Cystitis is an inflammation of the lower urinary tract, which can affect both men and women. We know this pathology better and how it is treated, thanks to the help of Dr. Massimo Lazzeri, urologist at Humanitas.

Cystitis is usually diagnosed through the symptoms the patient reports. Characteristic symptoms of this condition are: increased urinary frequency, pain when urinating, supra pubic discomfort, sense of clutter and weight; there may also be the presence of blood in the urine. The first symptoms of cystitis should be referred to your doctor, who will prescribe the most appropriate examinations and, where necessary, refer the patient to the reference specialist, if the clinical situation leaves you in doubt.

Some forms of cystitis are of modest intensity and occur with increased urinary frequency and burning; there is a more intense form, associated with blood in the urine, which is called hematuria. In this case, the urethral pain during urination is very severe.


How is cystitis treated?

Following two different but complementary paths cures cystitis. First of all, it is good to increase your liquid intake, thus drinking a lot of liquids, and then it is good to take supplements, blueberry above all others.

Numerous evidence from the scientific literature shows that the main property of blueberries is to inhibit the adhesion of bacteria to the bladder mucosa. The infection occurs at the moment when the germs nourish and proliferate, adhering to the bladder mucosa, thus generating cystitis.


When do I need antibiotics?

Unfortunately, the use of antibiotics has become widespread as soon as symptoms of cystitis occur, but we must remember that this therapy should only be used in the presence of a bacterial infection.

The inappropriate use of antibiotics can be a long-term problem as real colonies of antibiotic-resistant germs and bacteria can develop. Furthermore, the spread of antibiotic-resistant germs and bacteria represents, in the medium to long term, a real danger to public health.


The use of D-mannose

The inner wall of the bladder plays a role of impermeability: in fact, it prevents the liquid present in the bladder (containing toxic substances that must be eliminated from the body) to exude. In order to prevent exudation, there are structures that are mainly based on sugars (in very general terms) that protect against the absorption of toxic substances and, at the same time, prevent the adhesion of germs to the bladder mucosa. The use of D-Mannose allows to reconstruct the integrity of the bladder mucosa, that is to say to re-establish, so to speak, a good “enameling” of the inside of the bladder, representing a valid prevention of the recurrence of bacterial infections.

We find it in the form of a supplement and in various formulations. The problem with D-Mannose is mainly related to dosage. Very often, quite high doses have to be taken and, therefore, the therapy requires multiple doses throughout the day. This can be an obstacle to the completion of the treatment or the maintenance of prophylaxis, precisely because of the patient’s difficulty in following the prescribed dosage daily with commitment and constancy.


Can hyaluronic acid be used to treat cystitis?

Hyaluronic acid is the latest addition to non-antibiotic prophylaxis devices. Today it is one of the devices on which there is greater attention from the literature and the scientific community. The use of hyaluronic acid can be done either intravesically – and therefore, compared to other devices such as blueberry and D-Mannose; it is brought through an instillation directly in contact with the bladder – or orally.

Confirming the importance of hyaluronic acid today, scientific work was recently published in the British Medical Journal, which showed that one year later, the prevention of infectious recurrences was better where only hyaluronic acid had been used. It has been shown that antibiotic therapy, over time, led to the emergence of resistant bacterial strains.