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Cystitis and Urethritis

Inflammation of the bladder and urethra, called cystitis and urethritis respectively, is usually caused by bacterial infection. The bacteria involved are often normally harmless residents of the rectum, colon and vagina which for some reason invade the urinary tract and cause infection and inflammation. Sometimes the cause can be traced to an abnormality of the urinary system, in which case surgery will often cure the problem.

Cystitis and urethritis are more common in women, usually during the sexually active years, because the shortness of the female urethra and its close relationship to the vagina makes it highly accessible to bacteria. Urethritis can result if the urethra is bruised during sexual intercourse, when symptoms are caused by mechanical irritation rather than infection. Because symptoms are so similar to those of cystitis and are common in women who have just started having intercourse, it is sometimes called 'honeymoon cystitis'. Gynaecological conditions such as infected erosion of the cervix may also cause urethritis by affecting the types of organisms found in the vagina. Contraceptives and some tampons have also been thought to cause cystitis and urethritis because they change the environment in the vagina, encouraging the growth of certain strains of bacteria that may then invade the urinary system.

Cystitis and urethritis in men most often occur as a result of either obstruction to the urethra by the prostate or an infection of the prostate spreading to the bladder and urethra. Certain venereal diseases such as gonorrhoea, can cause urethritis in both sexes. There may be a wide variety of other unidentifiable causes.

Symptoms

The symptoms of both conditions are similar: frequent passing of urine with intense, scalding pain. There may be pain in the lower abdomen and a frequent, urgent, desire to pass urine which, in the event, is only a small amount.

Treatment

Isolation and identification of the bacteria causing the infection are an important part of the diagnosis, and analysis of a urine sample obtained under sterile conditions is essential. Antibiotics effective against the specific organism identified as the cause of the infection will cure it in most cases. Unfortunately, some people, particularly women, have recurring infections which are resistant to treatment.

There are several simple measures which can be taken to reduce the risk of repeated attacks. First is attention to hygiene - particularly in washing around the urethra, vagina and anus after defaecating or sexual intercourse. Wearing loose-fitting, cotton underwear may also help, and nylon tights and tight jeans are best avoided. It is advisable to cut down on drinks such as coffee which tend to concentrate the urine and to drink plenty of water instead. If bouts of cystitis appear to be linked with sexual intercourse it may be worth using a lubricant such as KY jelly to minimize possible bruising.

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