Treatment of acute cystitis
- Wait: In 30 to 50 out of 100 people affected, uncomplicated cystitis heals following a week without treatment.
- Painkiller: Active ingredients such as ibuprofen help once morest lower abdominal discomfort and the burning sensation when urinating.
- Phytopharmaka: Herbal medicines can support the treatment.
- Antibiotics: For more severe symptoms, experts recommend antibacterials. This will make the symptoms go away faster.
Recurrent bladder infections require other strategies, and antibiotics should be avoided if possible. Florian Wagenlehner recommends starting with behavioral measures (see info box “Tips for preventing cystitis”), such as paying attention to hygiene, drinking enough and avoiding hypothermia. Some of those affected can become free of infection. Ilona Hardt has no success with this, although she consistently follows the tips: she drinks three liters of water and tea every day, always has a heat pack with her and wears felt slippers even in midsummer.
»I have spent a lot of money on such means. It didn’t do much for me.”Ilona Hardt, Affected
Herbal remedies with antibacterial or anti-inflammatory effects can help. Cranberries, for example, contain substances that can prevent the bacteria from sticking to the bladder mucosa. An evaluation of studies suggests that that infections do not return or only return later. “The data situation is very heterogeneous, you can’t make a clear recommendation,” says Florian Wagenlehner. D-mannose also inhibits the docking of the germs. The Studies have shown that sugar is effectivebut with unclear evidence. »I spent a lot of money on such means«, Ilona Hardt looks back. “It didn’t do much for me.”
Tips to prevent cystitis
Not all measures are scientifically proven. Nevertheless, it can be worth paying attention to certain things in everyday life:
- Drink enough: Too much fluid flushes the urinary tract and makes it difficult for germs to build up.
- keep warm: If the body cools down, it becomes more susceptible to infections.
- Hygiene: Excessive care of the intimate area can damage the mucous membranes and encourage the penetration of bacteria.
- prevention: Spermicides change the vaginal flora and increase the risk of infection.
- empty bladder: After intercourse, urination is said to help flush out germs.
- wiping technique: Cleaning the bottom from front to back reduces the risk of intestinal bacteria getting into the urethra.
Therapy success is not always permanent
A good 15 years ago, a urologist recommended Ilona Hardt immune stimulation, which works in a similar way to a vaccination. Inactivated germs are injected three times at intervals of one to two weeks into the upper arm muscle, if necessary, a booster follows following a year. “This is supposed to improve the defense mechanisms of the urinary bladder,” explains Florian Wagenlehner. According to studies, the rate of recurrent infections drops by 26 to 93 percent. Ilona Hardt remained free of infection for five years. When she stopped the boosters, the inflammation came back. Three years ago she had herself immunized once more, but the infections increased followingwards.
Capsules containing fragments of E. coli bacteria are also suitable for stimulating the immune system. They are initially swallowed daily for three months, later on a daily basis. The according to a meta-analysis, reduces the recurrence rate by 39 percent. Ilona Hardt tried that too, but stopped following four weeks because of digestive problems.
The expert conclusion on immune stimulation is mixed. Florian Wagenlehner says: “The infections do not go to zero, but their frequency decreases.” Ursula Peschers observes it similarly: “Some patients have at least a period of rest.” However, because the effect has not been proven with certainty, the statutory health insurance companies pay immune stimulation does not.
Patients with frequently recurring bladder infections have usually tried everything, says Ursula Peschers. She draws up individual treatment plans for them, prescribing local estrogen therapy following menopause, for example. According to studies, the hormones can halve the risk of infection. Instillation treatment, for example, in which hyaluronic acid and chondroitin sulfate are given directly into the bladder via a catheter, also helps some women. Like a liquid bandage, the preparations should lie on the affected areas of the mucous membrane. The therapy takes place weekly at the beginning, then once a month and usually lasts half a year. According to Ursula Peschers, instillation of the bladder is expensive and not covered by statutory health insurance. Also, there are few studies on how effective these treatments are.