Cystitis or urine infection is the second leading cause of infection in women and it is estimated that almost half of them have suffered an episode at some time in their lives. Although it is not serious, it is very annoying. It is common for it to occur on a recurring basis, so it is essential to stop it as soon as possible and follow some hygiene and food guidelines. Dr. Montserrat Espuña, Head of the Urogynecology Unit at the Institute of Gynecology and Obstetrics of the Hospital Clínic de Barcelona, explains everything we need to know so that it does not happen again.
Why are cases of cystitis more frequent in summer?
There is no clear scientific reason that there are more cases of cystitis in summer. It is believed that there are circumstances such as heat, sweat or the fact that there are people who wear wet swimsuits for a long time, which can cause changes in the vaginal flora that, in turn, can promote urinary infections.
And for the rest of the year, what causes cystitis?
The main risk factors for uncomplicated cystitis in healthy women are sexual intercourse, the use of spermicides, and a history of urinary tract infections in childhood. In postmenopausal women, vaginal atrophy due to hormonal deficit (lack of estrogens) and pelvic floor dysfunctions such as urinary incontinence and genital prolapse can promote cystitis. In general, any circumstance that can alter the normal vaginal flora facilitates the entry of germs from the perianal area into the urethra and can predispose to cystitis.
Are there other causes of urine infection?
Certain diseases such as diabetes, having kidney stones or not emptying the urinary bladder are all possible causes of what we call complex cystitis. These cases require a specialized control by a urologist.
What is the treatment for cystitis?
It is usually an antibiotic. They are generally short-term treatments and are intended to eliminate the germs that cause the infection and cause the symptoms. To the antibiotic treatment, a series of recommendations are added such as a copious intake of fluids while the symptoms last. If there is a lot of pain or discomfort, a pain reliever is also prescribed.
At the first symptoms, can you take an antibiotic?
If it is a person who has already had cystitis several times and their doctor has indicated it, it is correct to start treatment when the first symptoms appear. However, it is very important that the woman, before taking the first antibiotic intake, collect urine so that later it can be analyzed and checked if indeed the antibiotic being taken was the appropriate one for the germ that has caused this episode of cystitis .
Recurrent cystitis, why?
Two situations can occur. It may be that the woman has self-medicated and taken an antibiotic that was not suitable and that has not been able to eliminate the germ that caused her cystitis. Although initially it seems that there is an improvement, after 10-15 days the symptoms reappear. Many times it is because there has been a new infection with the same germ because the infection had not been cured properly.
And what would be the other case?
Another different situation is that of the person who, having been correctly treated, after a month or a month and a half suffers a new cystitis from the same or another germ. When a woman has 3 or more episodes of cystitis in 12 months, we consider that she has recurrent cystitis. These cases must be studied and treated by a specialist.
Can urine infection be prevented?
In addition to general preventive measures, in cases of repeated cystitis we sometimes prescribe a small dose of antibiotic after sexual intercourse. Another alternative treatment for repeated cystitis is a very low dose of an antibiotic taken daily, in this way we ensure that the woman is protected for a few months and that for a long period she does not have new episodes of cystitis.
Is cranberry useful?
Yes, it is proven that its daily intake acts as a preventive measure in recurrent cystitis. But we are not talking about the juice or the fruit, but about the supplements that carry the necessary amount of the active substance to be effective.
Keys to prevent cystitis or urine infection
- Basic hygiene . You have to maintain a hygiene of the genitals, but without exceeding the number of washes per day. Excessive hygiene can be just as damaging as a lack of basic hygiene.
- Drink liter and a half . Drinking little favors that the urine is more concentrated and that there is a greater predisposition to a urinary infection. Another recommendation is to avoid constipation.
- At the time of urination . The bladder must be completely emptied and it is advisable to urinate before and after sexual intercourse. This is how the possible bacteria in the urethra are dragged.
- After menopause . In this stage there is genital atrophy that alters the normal vaginal flora that defends us from infections. It is advisable to treat it with vaginal estrogens.
Act on time
- Symptoms . Some of them, such as having a great urge to urinate, doing it many times and not much, can make us believe that we have cystitis, although this is not always the case.
- Over time . these symptoms are increasing. A typical symptom and sign of cystitis is pain when you finish urinating and seeing blood in the urine.
- What to do . When you suspect that you have cystitis, you must collect a urine sample to analyze it with a test strip.
- And later . It is advisable to go to our doctor urgently to analyze the urine again and indicate the appropriate treatment. If the infection is confirmed and the doctor considers it necessary, it is possible to determine the causative germ and to know which antibiotic is the most appropriate to treat it.
Cystitis during pregnancy
- Risk factor . Pregnancy is itself a factor that favors the presence of bacteria in the lower urinary tract. In addition, in pregnant women it is important to detect asymptomatic bacteriuria: although there are no symptoms, the analysis shows germs in the urine.
- Treatment . If you are not pregnant, the mere presence of bacteria in the urine, without symptoms, today is considered that it should not be treated. But in the case of a pregnant woman, yes, because the continuous presence of germs in the urine can cause problems and affect the growth of the fetus.
