Inflammation of the bladder (cystitis) falls into the somewhat more generally described area of uncomplicated urinary tract infections. One always speaks of such an uncomplicated infection when the kidney is not affected. Often an inflammation of the bladder is accompanied by irritation of the urethra.
Causes
The cause of an inflammation of the bladder is usually bacterial pathogens. The main pathogens are E. coli (which is part of the natural intestinal flora), as well as Proteus, Klebsiellen, Streptococci and Enterococci. These bacteria, through smear infections, reach the urinary tract and can lead to infections there.
Therefore, hygienic aspects, such as the direction of wiping after defecation, are particularly important in the development of urinary tract infections. An overall insufficient fluid intake can also promote inflammation of the bladder, since higher urine volumes can virtually flush the urinary tract and reduce bacterial colonization. Excessive hygiene, e.g. with intimate sprays or vaginal rinsing, can also contribute to the development of bladder inflammation by destroying the normal vaginal flora. A similar negative effect can also be brought about by a change in the hormone balance during the menopause.
Diagnosis
The diagnosis of bladder inflammation differs according to the affected patient group. In general, the symptoms recorded in the patient’s medical history, which represent the clinical picture relatively accurately, are groundbreaking. Especially in young, otherwise healthy women, in whom there is no indication of kidney involvement or other complications, these symptoms are sufficient for the diagnosis.
A urine examination is not absolutely necessary. However, a microbiological examination of the urine should also be performed at the first occurrence. The often common urine stix, which are also available for domestic use, do not significantly increase the accuracy of the diagnosis.
However, women in pregnancy should always have a urine test performed. In case of an inflammation of the bladder in men, only after exclusion of possible complications, the classification as uncomplicated cystitis is possible. This means that here an examination of the urethra and a rectal examination should also be carried out to identify more complicated causes.
In addition, an examination of the urine is also important here. This also involves so-called cultures of the urine, on which pathogens grow during incubation, so that the exact pathogen can be determined. It is important that the urine sample is taken from the medium jet urine and after prior cleaning of the limb or labia in women, as otherwise physiologically present pathogens from the outer genital area can falsify the sample.
If the doctor has the necessary experience, the urine can also be evaluated under the microscope to rule out a urinary tract infection. In case of a urinary tract infection, red or white blood cells can be found in the urine, in addition to the bacteria. The inflammation values in the blood, i.e. CRP and leukocytes, can also be elevated. In the case of frequently occurring inflammations of the bladder or complicated processes, the kidneys and urinary tract should be examined by means of ultrasound. A cystoscopy, i.e. the endoscopic examination of the bladder from the inside, is usually not necessary in the case of a urinary tract infection.
