Dr. Kremena Petkova, MD: Sexual activity increases the risk of cystitis

Dr. Kremena Petkova, MD: Sexual activity increases the risk of cystitis
Dr. Kremena Petkova, MD: Sexual activity increases the risk of cystitis

Cystitis likes to surprise and often occurs suddenly. The disease loves women, and history shows that every woman will have at least one case of cystitis in her life.

What is cystitis, what are the causes of its occurrence and how to protect ourselves from the disease, we are talking to Dr. Kremena Petkova, the chief assistant in the Department of Urology and Nephrology of the Academy of Medical Sciences.

In 2014, he defended his dissertation on "Endoscopic combined intrarenal surgery in the treatment of complicated forms of urolithiasis" and obtained an educational and scientific doctorate. In 2015, she acquired a speci alty in urology and was appointed as the main assistant in the department.

Her research interests are in the field of endourology and minimally invasive treatment of urolithiasis.

What is cystitis, Dr. Petkova?

- Cystitis is an inflammation of the bladder, most often caused by a bacterial infection.


Statistics show that every woman has at least one case of cystitis in her life. But there are also ladies for whom the disease is chronic. What types of cystitis are there?

- Acute uncomplicated cystitis is an acute bacterial inflammation of the lower urinary tract occurring in premenopausal women without anatomical or functional damage to the urinary tract and without accompanying diseases.

Recurrent cystitis is a chronic inflammation of the bladder, manifested by three episodes of cystitis in a year or at least two episodes in a six-month period. There is also the so-called interstitial cystitis, which is chronic inflammation and pain in the bladder area without the presence of infection.

What are the causes of this inflammation of the lower urinary tract and who are the risk groups?

- Women are more often affected due to the anatomically shorter length of the urethra, which makes it easier for bacteria to enter the bladder. 80% of uncomplicated urinary tract infections are caused by bacteria of the Escherichia coli species that live in the gastrointestinal tract.

Risk factors for lower urinary tract infections include abnormalities and diseases of the urinary tract, urological interventions, diabetes mellitus, previous uroinfections, atrophic vaginitis in postmenopausal women.

Sexual activity and having a new sexual partner also increase the risk of acute uncomplicated cystitis in premenopausal women. Poor hygiene and staying in contaminated water pools also increase the likelihood of bacteria entering the urinary tract.

What are the symptoms of cystitis?

- The main symptoms of acute cystitis are frequent and painful urination, pain in the lower abdomen, cloudy urine, and sometimes hematuria (blood in the urine).

Can it go away with self-treatment or should I definitely see a doctor? How is cystitis treated?

- The diagnosis and treatment of cystitis is based on the examination of urine - chemical analysis and sediment, microbiological examination of urine with the determination of the sensitivity of the microorganism to antibiotics.

It is extremely important that patients consult a specialist, especially in cases of recurrent uroinfections, as they may be a symptom of other serious accompanying diseases. It should be emphasized that serious urological diseases such as bladder cancer can also manifest with cystitis symptoms.

The main goals of treatment are control of symptoms, selection of an appropriate antibiotic with optimal dosage and duration of therapy, as well as prevention of relapses.

Self-treatment with antibiotics is not recommended as it is a condition for creating antibiotic resistance of bacteria. It can also cause adverse drug reactions.

In addition, the choice of an antibacterial agent unsuitable for the specific microorganism can lead to the penetration of the infection into the upper urinary tract and the appearance of complications.

What are the complications of cystitis when not treated properly?

- When not treated properly, it can lead to an acute infection of the upper urinary tract - acute pyelonephritis. This disease can be complicated by the formation of a kidney abscess and a septic condition (blood infection), which threatens the patient's life.

Recurrent uroinfections are sometimes a symptom of other diseases affecting the excretory system, such as congenital anomalies, kidney stones, but also of diseases outside the excretory system, such as diabetes mellitus.

Frequent uroinfections affecting the upper urinary tract lead to damage to the renal parenchyma and deterioration of renal function, especially in patients with risk factors and accompanying diseases.

What is the prevention of cystitis?

- General preventive measures include increased fluid intake, avoiding long periods of retention of urine in the bladder, cleaning the urogenital area from front to back, urinating immediately after sexual intercourse. Dietary supplements containing plant extracts have a supporting role in the treatment of cystitis and prevention of relapses.

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