Bladder infection (cystitis)

Bladder infection (cystitis) – every second woman knows the typical symptoms: burning during urination, pain in the lower abdomen during the toilet response and constant urination.

The mucous membrane (Urozystitis) or the entire wall (Pan Zystitis) of the urinary bladder is inflamed of cystitis. Physician are different depending on the course of the acute and the chronic (i.e. recurring) cystitis.

Together with Harnleitern, urethra and kidneys, the bladder is the so-called urinary tract, urethra and bladder the upper urinary tract comprising the lower urinary tract, urethra and kidneys. Therefore, the bladder infection, also known as cystitis, as well as the inflammation of the urethra (urethritis) is a lower urinary tract infection.

A bladder infection has its causes in an infection with bacteria. Especially the bacterium Escherichia coli nests is like in the urinary system one, moves into the bubble and there leads to inflammation. But also viruses, fungi and worms can stuck behind an infection of the urinary bladder.

Remain largely spared of cystitis. The reason: when the man the urethra is longer than for women, which penetrate and lead to inflammation of the organ pathogens cannot easily up into the bladder.

Because the most bladder infections caused by bacteria, usually antibiotics are the most effective means against a bladder infection: with their help it is possible to cure the inflammation quickly and effectively. It is also advisable to drink it adequately and to warm well. If is an impaired urinary flow behind the bladder infection, the treatment aims also to eliminate the cause (e.g., bladder stones or a prostate enlargement).

General: who drinks much, regularly goes to the toilet, warm attracts especially in the cold season and noticed certain hygiene rules, protects his bladder from pathogens and can largely prevent so of cystitis. Supporting acts the juice of the fruit of the cranberry. Because Cranberrys containing substances that can prevent the bacteria in the mucous membranes nest up and there cause a bladder infection.

Bladder infection (cystitis): Definition

A bladder infection (cystitis), also known as cystitis, is an inflammation of the mucous membrane (Urozystitis) or the entire wall (Pan Zystitis) of the urinary bladder. Such bladder infections can occur acutely or chronically always come back. Usually, a bladder infection is straightforward: by definition, an uncomplicated cystitis occurs when

  • the inflammation acute runs,
  • Function and Anatomy of urinary tract are normal,
  • the kidneys work undisturbed and
  • be not advantageous Comorbidities (like diabetes mellitus).

The so-called urinary tract consists of bladder, urethra, Harnleitern and kidney, and urethra and bladder the upper urinary tract be the lower urinary tract, urethra and kidneys. Therefore, the bladder infection as well as the inflammation of the urethra (urethritis) is a lower urinary tract infection.

The pathogens reach the bladder infection through the urethra into the bladder. Therefore, lower urinary tract infections typically only in the lower part of the urinary tract cause discomfort, pain during urination (dysuria), strong urination, frequent urination in small quantities or pain in the pelvic area.

The pathogens of the bladder infection go up but further from the bladder through the urethra, they can lead to a Nierenbeckenentzündung (so-called upper urinary tract infection) and in severe cases, trigger a blood poisoning (Urosepsis).


The bladder infection (cystitis) is one of the infections that most frequently lead to a visit to the doctor. With great frequency, it occurs in women: about 50 to 70 percent of women affected at least once in their lives from a bladder infection. In about 5 to 10 percent of cases, the bladder infections occur repeatedly. Bacteria in the urine (called bacteriuria) is found at about 5 percent of women of childbearing age.

The risk for a bladder infection is increasing in pregnancy, because the urine can flow through relatively slowly through the urinary tract. More dam to the urine, germs remain longer in the urinary bladder and increase the risk of infection. About 5 percent of pregnant women develop a cystitis.

A bladder infection is caused by bacteria is quite rare in men before the age of 50., because men have a longer urethra than women, so that pathogens can not easily penetrate up into the bladder. From the age of 50., the incidence of bacterial cystitis, but increasing in men. The reason: when the man over 50 prostate diseases emerge more frequently. This process usually increases the prostate and restrict the urethra. This hampered the outflow of urine, so that in addition to urine (Restharn) also more pathogens inside the bladder and urethra gather and can cause infections of the urinary tract.

Bladder infection (cystitis): Causes

Various pathogens as causes are eligible for a bladder infection (cystitis). The most bladder infections are due to infections with bacteria. In rare cases, viruses, fungi or worms cause an inflammation of the bladder. A chronic bladder infection can represent either a new infection or inflammation not yet fully healed, again blazing.


A bacterial bladder infection (cystitis) often has its causes in bacteria that come from the intestinal flora and ascend to the bladder through the urethra. This is mostly about the bacterium Escherichia coli: it is responsible for 80 percent of all infections of the urinary bladder by bacteria. But other bacteria can cause a bladder infection, Enterococcus, Proteus, staph.

The bladder infection caused by bacteria predominantly affects women.

This has two causes:

  • is the urethra is shorter than the man – and hence the way for the bacteria to the urinary bladder.
  • is the opening of the urethra, closer to the anus than at the man.

+The bacteria get usually via a so-called lubrication infection after or Chair in the urethra. Lubrication infections occur for example during sexual intercourse. This is the reason that sexually active women more often have a bacterial bladder infection. An acute bladder infection in women, who often have sexual intercourse, also known as honeymoon cystitis (honeymoon cystitis).

Viruses, fungi or worms

Rarely, arises a bladder infection (cystitis) not by bacteria, but has other causes – namely viruses, fungi or worms.

Possible non-bacterial trigger are for example:

  • Adenoviruses and poly Grandma: You are usually the cause of a bloody cystitis (hemorrhagic cystitis)
  • Candida albicans: this mushroom moved to especially in the Harnwegen of people whose immune system is weakened, or taking certain antibiotics.
  • A special form of chronic cystitis is the so-called granulomatous cystitis (Granuloma nodule). It is formed as a result of certain worm disease (schistosomiasis or bilharzia), which is widespread in the tropics and subtropics.
  • Risk factors

A bladder infection (cystitis) has its causes not alone in the respective pathogens – at their formation several risk factors play an important role that disrupt the flow of urine from the bladder and promote to bladder infections, because: when a disturbance of the urinary outflow of bacteria can cause easier a bladder infection, because the urine in these cases longer in the urinary bladder and the Harnleitern lingers. The pathogens have so more time to accumulate and trigger inflammation in the bladder.

An impaired urinary outflow can have different causes. The risk factors for urinary outflow disorder and thus for the emergence of a bladder infection include:

  • Constriction (stenosis) of the urethra
  • Foreign objects into the urethra
  • Bladder stones
  • Prostate in men:
  • congenital malformations in the Harnwegen
  • Swelling (tumor) of the urinary bladder and the urethra
  • Also, damage to the nerves can affect the function of the bladder emptying and as risk factors for the emergence of a bladder infection. Possible causes of nerve damage include paralysis or diabetes mellitus (diabetes).

Also includes the pregnancy, the risk factors for a bladder infection because: during Advanced pregnancy the urine to drain away often relatively slowly through the urinary tract. The result: The urine which impounds, germs stay longer in the urinary bladder and can more easily cause a bladder infection.

An increased risk for a bladder infection can have other causes than urinary outflow disorder.

Other risk factors for a bacterial bladder infection are:

  • Hypothermia (so-called cold foot Zystitis)
  • psychological influences
  • weakened immune system
  • Errors of the normal bacterial infection of derived urinary tract, for example through a catheters

+Some people remain largely spared by a bladder infection because certain hereditary factors protect against inflammation-inducing bacteria. They lack special docking stations (receptors) in the mucous membranes of the urinary tract. The bacteria need these receptors to trigger on a kind of adhesive mechanism in the mucous membranes and inflammation to arrive. Doctors call these special receptors as P blood group antigens. Missing this P blood group antigens, which is for the bacteria as they would try to establish a country without port with a ship.

Bladder infection (cystitis): Symptoms

The bladder infection (cystitis) is a so-called lower urinary tract infection – their symptoms typically confined to the lower part of the urinary tract. Common signs of an acute bladder infection are:

  • Burning during urination and the feeling to have to squeeze, against resistance
  • constant urination, with those affected at each toilet gear leave only small amounts of urine (so-called Pollakiuria), as well as
  • Pain in the area of dewlap, caused by the cramping contraction of the bladder during urination.
  • Sometimes blood is located at of acute cystitis in the urine (Hematuria). If the inflammation of the bladder over attacks on the kidneys or the prostate, can other symptoms such as fever and back pain or pain in the flanks is added next to the sign of cystitis.

Bladder infection (cystitis): Diagnosis

When a bladder infection (cystitis) are primarily based on the described symptoms and a urinalysis.

The cystitis is – as well as the urethra inflammation (urethritis) – a lower urinary tract infection: the bladder forms together with the urethra the lower urinary tract while ureter and kidneys make up the upper urinary tract. If the symptoms on the lower urinary tract are limited (e.g. pain during urination, strong urination, frequent urination in small quantities or pelvic pain) is the diagnosis to assume, that there is a lower urinary tract infection.

When the urine examination, a fishy smelling, purulent or bloody urine is already a clear indication on a bladder infection.

If the suspicion is true, the doctor for further diagnosis to determine the usually in urine:

  • white blood cells
  • Increased mucus
  • dead skin cell residue
  • sometimes red blood cells
  • most bacteria in the urine (called bacteriuria)

Also, as a result of chemotherapy, irradiation (so called radiogene cystitis) and a tuberculosis, a bladder infection can develop. In these cases, the search is not helpful however after bacteria in urine for the diagnosis because no bacteria in the urine found in the early stages of infection.

In addition to the urine examination, certain blood values can help to diagnose of a bladder infection. So, the number of white blood cells (leukocytes) is usually increased. In addition, you can demonstrate an increased rate of blood cells. This generally indicates an inflammation.

A bladder infection is continuing longer or it occurs repeatedly, a cystoscopy (cystoscopy) is suitable for further diagnosis to rule out other causes such as a may be malignant or benign tumor of the bladder. During mirroring, it is also possible to remove tissue samples and they study to run (so-called biopsy).

A bladder infection can arise as a result of a worm disease which is widespread in the tropics or subtropics (so called schistosomiasis). In the case, the diagnosis is made by a pathogen detection. The eggs of worms are only detectable five to twelve weeks after the infection in the urine.

Bladder infection (cystitis): Treatment

A bladder infection (cystitis) is usually straightforward. Then, the treatment mainly aims to alleviate the symptoms. What drugs and other measures it suited, depends on the specific cause.

What you can do

When a bladder infection (cystitis) a visit to the doctor is necessarily recommended, to set the appropriate therapy – but there is a lot you can do to support the treatment:

  • Drink much, even if hurts the urination by the bladder infection. Because who drinks much, flushes out the urinary tract and helps to free them from bacteria.
  • A warmers and sitz baths to relax and can relieve the symptoms of a bladder infection.
  • What the doctor can do

If you experience signs of a bladder infection (cystitis), a doctor in any case is recommended because: A successful therapy can some necessary make, only the doctor can do. If you rely solely on home remedies for a bladder infection and possibly carry off the infection due to the inadequate treatment, can the causal pathogens of the urinary bladder on the ureter continue to rise up and possibly a Nierenbeckenentzündung (so-called upper urinary tract infection) and one in severe cases cause blood poisoning (Urosepsis).

Effective means against an acute bladder infection are prescription antibiotics because they usually quickly and effectively eliminate the symptoms. Although the symptoms of cystitis disappear by itself in 25 to 42 percent even without antibiotics, the antibiotics cure rate but considerably increases and also fights the bacteria in the bladder infection – it comes after antibiotics treatment less frequently to new infections.

Which antibiotic you get administered against your bladder infection, depends on various factors – for example, whether you already a treatment with antibiotics made by whether you’re allergic to certain antibiotics or if you are pregnant. Wondering what agents for your bladder infection are responsible play an important role in the selection of the remedy for bladder infection: this is important to note that many pathogens against certain active substances can now defend – they are resistant or impervious. Therefore, appropriate drugs more are no help in the treatment of a bladder infection. So, for example, the commonly used antibiotics against the most common pathogens of cystitis – E. show coli – often no effect: ampicillin is used in 60 percent of cases ineffective, trimethoprim / sulfamethoxazole in 30 percent. And even the instead increasingly employed quinolones (Gyrasehemmer) are now useless in every 10. treatment against E. coli.

Often the combination of trimethoprim and sulfamethoxazole is against bladder infections. Apply as a drug of first choice for the short-term treatment of cystitis Fosfomycin Trometamol, nitrofurantoin and Pivmecillinam. However Pivmecillinam in Germany is not available – and nitrofurantoin is advisable only if effective and risky means against the bladder infection for you is not eligible. Fosfomicin Trometamol or a cephalosporin are suitable for the treatment of cystitis during pregnancy. Usually you need to take the tablets three to ten days. As long as your doctor prescribed it you if you tolerate it well, take the medication in any case. Otherwise, you should consider consulting with your doctor and consult.

A long-lasting (chronic) or you can also handle recurrent cystitis with antibiotics. The prescribed antibiotics are usually four to six weeks long to take. Some chronic bladder infection requires a treatment over an even longer period. In such cases, antibiotics are permanently used.

When a bladder infection often spasmodic pain during urination are very unpleasant. Usually antispasmodic painkillers (so called anticonvulsants) are well suited to relieve them. If the urinary outflow at you is disturbed, it is advisable to remove the causes for this. For example, an extension of the prostate behind your bladder infection, surgery can correct the flow noise of urine.

Bladder infection (cystitis): History

A bladder infection (cystitis) is usually a benign course: Rechtzeitig treated heals off within a few days. In 25 to 42 percent, the symptoms of uncomplicated acute cystitis disappear even by itself; However, a Antibiotik treatment can significantly increase the cure rate and at the same time eliminate the pathogens, so that there is less new infections.


A bladder infection (cystitis) can be connected to various complications later, although the bubble itself as well as other organs may be affected:

So, a bladder infection can cause complications, by ascend the causative bacteria from the bladder through the urethra to other organs: the bacteria to reach for example the kidneys, it can cause a Nierenbeckenentzündung there. These extremely by fever, chills and discomfort during urination. In addition, there may be pain in the kidney area. The risk that a bladder infection on the upper urinary tract spreads out, is only about two per cent but even without sufficiently effective treatment. In extremely rare cases with particularly serious during an acute renal failure may occur. A blood poisoning (sepsis) can also be the result of a bladder infection.

A uncomplicated bladder infection which spreads to other organs, cause also recurring course usually not serious complications. If that permanently continually occurs cystitis and concerns the whole wall of the bladder, this can damage the body with time: the tissues of the bladder can die off by the chronic cystitis (so called necrosis) and calcify or harden. Later, the bladder (so-called shrink bubble) decreases. Only in very severe cases, it is necessary to remove the bladder through an operation and then artificially to derive the urine.

Bladder infection (cystitis): Prevention

You can effectively prevent a bladder infection (cystitis) with a few and simple measures:

  • Drink much! Thus, you rinse well by their bladder and urinary tract and excrete bacteria. 1.5 To 2 liters per day are recommended.
  • Go in urgent need to urinate as soon as possible to the toilet.
  • Use no scented or disinfectant toiletries for your intimate care.
  • Especially in the cold season: dragging you to clothing, which warms you sufficiently. Belly-free should be taboo tops in winter.
  • Women are more prone to a bladder infection than men due to their shorter urethra – they can proactively therefore still note:
  • It is recommended to clean is always of the vagina to the anus after defecation. This prevents the harmful bacteria to enter into your urethra.
  • Go to any sexual intercourse as soon as possible to the toilet. Thus, they flush any germs from their urethra.
  • Especially after anal or oral sex, it is advisable to use condoms when switching to vaginal intercourse.
  • Certain contraceptives are not recommended for women who are prone to bladder infections. For example, diaphragms, and vaginal suppositories are unfavorable, while condoms protect better against the agents.
  • For women, where a cystitis chronic repeatedly occurs, following measures at its disposal are to prevent recurrence:
  • Supplement your diet with cranberry products, such as the urination, because: Cranberrys containing substances that can prevent bacteria in the mucous membranes of the urinary tract nest up and there trigger inflammation.
  • Under certain circumstances, your doctor may over time antibiotics enact (so-called permanent treatment) to prevent thus the repeated occurrence of a bladder infection. There is also the possibility to take antibiotics after intercourse. Ask your doctor for ways of antibiotic treatment to prevent chronic occurring bladder infections.
  • The cystitis often affects women in menopause. The possible cause is a lack of estrogen. Taking oestrogen can help here.

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