Cystitis (bladder infection) is rarely or never spoken about in men, but it is a problem that can affect men tooin which the infection may be a sign of another underlying problem: for example a prostatitis (prostate infection), an enlargement of the prostate gland (benign hypertrophy), an obstruction of the urinary tract, or kidney stones.
Neglected Symptoms
Statistics indicate that up to 50% of women Italians (that is, 15 million) are affected at least once in their life by urinary tract infections. In 4 out of 5 cases it is cystitis, an inflammation of the bladder almost always caused by bacteria present in the intestinal flora which, for various reasons, can cause damage to the urinary tract.
«Also about the 13-14% of men however, you will experience at least one urinary tract infection during your life, cystitis and nephritis (if it involves the kidneys) – explains Nicola Macchione, urologist and andrologist at the San Paolo Hospital in Milan -. Urinary tract infections are rare in adult men mainly due to the longer length of the male urethra (the channel that carries urine from the bladder to the outside) and the antibacterial properties of prostatic fluid that prevent the growth of bacteria. The incidence of the infection, however, increases with the passing of the years (especially after 60-65 years) and treatment is usually more demanding both because men tend to ignore the symptoms and to arrive at the diagnosis later, both because these are infections that are by definition “complicated” given that they usually also involve the prostate».
The causes (including alcohol consumption)
Beyond the numbers, the cystitis problem does not make any difference between sexes: symptoms, diagnostic tests, causes and therapies are substantially the same. Cystitis is generally of bacterial origin (the main responsible bacterium is Escherichia coli, a microorganism normally present in the intestine). «If the flow of urine remains partially blocked due to a calculation in the bladder or urethra, an enlarged prostate or a narrowing (stenosis) of the urethra, bacteria that enter the urinary tract are less likely to be eliminated with urine, the expert explains. Other triggers may be the use of urinary catheter for long periods of time; there radiotherapy at the pelvic level and the intake of chemotherapeutic drugs (especially cyclophosphamide and ifosfamide) in those who are taking a treatment for cancer. And again: diabetes, excessive alcohol consumption, poor or even excessive personal hygiene».
Symptoms and therapies
Fever, blood or pus in the urine, as well as cloudy, foul-smelling urine or pelvic pain occur rarely, mostly in severe cases.
The most frequent symptoms, in reality, are pain and burning during urination as well as frequency and urgency of urinationin the presence of which the doctor usually prescribes a urine test and urine culture with antibiogram.
«For therapies it is necessary to evaluate whether to prescribe a antibioticindicated if the disorder is of bacterial origin — says Macchione —. There is no single cure that is good for all cystitis, just as there is no universal antibiotic that works with all the different strains of Escherichia Coli. The treatment depends on the cause and must be followed scrupulously. Although antibiotics quickly eliminate bacteria from urine in the bladder, in fact, most are unable to penetrate the prostate enough to resolve the local infection. This is why if the drug therapy is interrupted early, the bacteria that survived at the bladder-prostate level could be the cause of a new infection, in addition to having perhaps developed resistance against the poorly performed therapy. When necessary, a painkiller can be added to calm the pain and reduce the inflammatory state.
The risks
No less important is the intake of much water to promote, through greater diuresis, the elimination of infecting bacteria, together with careful intimate hygiene andabstention from sexual intercourse until the infection has passed.
Many women who struggle with cystitis for weeks or months and opt (with poor results) for do-it-yourself therapies and report having had episodes of cystitis that have recurred over time. Too many male representatives, on the other hand, tend to ignore the warning signsexposing themselves to worse risks: «In the absence of timely and appropriate treatments, in male cystitis of bacterial origin, pathogens responsible for the infection can reach the kidneys and infect them in turn, giving rise to pyelonephritis which can permanently damage the kidneys if not treated adequately” concludes Macchione.
Prevention
A few simple good habits can help prevent cystitis or to alleviate its symptoms.
- First of all, it is necessary to follow a scrupulous hygiene of the genital area (especially after sexual intercourse)preferably with a neutral soap that does not alter the pH of the skin.
- You don’t have to hold your pee: not delaying bladder emptying helps prevent infections related to urine retention.
- Drink a lot and peeing (especially after intercourse) helps eliminate pathogenic microorganisms and reduces the risk of them multiplying.
- Another crucial point is the diet: it is advisable to follow one that does not include spicy foods, sausages, sweets and drinks that contain caffeine or alcohol. Everything that promotes inflammation and can irritate the bladder should be eliminated in the acute phase, starting with “stimulating” foods and drinks (containing theine, caffeine), spicy and alcoholic.
- Finally: correct nutrition, with many fibersfacilitates intestinal regularity, which is crucial because stool stasis can facilitate infections from germs.
A much more disabling form
There is a form of cystitis that is much more debilitating than that caused by bacterial infections: it is the interstitial cystitisa chronic and painful inflammation of the bladder wall, which mainly affects women (in a ratio of 5 to 1), but can also affect men. “Interstitial cystitis is not associated with a urinary infection and the diagnosis is usually confirmed with a cystoscopy,” explains Andrea Salonia, Professor of Urology at the Vita-Salute San Raffaele University in Milan. “It can have serious consequences on the quality of life, from work to social relationships, to sexuality. There are, however, effective treatment strategies: pharmacological treatment (which includes glycosaminoglycans to restore and strengthen the mucosal tissue of the bladder) and endoscopic treatment, with a bladder hydrodistension procedure, which in addition to having a diagnostic purpose can act on the nerve endings responsible for the pain.”
