Effective treatments for cystitis in women

Due to the anatomical features of the genitourinary system, cystitis is more common in women than in men. In most cases, the cause of cystitis is an infection caused by bacteria, viruses, fungi, or protozoa. Non-infectious cystitis also occurs (allergic, radiation, traumatic, etc.). In addition, cystitis can be primary and secondary, acute and chronic, and therefore it is treated differently. Effective treatment can only be prescribed by a doctor who should be contacted immediately after the onset of characteristic symptoms:

• pain/burning when urinating;
• pain in the lower abdomen / in the pelvic area;
• feeling of incomplete emptying of the bladder;
• frequent and strong urge to go to the toilet.

Treatment of cystitis is always strictly individual. Due to an incorrectly selected drug or dosage, therapy may be ineffective or lead to unpleasant consequences. For example, cystitis from an acute form can become chronic. And this is fraught with constant relapses and complications – pyelonephritis, uncontrolled urination, etc.¹

Most often, the doctor prescribes a complex treatment of cystitis, taking into account the results of the tests, the characteristics of the course of the disease, as well as the reaction to drugs. Comprehensive treatment includes:

1.  Taking medications, vitamins;
2. Diet (spicy, salty, alcohol is prohibited);
3. Proper implementation of hygiene procedures;
4. Taking painkillers (if necessary);
5. Physiotherapy treatment (not in the acute stage of the disease). 

Sometimes in the treatment of cystitis it is necessary to use surgical methods and other manipulations.

Medicines for cystitis in women

Uroseptics or uroantiseptics are the main group of drugs for the treatment of cystitis. These are medicines with antimicrobial and antiseptic action that destroy the causative agent of the disease, reduce the number of relapses, the risk of complications, and prevent the spread of inflammation in the body.

Uroseptics include:

1. antibiotics;
2. antibacterial drugs from the group of nitrofurans;
3. herbal preparations with antiseptic, antimicrobial and anti-inflammatory action.

In addition to uroseptics, antifungal drugs (for fungal cystitis or to prevent the onset of a fungal infection) and antiviral drugs (if the virus that caused cystitis could be identified) can be prescribed for treatment.

herbal medicines

Herbal uroseptics are effectively and safely combined with synthetic drugs, they can also be taken by pregnant women.

• “Canephron”. As part of this preparation, an extract of rosemary leaves, herbs of centaury ordinary and lovage officinalis. It is an antiseptic, anti-inflammatory, and antispasmodic. “Canephron” is used in the complex treatment of chronic cystitis. 
• “Cyston”. Another well-known drug, consisting of a dozen natural ingredients, including mummy powder. It acts as an analgesic, anti-inflammatory, antispasmodic, antimicrobial and diuretic effect.
• “Uriflorin”. The preparation based on bearberry leaves has anti-inflammatory, antimicrobial and diuretic effects.
• “Urolesan”. Contains extracts of oregano, carrot seeds, hop cones, peppermint and fir oils. It has a diuretic and antispasmodic effect.
• “Phytolysin”. It is an extract from a mixture of couch grass and lovage roots, birch leaves, fenugreek seeds, other medicinal plants, combined with orange, sage, pine and peppermint oils. A diuretic drug that also helps relieve spasm and inflammation.

Antibiotics

Cystitis caused by a bacterial infection is treated with antibiotics. At the same time, there are a lot of antibacterial drugs, and only a doctor should choose them.

What antibiotics are most often used to treat cystitis:

1. Phosphanic acid derivatives. The most famous substance from this group, fosfomycin, is the basis of the modern drug Monural. It is prescribed for acute or recurrent chronic form of the disease.².
2. Penicillins: Amoxiclav, Augmentin, etc. Broad-spectrum antibiotics. Due to their active use in the treatment of other diseases, there is a risk of developing resistance (resistance to antibiotics).
3. Cephalosporins: Ceftriaxone, Cedex, Suprax, Cefotaxime, etc. More often used in injectable forms. There is a low toxicity of these drugs with their high efficiency. 
4. Fluoroquinolones: Levofloxacin, Flexid, Ofloks, etc. They can cure cystitis in a short time, but they are rarely prescribed because of their side effects.

Synthetic drugs

Synthetic drugs include nitrofuran derivatives: Furamag, Furasol, Furagin. These are synthetic antibacterial drugs that are widely used in the treatment of infectious diseases of the urinary tract. Unlike antibiotics, they practically do not develop drug resistance. Nitrofuran derivatives are used for uncomplicated infections and prevent the transition of acute cystitis to a chronic form.

It’s important

If the cause of cystitis is a virus or fungus, then it cannot be treated with antibiotics. Treatment will not only not give an effect, but also adversely affect the microflora.

Antifungal means

These drugs are prescribed if the fungal nature of cystitis is confirmed. Or for the prevention of candidiasis, which sometimes occurs after antibiotic treatment. With cystitis in such cases, Fluconazole, Diflucan, Levorin, etc. are used.

Painkillers

If cystitis is accompanied by severe pain, they can be reduced with the help of non-steroidal anti-inflammatory drugs (Indomethacin, Ibuprofen, Nimesil) and antispasmodics (Drotaverine, No-shpa, Papaverine).

Like any medication, painkillers have side effects and contraindications. Therefore, their uncontrolled intake can lead to exacerbation of gastrointestinal diseases, disorders in the cardiovascular system, kidney disease, etc.

Vaccination

Vaccination is indicated for women with chronic cystitis, which appears again and again. For immunoprophylaxis, the drug “Uro-Vaxom” is used. It can be prescribed both during an exacerbation of cystitis along with antibiotics and antiseptics, and during remission. But this is not a vaccine in the usual sense of the word, but a drug in tablets, which is taken as prescribed by a doctor.

Surgery for cystitis in women

If conservative treatment of cystitis does not bring the desired effect, the doctor may recommend surgical methods.

For example, if relapses of cystitis in women occur after sexual intercourse (this happens if the external opening of the urethra is located very close to the vagina), then with the help of an operation it is possible to transfer the final section of the urethra above the entrance to the vagina. This reduces the risk of infection³.

With ulcerative forms of cystitis, it is sometimes necessary to surgically remove part of the mucous membrane of the bladder. The altered area is removed by laser ablation, electrocoagulation or resection.

Instillation

To increase the effectiveness of treatment, instillations are carried out (translated from Latin as “infusion drop by drop”) of the bladder. During the procedure, special medicinal solutions are introduced into the bladder through a thin catheter to restore its mucous membrane, enhance the antibacterial and anti-inflammatory effect of therapy. This method allows you to deliver drugs directly to the pathological focus.

Intravesical instillation is more often used for chronic sluggish cystitis, which affects the tissues and mucous membranes of the bladder.

Physiotherapy

Physiotherapeutic procedures are prescribed only for the chronic course of cystitis, in the acute stage they are contraindicated. 

• Magnetotherapy – to accelerate the destruction of bacteria and viruses.
• Electrophoresis – enhances the penetration of active substances of drugs, relieves inflammation.
• EHF – exposure to an electromagnetic field reduces inflammation, helps fight viruses and bacteria.

Popular questions and answers

How to quickly get rid of the symptoms of cystitis, are alternative methods of treatment effective and answered other popular questions Mikhail Kutushev, a toxicologist.

Sources of:

1. Clinical recommendations “Cystitis in women”. Russian Society of Urologists. M., 2021. http://disuria.ru/_ld/10/1014_kr21N30mz.pdf
2. Acute cystitis: etiology, clinic, treatment. Yu. G. Alyaev, Doctor of Medical Sciences, Professor, A. Z. Vinarov, Doctor of Medical Sciences, V. B. Voskoboinikov, Ph.D. I. M. Sechenov, Moscow. https://www.lvrach.ru/2002/04/4529367
3. Recurrent cystitis after intercourse: why the gynecologist has a say. Alessandra Graziottin, Italy. https://www.alessandragraziottin.it/ew/ew_voceall/36/2668%20-%20recurrent%20cystitis%20after%20intercourse.pdf