Patient's question:
Does her frequent urination and urgency indicate urethritis? Is there any relation to the kidneys?Doctor's answer:
Overview Cystitis is a common disease, more prevalent in women. Clinically, it is classified as acute or chronic, non-specific cystitis, and gonococcal cystitis. The latter two have similar clinical manifestations and must be differentiated based on medical history and bacteriological tests. This section focuses only on non-specific cystitis. The main pathogens of non-specific cystitis are Escherichia coli, Streptococcus, and Staphylococcus, often involving mixed infections.Clinical manifestations
1. Acute cystitis In male patients, the main symptom is excessive urethral discharge, initially mucoid and gradually becoming purulent. In female patients, urethral discharge is less common.
2. Burning pain during urination, urinary frequency and urgency, making urination difficult.
3. Chronic cystitis Urethral discharge decreases, with only itching or crawling sensation. Urinary irritation is less pronounced than in the acute phase, and some patients may be asymptomatic.
Diagnostic criteria
1. Urethral irritation symptoms;
2. Swollen and red urethral orifice with purulent discharge, with tenderness along the urethra;
3. Numerous red blood cells and white blood cells in urine, with abnormal results in the first cup of the three-cup test;
4. Urethral discharge smear staining or bacterial culture identifies pathogens, allowing differentiation from gonococcal cystitis.
Treatment principles
1. Drink plenty of water to increase urine volume, flushing out urethral discharge during urination;
2. Use sedative and analgesic drugs to relieve pain;
3. Rest, avoiding sexual activity in the acute phase for a short period;
4. Antibiotic treatment. Select effective antibiotics based on bacterial culture and drug sensitivity tests;
5. For chronic cystitis or urethral stenosis, in addition to medication, urethral dilation should be performed.
Principles of medication
1. Use broad-spectrum, effective antibiotics;
2. Select effective antibiotics based on clinical presentation, urethral discharge bacterial culture, and drug sensitivity tests (including new and special drugs).
Auxiliary tests
1. For acute cystitis, the examination protocol primarily focuses on Box A;
2. For chronic cystitis, the examination protocol includes Boxes A, B, and C.
Evaluation of efficacy
1. Cured: Symptoms and signs disappear, urination is unobstructed, and urinalysis is normal.
2. Improved: Symptoms and signs improve, urethral discharge significantly decreases, and urinalysis shows a small number of red blood cells and white blood cells.
3. Unresolved: Symptoms and signs do not improve, with swollen and red urethral orifice, discharge, and positive bacterial culture.