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  2. 2. INTRODUCTION • Infection of urinary bladder is known as Cystitis. • It's usually caused by an infection in the bladder, but can also be caused by irritation or damage (from friction during sex). • It is more common in women. • A urinary tract infection (UTI) (also known as cystitis or bladder infection) is an infection that affects part of the urinary tract.
  3. 3. CAUSES • The most common cause of cystitis is a bacterial infection. If bacteria reach the bladder, they can multiply and irritate the bladder lining, causing the symptoms of cystitis. • Cystitis can also result from damage or irritation around the urethra. The urethra is the tube that carries urine from the bladder out of the body. In men, the urethral opening (where urine leaves the body) is at the tip of the penis. In women it's just below the clitoris.
  4. 4. BACTERIAL INFECTION • This happens when bacteria get into the bladder and multiply. It can happen if you don't empty your bladder properly. • Bacterial infection can also happen when bacteria from the anus are transferred to the urethra. This is more common in women than in men, as the urethra is closer to the anus in women than it is in men.
  5. 5. BACTERIAL INFECTION In women, transferring bacteria in this way can happen when you are: • Having sex • Wiping after going to the toilet (you're less likely to transfer bacteria in this way if you wipe from front to back) • Inserting a tampon • Using a diaphragm (a soft dome made of latex or silicone) for contraception
  6. 6. BACTERIAL INFECTION • In women who have had, or are going through, the menopause, the lining of the urethra and the bladder become thinner. This is due to a lack of the hormone oestrogen. The thin lining is more likely to become infected or damaged. Women also produce fewer vaginal secretions after the menopause, which means that bacteria are more likely to multiply.
  7. 7. DAMAGE OR IRRITATION Cystitis can also be caused by damage or irritation in the area around the urethra in both men and women. This could be the result of: • Wearing tight clothing • Chemical irritants – for example, in perfumed soap or talcum powder • Other bladder or kidney problems, such as a kidney infection or prostatitis
  8. 8. DAMAGE OR IRRITATION • Diabetes (a long-term condition caused by too much glucose in the blood) • Damage caused by a catheter (a tube inserted into the urethra to allow urine to flow into a drainage bag, which is often used after surgery)
  9. 9. SYMPTOMS Children and adults can get cystitis, and the symptoms can be different.
  10. 10. SYMPTOMS Symptoms in men and women: • Cystitis in men and women can cause: • pain, burning or stinging when you urinate • needing to urinate often and urgently but passing only small amounts of urine • urine that's dark, cloudy or strong smelling. • urine that contains traces of blood (haematuria) • pain low in your belly (directly above the pubic bone), or in the lower back or abdomen • feeling unwell, weak or feverish
  11. 11. SYMPTOMS Symptoms in children • Symptoms of cystitis in children may include: • weakness • irritability • reduced appetite • vomiting • pain when urinating • Cystitis is usually treated easily. Find out more about treating cystitis.
  12. 12. SYMPTOMS The symptoms caused by cystitis could also be caused by: • sexually transmitted infections (STIs), such as gonorrhoea or chlamydia • being infected with bacterium such as E-coli • vaginal thrush, also known as candida (a yeast infection) • inflammation of the urethra (urethritis) • urethral syndrome (women only)
  13. 13. SYMPTOMS • inflammation of the prostate gland, also known as prostatitis (men only)
  14. 14. PATHOGENESIS • The bacteria that cause urinary tract infections typically enter the bladder via the urethra. However, infection may also occur via the blood or lymph. It is believed that the bacteria are usually transmitted to the urethra from the bowel, with females at greater risk due to their anatomy. After gaining entry to the bladder, E. Coli are able to attach to the bladder wall and form a biofilm that resists the body's immune response.
  15. 15. PATHOGENESIS • It is the most frequent bacterial infection in women. • They occur most frequently between the ages of 16 and 35 years, with 10% of women getting an infection yearly and 60% having an infection at some point in their lives. • Recurrences are common, with nearly half of people getting a second infection within a year. Urinary tract infections occur four times more frequently in females than males.
  16. 16. PATHOGENESIS • Pyelonephritis occurs between 20–30 times less frequently . They are the most common cause of hospital acquired infections accounting for approximately 40%. Rates of asymptomatic bacteria in the urine increase with age from two to seven percent in women of child bearing age to as high as 50% in elderly women in care homes. Rates of asymptomatic bacteria in the urine among men over 75 are between 7-10%.
  17. 17. PATHOGENESIS • Urinary tract infections may affect 10% of people during childhood. Among children urinary tract infections are the most common in uncircumcised males less than three months of age, followed by females less than one year. Estimates of frequency among children however vary widely. In a group of children with a fever, ranging in age between birth and two years, two to 20% were diagnosed with a UTI.
  18. 18. PATHOGENESIS • The symptoms of cystitis usually clear up without treatment within 4-9 days. There are some self-help treatments that can ease the discomfort of any symptoms.
  19. 19. Self-help treatments Over-the-counter (OTC) painkillers, such as paracetamol or ibuprofen. These can reduce pain and discomfort. Always read the label and check with your pharmacist first, particularly if you have any other medical condition, you are taking other medicines, or you're pregnant or breastfeeding. Drinking plenty of water is often recommended as a treatment for cystitis. There's no evidence that this is helpful, although drinking around 1.2 liters (6-8 glasses) of water a day is generally good for your health. Also avoid alcohol.
  20. 20. Self-help treatments Don't have sex until your cystitis has cleared up because having sex can make it worse. • Some people find that using urine alkanising agents, such as sodium bicarbonate or potassium citrate, for a short period of time may help to relieve pain when urinating. However, there is currently a lack of clinical evidence for their effectiveness.
  21. 21. Antibiotics • This will usually involve taking a tablet 2-4 times a day, for three days.
  22. 22. PREVENTION It's not always possible to prevent cystitis, but you can take some steps to help avoid the condition: • don't use perfumed bubble bath, soap, or talcum powder around your genitals - use plain, unperfumed varieties • have a shower, rather than a bath, to avoid exposing your genitals to the chemicals in your cleaning products for too long
  23. 23. PREVENTION • always empty your bladder fully when you go to the toilet • don't wait to go if you need to urinate: delaying it can place extra stress on your bladder and could make it more vulnerable to infection • wear underwear made from cotton rather than synthetic material such as nylon • avoid wearing tight jeans and trousers
  24. 24. PREVENTION • always wipe from the front of your genital area to the back, not back to front, when you go to the toilet • some people find certain types of food and drink make their cystitis worse: for example, coffee, fruit juice or spicy foods. If there is anything that triggers your cystitis, you may wish to avoid it
  25. 25. NURSING MANAGEMENT TO REDUCE PAIN: • Monitor urine color changes, monitor the voiding pattern, input and output every 8 hours and monitor the results of urinalysis repeated. • Perineal care. • Catheter treatment 2 times per day.
  26. 26. Impaired Urinary Elimination • Assess the patient's pattern of elimination. • Encourage the patient to drink as much as possible and reduce drinking in the afternoon. • Encourage the patient to urinate every 2-3 hours and when it suddenly felt.
  27. 27. Disturbed Sleep Pattern • Provide a comfortable bed. • Increase comfort bedtime regimen, for example, a warm bath and a massage, a glass of warm milk. • Reduce noise and light.