Sudden urgency, frequent urination, dysuria, hematuria… Please keep this medication guide away

As an obstetrician and gynecologist, I often receive various urgent calls for help, and the most frequent one is receiving this message in the middle of the night:

HELP—SOS

Help! After doing homework with my husband at night, after waking up, I squatted on the toilet and couldn’t get up. After urinating, I wanted to urinate. Every time I urinated a few drops. Now I can’t go to the hospital even if I want to. Is there any first aid?

I usually tell her half-jokingly that frequent urination, urgency, dysuria, incomplete urination, blood in the urine after sex is a typical “honeymoon cystitis, the symptoms are typical, you can report without coming to the hospital, you need to take this medicine~

What is honeymoon cystitis?

Honeymoon cystitis is actually acute cystitis, because it is more common in women who have frequent sex during the honeymoon period, so this non-academic but very vivid Name – “Honeymoon Cystitis”.

Although it is induced by sexual intercourse, the incidence of women is significantly higher than that of men, because women’s urethra is short and adjacent to the vagina and anus (normal In this case, the female vagina and anus are bacteria), which are easily invaded by surrounding bacteria. Coupled with frequent “poker sports”, the “resident bacteria” that originally existed in the female urethra and male genitals are “squeezed” into the body. bladder.

If not urinating in time, bacteria stay in the bladder for a long time, where they can multiply and cause cystitis.

What are the symptoms of honeymoon cystitis?

Cystitis can occur a few hours after sexual intercourse, manifested as frequent urination, urgency, dysuria and lower abdominal pain, often cloudy and odorous urine, 30% patients may have hematuria.

Generally asymptomatic, normal or low-grade fever. If you have these symptoms or signs after sexual intercourse, you should be careful, you may have acute cystitis!

At this point, some women wonder…

I clearly don’t have “exercise”,

How can I have symptoms of cystitis?

Sex is a risk factor, but not the only one.

For example, older women, due to the atrophy of the vaginal mucosa after menopause, the urethra is pulled and the urethral mucosa is exposed, so that the urethral closure is reduced, and the The occurrence of senile vaginitis makes the bacteria in the vagina spread up along the “open” urethra, and it is easy to induce the occurrence of acute cystitis.

Also, women with immunodeficiency diseases, diabetes, and pregnant women are also susceptible to acute cystitis.

Suspected acute cystitis,

How is it diagnosed?

Acute cystitis should be suspected in women with acute urinary symptoms, i.e., frequent urination, urgency, dysuria, and/or suprapubic pain, because among these symptoms Either way, the probability of cystitis is greater than 50%.

And for women with dysuria and frequent urination without abnormal vaginal discharge and irritation (excluding vaginitis), the cystitis probability is greater than 90%.

Therefore, if you have typical symptoms, symptoms alone can confirm the diagnosis without additional testing.

If urinary symptoms are not typical, but acute cystitis is suspected, the doctor will prefer a urinalysis, which is what we usually do The said urine routine” test to observe whether there is pyuria and bacteriuria to confirm the diagnosis.

For those who do not respond to medication, urine culture + drug susceptibility test” may also be required to determine the type of bacteria that is infecting and the drug susceptibility.

Reminder: Some sexually transmitted diseases, such as chlamydia and gonococcal infection, are also induced by sexual life, and the symptoms are similar. Too suitable. A urinalysis can help doctors make a good differential diagnosis. Therefore, not a last resort, it is best to take medicine under the guidance of a doctor.

How is it treated?

General Treatment

During acute cystitis, it is necessary to suspend sexual life, drink plenty of water, urinate frequently, avoid fatigue, and get enough rest.

Medications

The first-line preferred agents for the empirical treatment of acute simple cystitis are nitrofurantoin, co-sulfamethoxazole, fosfomycin, and pimecillin strong> (if available) because these drugs have a good balance between effectiveness and adverse effects, including the risk of resistance.

Two first-line regimens:

Alternative treatment options:

Is there any way to prevent it?

If cystitis recurs, there are a few things you can do to prevent it, including:

Increase fluid intake

Vaginal estrogen: In menopausal women, vaginal estrogen can help prevent bladder infections.

Avoid spermicides (cream or gel): Spermicide is a form of birth control, especially when combined with A vaginal diaphragm appears to increase the risk of bladder infections in some women when used together.

Immediately urinating after sex: Helps flush out germs that may enter the bladder during sex and flush germs around the opening of the urethra.

If bladder infection occurs frequently, but the above methods do not help, you need to see a doctor to find the cause, and the doctor will develop a further diagnosis and treatment plan.

References

1. Acute uncomplicated cystitis in women, UP TO DATE;

2. Expert consensus on diagnosis and treatment of urinary tract infection in Chinese women[J]. Chinese Journal of Medicine, 2017, 97(36):2867-2832.

3. International Clinical Practice Guidelines for the Treatment of Acute Uncomplicated Cystitis and Pyelonephritis in Women: A 2010 Update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases[J] . Clinical Infectious Diseases, 2011, 52(5):e103-e120.

Author: Hu Yun

Reviewer: Muta

Medical Editor: Dada

Producer: Yellow

© 2021 All Rights Reserved. Design & Developed By Besticoder