Cystitis
Cystitis is a common urinary tract infection (UTI) for many people, especially women. It’s a bladder infection caused by bacteria entering the urethra and travelling up into the bladder.
Overview of Cystitis
Cystitis is a common form of bacterial infection which causes inflammation of the bladder. In most cases it’s caused by bacteria found in faeces (Escherichia coli) entering the urethra, the tube through which urine flows from the bladder to outside the body, then travelling up the urethra and into the bladder. In these cases, it is also referred to as a lower urinary tract infection (UTI).
Getting more than three infections in a year, or more than two in six months, is termed a recurrent UTI.
While men and women both get cystitis, women tend to be more susceptible to it as a woman’s urethra is shorter than a man’s. Making it easier for bacteria to travel into the bladder. A woman’s risk of getting cystitis also increases when pregnant and around the time of menopause, due to hormone changes.
However, some men are at higher risk of getting cystitis if they perform insertive anal sex, or have an uncircumcised penis which can trap bacteria near the end of the urethra, or have a urethral obstruction due to an enlarged prostate.
Other risks of developing cystitis common to both men and women include:
- Diabetes
- Sexual intercourse
- Urinary or faecal incontinence
- Recent catheter insertion into the urethra
- Trouble fully emptying the bladder
- Lack of adequate bladder control due to brain, nerve or spinal cord problems like multiple sclerosis and Parkinson’s disease.
Although bladder infections, cystitis and UTIs are common, please remember that symptoms of cystitis can also be caused by irritation or damage to the bladder or urethra. They can also be a sign of more serious underlying diseases of the bladder such as cancer.
Please consult your doctor if your symptoms persist, as further diagnostic reassurance is warranted.
Symptoms of Cystitis
People with cystitis (lower urinary tract infection) often experience uncomfortable symptoms including:
- A strong, persistent urge to urinate.
- A burning or stinging sensation when you pee.
- Passing frequent, small amounts of urine.
- Urine that appears cloudy, dark, or has a strong smell.
- The presence of blood in your urine (it may look pink, red, or cola-coloured).
- Pain in your lower abdomen or pelvic area.
- Cramps or pressure in the lower back or abdomen.
It’s important to note that older people may have cystitis but not show any of these common symptoms. Instead they can present with confusion, agitation or changes in behaviour.
If you suspect you have a UTI, we urge you to seek medical advice for an accurate diagnosis and appropriate treatment, which often involves urine tests and a course of antibiotics.
Diagnosing Cystitis
The Urology Partnership offers a full and comprehensive service to diagnose and treat cystitis and recurrent UTIs. So please don’t hesitate to contact us directly if you have any concerns.
Diagnosis involves your specialist taking a thorough history and exploring your infections. We also offer a comprehensive set of advanced tests including:
- Urine flowmetry analysis
- Post micturition bladder volume scan assessment
- Urine analysis
- Rapid urine culture test
- Urine antibiotic sensitivity testing (AST)
- Cytology urine tests to exclude cancer
- Renal tract and abdominal ultrasound scan by a Consultant Radiologist
- Cystoscopic assessment of the bladder
These tests are often performed on the same day in our state-of-the-art diagnostic clinic in order to expedite your treatment and care.
Treatments for Cystitis
Once equipped with information from our diagnostics, your clinician will take the time to explain the results and discuss with you the best treatment options. Leading to a personalised treatment plan based on the specifics of your case.
Common treatments for cystitis include:
Antibiotics
The standard treatment for UTIs (including cystitis) is with antibiotics, which most patients with a single episode respond to very well.
Our approach to the selection of antibiotics is tailored to the individual patient based on unique sensitivity profiling of urine cultures using our advanced rapid diagnostic test. This gives us fast and accurate information which we use to make a clinical decision on the best antibiotic for targeting the specific bacteria causing the UTI, leading to faster relief and improved patient outcomes.
If the infections become more chronic, antibiotic treatments range from keeping antibiotics at home, to going onto a low dose antibiotic where you take one every night or just one antibiotic after sexual intercourse.
There is currently a lot of concern about long-term use of antibiotics and although they are well recognised and well established, alternative treatments such as intravesical (bladder) instillations are becoming more popular.
Intravesical Instillations
Part of the problem with patients with recurrent urinary tract infections is a deficiency in the lining of the bladder which makes them much more susceptible to infections with low levels of bacteria.
A well-established treatment is a course of bladder instillations which can be performed either by the nurse, or by the patient themselves, once a week for six to eight weeks. This is followed by a monthly course for six months. These are available in many NHS hospitals, covered by insurance companies and are very well tolerated.
Seventy percent of patients with recurrent infections respond well to intravesical treatment, with both an increase in bladder comfort and a reduction in infection rates.
Vaginal Laser Treatment
Many women develop urinary tract infections after the menopause due to a change in vaginal health. Routine treatments with hormone replacement therapies and local oestrogen cream can reverse some of these effects, but are often unpopular with the patients.
We recently conducted a one-year study using laser vaginal rejuvenation to reverse these menopausal symptoms. We have seen improvements in vaginal health and patients becoming much more comfortable, with a reduction in urinary tract infections and improvements in sexual health.
Laser vaginal rejuvenation treatment now forms part of our treatment plans for women with UTIs.
Research on UTI Vaccines
Our urology specialists were the first in the UK to research treating patients with a new sprayable under the tongue vaccine for UTIs, and are heavily involved in the international clinical trials for this treatment.
Research so far has shown that when used once a day for 3 months, this game-changing vaccine has prevented recurrent UTIs in up to 80% of patients who use it.
Working by stimulating and strengthening the body’s own immune system, it educates the patient’s immune cells to recognise and fight the bacteria. As a result, when the patient encounters the bacteria again, their immune cells can mount a rapid and strong response. This eliminates the infection before symptoms develop or antibiotics become necessary.
Currently UTI vaccines remain unlicensed in the UK and are administered by select specialist consultants on a named patient basis privately, or as part of clinical trials.
Lifestyle Changes
In addition to the above, there are a few simple steps you can take to avoid UTIs.
- Always wipe from the front to the back after using the bathroom. Do not try to reach from behind because germs from the rectum can be transferred to the hand and tissue. After bowel movements, clean the area around the anus gently, wiping from front to back. Never wipe twice with the same tissue.
- Take showers and avoid prolonged baths. Bath water may quickly become contaminated by the bather’s own natural bacteria. Sitting in a tub allows bacteria to reach the urethra and bladder. Rinse well and remember to wipe correctly from front to back. Douches have no proven benefit in preventing bladder infections.
- Use tampons for periods. Tampons are advised during the menstrual period rather than sanitary pads because they keep the entrance to the urethra drier, thereby limiting bacterial overgrowth.
- Avoid long intervals between urinating. Try to empty the bladder at least every 4 hours during the day while awake, even if the urge to go is absent. When feeling the need to empty the bladder, do not try to “hold it” until a more convenient time or place.
- Do not wear tight-fitting undergarments made of non-breathing materials as moisture can build up leading to bacterial over growth near the opening of the bladder. Cotton underwear for general use is suggested.
- Drink more water. Start with 1 extra glass with each meal. If the urine appears any darker than a very pale yellow, this means not enough liquid is being ingested; increase the fluid intake. Cranberry juice and cranberry pills have unproven benefit in reducing UTIs but may give some benefit, particularly in younger women.
- Empty the bladder frequently when engaging in physical activity and exercise, and drink plenty of water and other fluids. Take special precautions after sexual activity. The bladder should be emptied after intercourse; drink 2 extra glasses of water. Avoid the use of spermicidal jelly as this kills the normal vaginal bacteria which are extremely important in suppressing infection causing bacteria.
- After menopause an oestrogen vaginal cream may help increase resistance to bladder infections. The cream helps keep the tissues around the bladder healthy and more resistant to infection.
Expert Clinician-led Care for Cystitis
At The Urology Partnership our specialists are world renowned for their research into UTIs and have pioneered cutting edge diagnostics and treatments for this debilitating disease.
To book an appointment with one of our UTI specialists please call our clinic on 0118 920 7040.
Or make an appointment using the form below.
Next Steps
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Insured patients
Contact your GP and ask for a referral to the Urology Partnership.
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Self-funding initial consultation fee is £250. Follow up fees are £175.
Consultation charges are exclusive of any tests and other investigations that the consultant may wish to carry out.