When the Bladder Inflames ...
A urinary tract infection (UTI) is an infection that affects the urinary tract – ureter, urinary bladder, urethra. It is the most common bacterial infection. Women are significantly more affected than men.
If just the urinary bladder is affected, it is referred to as bladder infection (cystitis). In urethral inflammation (urethritis), the anterior portions of the urethra are inflamed. If the renal pelvis and the renal connective tissue are attacked by bacteria, this is known as renal cell inflammation (pyelonephritis).
The following symptoms usually occur during urinary bladder infections:
- general malaise (as with flu)
- fever, chills
- pain and burning sensation when urinating
- frequent urge to urinate with only small amounts of urine
- difficulty emptying bladder
- blood in the urine
- genital pain
If a urinary bladder infection advances to pyelonephritis, symptoms will include high fever, pain in the kidneys, and a severe feeling of illness. In addition, a sufficient high level of bacteria can be detected in the urine. 5% of all women have asymptomatic bacteriuria, which means that bacteria can be detected in the urine but the cells are not inflamed. Additionally there are no symptoms.
Any bladder infection must be treated quickly and thoroughly, as otherwise there is the risk of an infection of the kidneys. Therefore, please contact your treating physician if symptoms occur.
For simple bladder infections, a short course of antibiotics will usually suffice. In severe cases, e.g. with diabetics or if the renal pelvis is involved, a longer course is necessary. Treatment is further supported by a sufficient daily intake of fluids per day and warmth.
For more frequent bladder infections, further urological examinations are recommended. For example, prostate enlargement in men, frequent sexual contact, oestrogen deficiency in menopausal women, or even insufficient bladder emptying due to weak or paralysed pelvic muscles can lead to recurring urinary tract infections.
Chronic, Non-bacterial Cystitis
Chronic Interstitial Cystitis
So-called interstitial cystitis (IC) is a special type of cystitis. It is not caused by bacteria or viruses, but instead it is believed to be caused by autoimmune processes, vascular occlusions, hormonal or psychogenic factors. It affects mainly women from the age of 40. Many have a long history of suffering behind them before they are properly diagnosed.
Interstitial cystitis manifests itself as severe pain in the bladder and lower abdominal region and a very frequent urge to urinate that cannot be supressed. Patients often need to go to the toilet up to 60 times a day. The functional urinary bladder volume is considerably reduced, i.e. the amount of urine that can be held is significantly lower than in a healthy bladder. Rheumatoid joint pain, migraine headaches, allergies and/or stomach or bowel problems often occur at the same time.
Diagnosis of Interstitial Cystitis
A cystoscopy shows that it is not the bladder mucosa that is chronically inflamed but rather the deeper interstices in the bladder wall. This results in scarred changes in the bladder wall, which in turn reduce the bladder capacity.
Interstitial cystitis is diagnosed via a process of exclusion using the clinical symptoms, the results of the cystoscopy and the micturition diary. First, however, diseases with similar symptoms must be excluded. These include, for example, benign and malignant bladder tumours, ureteral stones, bacterial infections, bladder tuberculosis as well as prostate inflammation (prostatitis) in men).
Treatment of Interstitial Cystitis (IC)
IC is mainly treated with drugs that concern the defects in the mucous membrane of the bladder with the aim of promoting regeneration of this important protective layer.
With the so-called »EMDA®«* method (electromotive drug administration), drugs can be targeted deeply at the damaged bladder tissue and take immediate effect there.
Identify and Avoid the Risk of Infection
Each bladder catheterisation presents a risk of urinary tract infection, and this risk is particularly high with indwelling catheters. Infections can originate from various risk areas:
- By the patient: Infections frequently come from bacteria filled areas such as the perineal region, the genital region and the lower abdomen (pubic hair). The risk of infection is increased by factors such as manipulation of the drainage system, obstruction of the urinary tract, inadequate diuresis, immunosuppression, diabetes mellitus, immobility, age and faecal incontinence.
- By nursing staff: Insufficient training level is often the cause of improper manipulation of the catheter and the urinary diversion system. Infections can also be caused by a lack of basic care of the patient and the catheter.
- By catheter material: This should be biostable and biocompatible like the 100% medical silicone catheter material from UROMED.
The indication for catheterisation of the urinary bladder is always made by the treating physician. Nurses must be familiar with aseptic and antiseptic techniques and requirements, as well as catheter hygiene. Regular training courses, including the identification of catheter-associated complications and practical training, are essential.
The prevention of infections in the urogenital area of catheterised patients is therefore one of the most important tasks for nurses. Aseptic conditions when inserting, maintaining and changing the catheter are essential for avoiding the infiltration of pathogenic bacteria.
It is the responsibility of the nursing staff to reduce the risk of infection to a minimum by following recognised guidelines. We recommend the guidelines of the Working Group of Scientific Medical Societies (AWMF).
Another important factor is the quality of the aids used. Our silicone catheters are bio-compatible, comfortable to wear thanks to their shape and consistency, and are economical due to their long-term use. In our opinion they are the only alternative to conventional latex catheters, which involve problems such as migration, incrustation and allergic reactions.
* Only available in Germany and Switzerland