"Treatment guidelines for children under one year of age are individualized".
DR. FELIPE VILLACAMPA
SPECIALIST. UROLOGY DEPARTMENT
Cystitis is a urinary tract infection that affects the bladder.
Urinary tract infection is the most common disease of the urinary system and the entire body after respiratory diseases. In the hospital environment it is the most common infection.
It is defined as the presence of germs in the urine. Usually these are bacteria (bacterial) and exceptionally, fungi (fungal) or viruses (viral). It is evidenced by the culture of urine in appropriate growth media.
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What are the symptoms of cystitis?
Cystitis is defined by a characteristic clinical picture of painful or itchy urination, very increased and scarce frequency of urination (frequency), permanent sensation of desire to urinate (urgency) and sometimes bloody urine (hematuria). The picture is always without fever.
If fever is present, it indicates that another organ is also affected. In a male, the prostate may be the affected organ. The condition is called acute prostatitis.
If the affected organ is the kidney, the picture is called acute pyelonephritis and it is characterized by fever, chills, lumbar pain, malaise..., accompanied by significant bacteriuria.
The most common symptoms are:
- Pain or burning sensation in the urine.
- Very increased frequency of urination.
- Permanent sensation of desire to urinate.
- Bloody urine.
Do you have any of these symptoms?
You may have cystitis
What are the causes of cystitis?
The usual germs come from feces (enterobacteria). The absolute protagonist is the Escherichia Coli, responsible for 85% of uncomplicated infections in sexually active women, 70% of uncomplicated infections in adults and 50% of hospital infections.
After E. Coli, the most common germs are Proteus, Klebsiella, Enterobacter, Citrobacter, Pseudomona, Serratia, Staphylococcus Streptococcus Faecalis and especially Staphylococcus Saprophyticus (15% of infections in sexually active women).
What are the risk factors for cystitis?
There are demographic factors (poverty, nosocomial -hospital environment-, pregnancy), urological factors (probes, anomalies, stones, obstruction), medical factors (diabetes, immunosuppression) and behavioral factors (barrier type contraceptives increase four times the infection rate, the risk increases 40 times in sexually active women) that facilitate urinary infection.
Despite this, there are situations in which the predisposition is more important:
- Pregnancy: includes a higher risk of asymptomatic bacteriuria that, if left untreated, can cause pyelonephritis in the last trimester.
- Infection in children and vesico-renal reflux.
- Infectious lithiasis: struvite stones are a consequence of infection. The infection will not disappear until the stones are removed.
- Obstruction: the most important risk factor. It allows greater growth and intrarenal penetration of germs and is decisive in renal destruction.
How is cystitis diagnosed?
To be considered as cystitis, the growth of bacteria in the urine culture must show significant bacteriuria. Then, it is necessary to identify the anatomical location of the infection, using the clinical symptoms and, if necessary, complementary explorations.
Finally, it is necessary to indicate whether it is one:
- Primoinfection or isolated infection.
- Unresolved infection.
- Recurrent infection: either by bacterial persistence or much more frequently by reinfection, which is defined by 2 symptomatic cystitis in less than 6 months or more than 3 in 12 months.
How are cystitis treated?
The treatment is antibiotic and should be done, if possible, selectively, choosing the best of those to which the germ is sensitive (should therefore be done urine culture and antibiogram).
The application of treatment is different depending on age, location, type of infection, recurrence, etc.
Where do we treat it?
IN NAVARRE AND MADRID
The Department of Urology
of the Clínica Universidad de Navarra
The Department of Urology of the University of Navarra Clinic offers the patient a medical team, composed of first-rate professionals, and state-of-the-art diagnostic and therapeutic means such as the Da Vinci® robotic surgery.
The Department of Urology possesses the certificate of accreditation of the European Board of Urology, a reinforcement of the excellence of the service at the level of care, teaching and research, which in Spain only three hospital centers possess.
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