OBGYN.net: The Universe of Women's Health

Bacterial Cystitis

Cystitis is defined as an inflammation of the bladder, and may be caused by such things as bruising, as in the case of ‘Honeymoon Cystitis’, sexually transmitted diseases, or even a reaction to ‘personal care’ products.

Gonorrhea and chlamydia infections may cause symptoms similar to cystitis. Cystitis-like symptoms among young sexually active men may be caused by venereal diseases. If this is suspected please attend your nearest NHS sexual health clinic [in the phone book under genito-urinary medicine (GUM)]. You will get free, confidential advice and treatment and you can go to any clinic anywhere in the country.

Bacterial Cystitis is an inflammation caused by an infection with the presence of bacteria, usually those found in the intestinal tract, and is so common it is likely to affect 20% of all women. The condition may be referred to as a UTI (Urinary Tract Infection) affecting the urethra (the tube connecting the bladder to the exterior), the bladder, and in severe cases the kidneys.

The good news is that with proper treatment the symptoms should only last two or three days.

The symptoms can include:

• A frequent urge to pass urine, but only pass small amounts.
• Pain or burning/stinging feeling when you pass urine.
• A need to get up several times during the night.
• Dark or clouding looking urine which may contain blood strong or even fishy smelling urine.
• The urge to pass urine is so strong that you can't get to the lavatory in time.
• A dull ache or pain in the lower back or abdomen.
• Generally feeling unwell.
• Fever.

The most obvious symptoms for a simple UTI are the frequency, pain and foul smelling urine.

The cause is almost invariably the transference of bowel bacteria from the anus to the urethra. This is more common in women because of the shortness of the urethra and its close proximity to the vagina and anus. It is possible for bacteria to be pushed into the urethra when tampons are being inserted, during sexual intercourse or from wiping your bottom from back to front.

Treatments. If you recognize the symptoms as a simple infection then a pharmacist can supply products to relieve the symptoms.

If the symptoms persist or include others from the list or you have a vaginal discharge, or you are pregnant, a child, or male then you should see your own doctor for tests. The most important test of urine is done by a dipstick test, which is very quick, and by urine culture where the specimen is sent to a hospital laboratory to grow and examine the bacteria. The sample must be fresh and a ‘clean catch’ where the woman has separated her labia (lips) during urination, to avoid bacteria from the skin and vagina contaminating the specimen. The doctor will identify bacteria and red and white blood cells in the urine and prescribe a course of antibiotics, which should always be completed unless the doctor prescribes another after the laboratory results.

Self help while waiting to get to the pharmacy or doctor’s:

• Drink as much water, weak tea or fruit squash as you can to flush out the system to dilute the urine and reduce any stinging.
• Try a teaspoon of bicarbonate of soda dissolved in a glass of water to reduce the acidity, but not if you have high blood pressure or heart trouble.
• Go to the lavatory as much as you need to, don't try to 'hold on'.
• Keep warm and place a well-covered hot water bottle over your tummy or between your thighs.
• Take one or two aspirin or paracetamol tablets for the pain.
• Rest as much as possible.

Bacterial Cystitis avoidance, although not always possible, should include these simple lifestyle changes:

• When using toilet paper wipe from front to back.
• Wash and keep anus and genital area clean and dry.
• Urinate after sexual intercourse.
• "Void" urine as soon as possible when the feeling arises and at least every three hours. Ensure you are empty by sitting upright rather than leaning forward.
• Avoid tight trousers or underwear, especially if they're made from artificial fibers. Choose cotton underwear with stockings and looser clothes such as skirts. This helps prevent the warm moist conditions and rubbing, which encourages germs to spread.

Drink plenty so the bladder is flushed thoroughly, especially 3 to 4 pints of bland fluids like water, weak tea or squash.