) cystitis to prevent the infection from spreading and causing further damage.
Important: If cystitis has not improved after antibiotic treatment, those affected should see a doctor again. The doctor may prescribe a different medicine.
What else can help:
Painkillers (such as those containing the active ingredient ibuprofen) can help with mild to moderate pain. Some people find that applying heat, for example by keeping a cherry pit cushion on their abdomen, also provides relief from the discomfort caused by cystitis.
APOGEPHA products – medicines for cystitis
Herbal remedies can be used to support an antibiotic therapy. These remedies flush the urinary tract by stimulating kidney activity, thereby preventing the settling of bacteria. Goldenrod extract is particularly suitable for this purpose.
Prevention
How can cystitis be prevented?
Although there is no magic bullet that will always prevent a urinary tract infection, there are a few things you can do to reduce your risk of cystitis:
- Drink a lot of fluids: drink 1.5 to 2 litres of fluid per day to flush bacteria out of the bladder (except in the case of heart or kidney disease).
- Keep warm: Protect yourself from hypothermia. Take off wet clothes or swimming gear as soon as possible and change into dry clothes.
- Don't hold back: don't hold back the urge to urinate for long. Instead, go to the toilet as soon as possible. It is normal to urinate 5 to 7 times a day (and up to 1 time at night).3
- Sex: women should go to the toilet to urinate after sexual intercourse. Do not switch from anal to vaginal intercourse without changing the condom.
- Hygiene: clean the genital area after evacuating the bowels only from front to back.Do not wash your genital area too often and only wash it with skin-friendly liquid soap and warm water. Do not use any disinfectants or sprays in the genital area so that the protective acid mantle of your skin is protected.
- Textiles: Wear fresh, comfortable cotton underwear daily. Change the flannel used for the genital area daily and reserve a special towel for this area. Never use common towels for this area.
If you suffer from frequent urinary tract infections despite these tips, you should definitely consult a doctor for clarification.
Specialist groups
Urinary tract infection: information for specialist groups
In general, urinary tract infections are among the most common urogenital diseases. In outpatient treatment, uncomplicated urinary tract infections (HWI) are actually the most common reason for antibiotic prescriptions after respiratory infections. Resistance to pathogens of uncomplicated UTIs is increasingly becoming a worldwide problem.
From the APOGEPHA portfolio, you will find 3 antibiotics that are listed in the current S3 guideline (AWMF register no.: 043/044) as the treatment of choice for acute uncomplicated cystitis due to their excellent resistance and targeted effect in the bladder.
We also offer non-antibiotic products for supplementary treatment or prevention. More information on these too is available in the products section.
Simply click here to access the detailed product information on antibiotics for cystitis via the free specialist group login:
Downloads
Cystitis: free downloads and services
Download free service material on cystitis here:
FAQ
Frequently asked questions and answers about cystitis
Typical symptoms are burning or pain when urinating and a frequent urge to urinate. Cloudy urine and a general feeling of illness are also possible symptoms.
In general, the symptoms of cystitis in men are similar to those in women: a more frequent urge to urinate, sometimes an unpleasant burning sensation and a general feeling of exhaustion
It is usually caused by bacteria that enter the bladder via the urethra, for example during sexual intercourse or when going to the toilet, and cause an infection there.
In many cases, a simple cystitis heals on its own. However, medicines (antibiotics) can shorten the duration of the illness and alleviate the symptoms. A doctor's prescription is required for these.
Antibiotics usually work relatively quickly for cystitis. However, the exact time varies from person to person. If there is no improvement after 1 week, it is advisable to consult a doctor again.2
You should avoid alcohol, coffee and acidic citrus juices if you have cystitis, as these can further irritate the urinary tract.
Bacteria can enter the urethra, for example during sexual intercourse or when you go to the toilet, if you wipe incorrectly (from the back to the front instead of the other way round) and cause infection there.
This is theoretically possible, but rather unlikely. In most cases, cystitis is caused by your own intestinal bacteria entering the urethra.
What can help: drink plenty of fluids, go to the toilet regularly and ensure thorough but not excessive intimate hygiene. You should also avoid hypothermia (caused by wet swimwear for example) as much as possible. Special products can also help with prevention.
Sources
- 1 “Rezidivierende Harnwegsinfektionen: Wie vermeiden und behandeln?” (How to prevent and treat recurrent urinary tract infections?). Aerzteblatt.de, https://www.aerzteblatt.de/archiv/171807/Rezidivierende-Harnwegsinfektionen-Wie-vermeiden-und-behandeln. Accessed on 15 July 2024.
- 2 “Blasenentzündung – Brennen beim Wasserlassen” (Cystitis - burning sensation when urinating). Patienten-Information.de, https://www.patienten-information.de/kurzinformationen/blasenentzuendung. Accessed on 15 July 2024.
- 3 “Wie funktioniert die Harnblase?” (How does the bladder work) Stiftung Gesundheitswissen, https://www.stiftung-gesundheitswissen.de/gesundes-leben/koerper-wissen/wie-funktioniert-die-harnblase. Accessed on 15 July 2024.