To prevent cystitis (bladder infection), attention must be paid to reducing individual risk factors.
Behavioral risk factors
- Diet
- Inadequate fluid intake – the better the urinary bladder is “flushed,” the less likely it is to be inflamedNote: Drink an adequate but not excessive amount of fluids. Excessive fluid intake can dilute antimicrobial peptides present in the urine, such as Tamm-Horsfall protein (Uromodulin) and cathelicidins.
- Micronutrient deficiency (vital substances) – see prevention with micronutrients.
- Psychosocial conflict situations (stress and constant tension – tense bladder walls increase the risk due to decreased mucus production):
- Bullying
- Mental conflicts
- Social isolation
- Stress
- Use of vaginal diaphragms and spermicides – this alters the normal bacterial vaginal flora, so there may be an increase in the bacterium E. coli – Escherichia coli – in the vagina, which is associated with an increased risk of cystitis
- Sexual activity:
- Through coitus (sexual intercourse) bacteria can enter the bladder and cause cystitis (= timely sexual intercourse). Micturition (urination) postcoital (after intercourse) can reduce the risk, as this flushes out any bacteria that may be present. Furthermore, the male partner should ensure adequate hygiene
- After the honeymoon due to frequent sexual intercourse (“honeymoon cystitis“); common symptoms here are alguria (pain when urinating, dysuria (difficult (painful) urination) and pollakisuria (urge to urinate frequently without increased urination).
- Anal intercourse in men who have sex with men (MSM) is associated with increased risk
- Lack of hygiene – but also exaggerated hygiene.
- Wearing damp swimwear for a long time, cold drafts.
Medication
- Contraception (birth control) with DMPA (depot medroxyprogesterone acetate).
- Cytostatics
- Immunosuppressed patient(s)
- Antibiotic therapy 2 to 4 weeks ago.
Other risk factors
- Mechanical stimuli – e.g. indwelling catheter.
- Stress and constant tension – tense bladder walls increase the risk due to decreased mucus production.
- Condition after discharge from an inpatient facility within the last two weeks.
Prophylactic measures
- Oral immunoprophylaxis with bacterial cell wall components of uropathogenic Escherichia coli strains (OM89, Uro-Vaxom); for basic immunization, one capsule daily for a period of 3 months; to refresh the body’s immune defenses three months after completed basic immunization, one capsule daily for 10 days each as boosters (interval boosters) for three consecutive months.
- Parenteral immunostimulation with inactivated pathogens (StroVac); for basic immunization: 3 injections of 0.5 ml vaccine suspension at intervals of 1-2 weeks; for booster: 1 injection of 0.5 ml vaccine suspension circa 1 year after basic immunization.
Prevention factors (protective factors)
- Circumcision (foreskin circumcision): the incidence (frequency of new cases) of urinary tract infection in non-circumcised boys is 10-fold higher than in circumcised boys.
- In postmenopausal patients, local vaginal prophylactic estrogen therapy (ethinyl estradiol; estriol) is an appropriate measure to prevent recurrent cystitis (UTI).
