Cystitis in children 5 years old what to do. How to treat cystitis in children. Forms of cystitis in babies

Cystitis is an inflammatory disease of the mucous and submucous layer of the bladder. Cystitis is one of the most common urinary tract infections (UTIs) in children. There are no exact statistics on the prevalence of acute and chronic cystitis in our country, since often the disease remains unrecognized, and patients are observed for UTI.

Cystitis occurs in children of any gender and age, but girls of preschool and primary school age get it five to six times more often. The prevalence of cystitis among boys and girls of infancy is approximately the same, while at an older age girls suffer from cystitis much more often.

The relatively high incidence of cystitis in girls is due to:

• anatomical physiological characteristics urethra (proximity to the natural reservoirs of infection (anus, vagina), short urethra in girls);
• the presence of concomitant gynecological diseases (vulvitis, vulvovaginitis) caused by hormonal and immunological disorders of the growing female body;
• endocrine dysfunctions.

Infectious agents enter the bladder in various ways:

• ascending - from the urethra and anogenital zone;
• descending - from the kidney and upper urinary tract;
• lymphogenous - from neighboring pelvic organs;
• hematogenous - with a septic process;
• contact - when microorganisms enter through the wall of the bladder from nearby foci of inflammation.

The urinary system of healthy children is cleansed by the surface current method from top to bottom. It should be noted that the bladder mucosa is highly resistant to infection. In the anti-infectious protection of the bladder mucosa, the periurethral glands take part, producing mucus with a bactericidal effect, which covers the urethral epithelium with a thin layer. The urinary bladder is cleansed of microflora by regular "flushing" of it with urine. In case of interruption of urination, there is insufficient clearance of the bladder from bacteria. This mechanism is most often triggered in neurogenic bladder dysfunction, when the rest of the bacteria in the urethra can move to the overlying regions. This is due to the detrusor-sphincteral dyssynergism observed in neurogenic bladder dysfunction. At the same time, intraurethral pressure may increase, and the flow of urine is not laminar (layered), but turbulent flow with "eddies". In this case, bacteria move from the urethra to the overlying sections. The most "infected" part of the urinary system is the distal urethra.

Conditions necessary to protect the bladder from the development of a microbial-inflammatory process:

• "regular" and complete emptying of the bladder;
• anatomical and functional preservation of the detrusor;
• the integrity of the epithelial lining of the bladder;
• sufficient local immunological protection (normal level of secretory immunoglobulin A, lysozyme, interferon, etc.).

Almost 100 years ago, Rovesing, in The Real Encyclopedia, published in 1912, noted that "injecting a pure culture of bacteria into a well-functioning bladder does not cause pathological changes." In subsequent years, it was proved that for the occurrence of cystitis, the presence of only a microbe is not enough, the presence of structural, morphological and functional changes in the urinary bladder is necessary. Bacterial "contamination" of the bladder is only a prerequisite for inflammation, while its implementation occurs when the structure and function of the bladder is disturbed.

In the protective system of the bladder mucosa, an important role is played by the glycoprotein, the glycocalyx, which covers the bladder mucosa. Glycocalyx is produced by the transitional epithelium of the urinary bladder, envelops the microorganisms that have entered the bladder, and eliminates them. The formation of a special mucopolysaccharide layer is a hormone-dependent process: estrogens affect its synthesis, and progesterone affects the secretion of epithelial cells.

By etiological characteristics, cystitis is divided into non-infectious and infectious. Among the latter, nonspecific and specific are distinguished. The leading role in nonspecific cystitis belongs to bacteria. In the development of the inflammatory process in the bladder, not only the type of pathogen is important, but also its virulence.

Most often when cystitis is sown E. coli(up to 80%). Jamomoto S. et al. (2001) suggested that the genome of uropathogenic E. coli contains a special virulent locus that includes the usp gene responsible for the synthesis of a specific protein. Experiments on animals have shown that this gene is significantly more often associated with uropathogenic E. coli (79.4% in cystitis and 93.8% in pyelonephritis). The Usp gene in fecal E. coli is detected only in 24% of cases. The researchers concluded that this gene may contribute to the development of UTIs and is the main factor determining the virulence of uropathogenic E. coli. Back in 1977, A.S. Golokosova showed the selective ability of various serogroups E. coli cause infection of the upper and lower urinary tract. So, serotypes O2, O6, O10, O11, O29 are more often detected in cystitis, and serotypes O8 and O12 - in pyelonephritis.

In a much smaller number of cases with cystitis in children, Klebsiella pneumoniae, Proteus mirabilis, Pseudomonas aeuruginosa, Staphylococcus epidermitidis... The latter is more often sown in girls of puberty who are beginning to have a sex life. Pseudomonas aeruginosa is often detected in patients who have undergone instrumental studies. Klebsiella and Proteus found more often in children early age... A quarter of the total number of children with cystitis has no diagnostically significant bacteriuria. In recent years, the role of microbial associations in the genesis of urogenital infections, including cystitis in children, has been recognized (E. coli + fecal streptococcus, E. coli + epidermal staphylococcus, etc.).

The question of the importance of viruses in the etiology of acute cystitis is controversial. The role of viruses in the development of hemorrhagic cystitis is now recognized. In adenovirus, herpes, parainfluenza infections, viruses often play the role of a factor predisposing to microcirculation disorders, with the subsequent development of bacterial inflammation.

There is evidence of a possible etiological role Chlamidii trachomatis in the development of cystitis in children with non-observance of hygienic standards, the presence of patients with chlamydia in the family, visiting swimming pools, saunas. In some cases, cystitis is caused by myco- or ureaplasma infection. However, it should be noted that "chlamydial" and "mycoplasma" cystitis, as a rule, are combined with bacterial flora.

The risk group for the development of cystitis of fungal etiology are children:

• with immunodeficiency states;
• receiving antibiotic therapy for a long time;
• with congenital malformations of the urinary system;
• after surgery.

Specific cystitis of tuberculous, gonorrheal and Trichomonas etiology is more typical for the adult contingent of patients.

Factors such as metabolic disorders (calcium oxalate, urate, phosphate crystalluria), the use of drugs (urotropine, sulfonamides, etc.) are also important in the genesis of non-infectious cystitis in children. There are known cases of the development of hemorrhagic cystitis after the use of cytostatic drugs (cyclophosphamide). Radiation, toxic, chemical and physical (cooling, trauma) factors also serve as risk factors for the development of cystitis (see).

N. A. Lopatkin et al. (2000) believe that such structural features of the bladder wall as lymphangiomatosis, hemangiomatosis, excessive development of lymphoid tissue, cysts, squamous cell metaplasia of the urothelium create conditions for bacterial invasion.

The inflammatory process of the bladder mucosa can be focal and total (diffuse). If the bladder neck is involved in the pathological process, then cystitis is called cervical, with pathology in the region of the Lieutenant triangle - trigonitis.

In pediatric practice, the most common classification of cystitis by form, course, nature of changes in the mucous membrane and the prevalence of inflammation (see).

Primary cystitis, unlike secondary cystitis, occurs without previous structural and functional damage to the bladder. At the same time, hypothermia, hypovitaminosis (especially vitamin A), frequent viral infections in children with immune dysfunction. The diagnosis of primary cystitis is eligible in cases where a thorough examination of the child has been carried out, including X-ray urological and urodynamic studies.

In the development of secondary cystitis, the leading role is played by incomplete emptying of the bladder as a result of mechanical and / or functional obstruction, which forms the formation of residual urine. According to Javad-Zade, V.M.Derzhavin, E.L. Vishnevsky (1987), most of the chronic cystitis in children is caused by neurogenic dysfunction of the bladder. In a number of patients, secondary cystitis develops against the background of an anomaly or malformation of the urinary system (diverticula of the bladder, ectopia of the mouth of the bladder, etc.).

According to the characteristics of the course, acute and chronic cystitis are distinguished. In acute cystitis, the inflammatory process is limited to the mucous membrane and submucosa and is morphologically characterized by catarrhal and hemorrhagic changes. In the chronic process, there are deeper structural changes in the bladder wall with the involvement of the muscle layer (granular, bullous, phlegmonous, necrotic, etc.). In most cases of chronic cystitis, all layers of the bladder are damaged.

For the diagnosis of acute and chronic cystitis in children are important:

• clarification of the patient's complaints;
• study of medical history and life, including pedigree data;
• character analysis clinical manifestations;
• characteristics of the urinary syndrome;
• data of ultrasound and X-ray urological examination;
• results of cystoscopic examination.

When collecting a genealogical history, it is necessary to clarify the presence of cystitis or other microbial-inflammatory diseases of the urinary system in the family, as well as metabolic disorders and neurogenic dysfunction of the bladder in parents and close relatives.

The clinical manifestations of cystitis depend on the form and nature of the course of the disease. Acute cystitis usually begins with a urinary disorder. There are imperative urge to urinate every 10-20-30 minutes. The frequency of urination depends on the severity of the inflammatory process. Disorders of urination in acute cystitis are explained by an increase in reflex excitability of the bladder, compression of the nerve endings. Older children notice pain in the lower abdomen, in the suprapubic region with irradiation to the perineum, aggravated by palpation and filling of the bladder. At the end of the act of urination, stranguria may be observed, i.e. pain at the base of the bladder, urethra, or penis in boys. The intensity of the pain syndrome is proportional to the prevalence of the inflammatory process (severe pain occurs when the Lieto triangle is involved in the inflammatory process). Urinary incontinence is sometimes observed. Often, when the detrusor contracts, droplets of fresh blood are released (the so-called "terminal" hematuria).

In young children, the clinic of acute cystitis is nonspecific. Typically acute onset, restlessness, crying during urination, its frequency. Due to the limited ability of young children to localize the infectious process, the spread of the microbial-inflammatory process into the upper urinary tract is often observed, general symptoms in the form of toxicosis, fever. Such symptoms are often absent in older children, in whom, with cystitis, the general condition is slightly disturbed. As a rule, there are no signs of intoxication, an increase in temperature, which is due to the peculiarities of the blood supply to the mucous and submucous layer of the bladder.

Due to spasm of the external urethral sphincter and pelvic floor muscles, young and older children may experience reflex urinary retention, often mistaken by doctors for acute renal failure (ARF). In such situations, the absence of impaired renal nitrogen excretion helps to exclude acute renal failure. Older children complain of pain in the perineum and anus.

Acute inflammatory changes in clinical analysis blood in uncomplicated cystitis are very rare (mainly in young children), and with complicated cystitis, they depend on whether pyelonephritis has joined or not.

Urinary syndrome in cystitis is characterized by leukocyturia of a neutrophilic nature (from 10-12 cells to the number covering all fields of view), erythrocyturia of varying severity (usually terminal, up to macrohematuria), the presence of transitional epithelium and bacteriuria. As a rule, patients with chronic cystitis have a high degree of bacteriuria.

With hemorrhagic cystitis, urine takes on the color of "meat slops". In some cases, to clarify the source of leukocyturia, a two-glass test is carried out, the determination of "active" leukocytes and "bacteria coated with antibodies". For the same purpose, a consultation with a gynecologist is indicated. Proteinuria, as a rule, with isolated cystitis is absent or is minimal due to the presence of formed elements in the urine. When combined with pyelonephritis, the severity of proteinuria depends on the degree of damage to the tubular epithelium. Cystitis is characterized by a large amount of mucus in the urine; for acute cystitis - the presence of a large number of squamous epithelial cells in the urine.

It should be noted that domestic and foreign experts consider the primary test for cystitis to screen urine for nitrites, which are formed as a result of the reduction of nitrates by bacteria to nitrites. Most researchers believe that urine culture should only be done if a nitrite test is positive. The widespread introduction of test strips that identify the presence of blood, protein, leukocytes in urine is desirable, it allows you to quickly obtain a result and determine a rational therapeutic tactics for a particular patient. It is important not only to obtain data on the presence in the urine of a patient with cystitis of an increased number of leukocytes, erythrocytes, protein, bacteria, but also to monitor the effectiveness of therapy after a few days in order to make sure that the prescribed treatment is correct. Persistent leukocyturia after several days of therapy requires a more complete examination to clarify the diagnosis.

Several methods of urine collection have been described. However, in pediatric practice, the most physiological is the intake from the middle stream with free urination. In this case, it is necessary to thoroughly wash the hands, perineum and genitals of the child with soap. The girl is washed from front to back, and the boy needs to rinse the preputial sac. For inoculation, morning urine is collected in a sterile test tube. It is advisable to conduct a microbiological study before the appointment of antibiotic therapy, three to four days after its start and a few days after the end of treatment. Urine samples must be delivered to the laboratory within an hour after collection. If it is impossible to fulfill this condition, it is necessary to store urine in a refrigerator in a closed sterile container for no more than 24 hours. Bladder catheterization for the purpose of studying urinary sediment is used only for strict indications, most often with acute urinary retention. It is performed after the treatment of the perineum with a sterile catheter from the "middle" stream of urine. It should be noted that in pediatric practice, suprapubic puncture of the bladder in order to obtain urine is not used. Urine cultures are usually sterile for viral cystitis.

It is advisable to start the diagnosis of a child with acute cystitis with an ultrasound examination, which is carried out against the background of a "physiologically filled" bladder. The detrusor state is assessed before and after the miction. Typical for cystitis is the detection of thickening of the mucous membrane and a significant amount of "echo-negative" suspension. In acute cystitis, X-ray urological examination is not indicated. Endoscopy of the bladder allows you to assess the degree and nature of mucosal lesions. This examination must be carried out during the period of the inflammatory process subsiding or remission - if chronic cystitis is suspected. For young children, cystoscopy is performed under general anesthesia. Functional studies of the bladder in the acute period of cystitis are not carried out.

The differential diagnosis of acute cystitis should be carried out with acute appendicitis (with an atypical location of the appendicular process) and paraproctitis. With these diseases, a picture of reactive cystitis with minimal changes in urine tests is possible. In rare cases, especially with sudden onset of gross hematuria, the differential diagnosis is carried out with a tumor of the bladder. In this case, ultrasound examination of the bladder, excretory urography and cystoscopy helps to clarify the diagnosis.

The differential diagnosis is with acute pyelonephritis. In uncomplicated cystitis, there is no fever, pain in the lumbar region, symptoms of intoxication and impaired renal tubular function. Detection of “bacteria coated with antibodies” in urine confirms the diagnosis of pyelonephritis. The test is considered positive if two or more specific luminous bacteria are found when viewing 20 visual fields.

The prognosis for acute cystitis is usually favorable and depends on the timeliness of the treatment started. In the case of the development of cystitis in children with endogenous risk factors, the disease often takes on a chronic course.

Treatment of cystitis in children should be comprehensive and include general and local effects. For acute cystitis, bed rest is recommended. Rest is necessary, contributing to the reduction of dysuric phenomena and the normalization of the function of the bladder and the urinary system as a whole. General warming of the patient and local thermal procedures are shown. Dry heat can be applied to the bladder area. "Sitting" baths are effective at a temperature of + 37.5 ° C with a solution of herbs that have an antiseptic effect (chamomile, St. John's wort, sage, oak bark). In no case should you take hot baths, as the heat of high temperatures can cause additional hyperemia with impaired microcirculation in the bladder.

Food should not be annoying, it is advisable to exclude all spicy, spicy dishes and spices. Shown are dairy products, fruits rich in vitamins. It is advisable to use yoghurts enriched with lactobacilli in the diet of patients with cystitis, which, due to the properties of adhesion to the mucous membrane of the urogenital tract, are able to prevent the recurrence of the microbial-inflammatory process in the urinary tract in a child. Effective use of fruit drink from cranberry, lingonberry.

The drinking regimen is determined by the patient's needs. However, in case of acute cystitis, it is better to recommend drinking plenty of fluids (50% higher than the required volume), which increases urine output and helps to flush out inflammation products from the bladder. The daily amount of fluid is distributed evenly throughout the day. It is better to recommend an increase in the drinking regime for acute cystitis after the removal of the pain syndrome. Shown are slightly alkaline mineral waters, fruit drinks, weakly concentrated compotes. Reception of mineral water (such as "Slavyanovskaya", "Smirnovskaya", etc.), which is a source of trace elements such as bromine, iodine, barium, cobalt, has an effect on metabolism, has a weak anti-inflammatory and antispasmodic effect, changes urine pH. You can use the mineral water from Slovenia - "Donat Mg", which contains 1000 mg of magnesium in 1 liter of water and has an impact on energy, plastic and electrolyte metabolism. Donat Mg can be used for cystitis that has developed against the background of metabolic disorders (phosphaturia, oxaluria, impaired purine metabolism). Medicinal mineral waters for oral administration with cystitis must have a mineralization of at least 2 g / l. Water is taken warm, without gas. Mineral water is dosed at the rate of 3-5 ml / kg of mass per intake or:

• children aged 6-8 years - from 50 to 100 ml;
• at the age of 9-12 years - 120-150 ml;
• children over 12 years old - 150-200 ml per appointment.

Water for cystitis is usually drunk three times a day 1 hour before meals. The intake of mineral water in patients with cystitis provides a regime of frequent urination, which prevents the accumulation of "infected" urine, and thereby helps to reduce the irritating effect on the "inflamed" mucous membrane of the bladder, "flushing" the products of inflammation from the bladder.

Therapy of acute cystitis in children should be aimed at:

• elimination of pain syndrome;
• normalization of urination disorders;
• elimination of the microbial-inflammatory process in the bladder.

Drug treatment of acute cystitis includes the use of antispasmodic, uroseptic and antibacterial agents. With pain syndrome, the use of no-shpa, belladonna, papaverine inside or outside in candles, baralgin is indicated.

The mainstay of treatment for acute cystitis in children is antibiotic therapy, which is usually carried out empirically before the results of bacteriological research are obtained, based on the knowledge of the most likely pathogens for this disease. However, given the increasing resistance of the microbial flora to antibacterial drugs, therapy should not be carried out without bacteriological control. For this purpose, urine culture is required two to three days after the start of therapy. For cystitis, it is advisable to use oral antimicrobial drugs, which are excreted mainly through the kidneys and create a maximum concentration in the bladder. The choice of antibacterial drugs is determined by the severity of the patient's condition, his age and the nature of the course of cystitis.

• co-trimoxazole or trimethoprim;
• amoxicillin or amoxicillin / clavulanate;
• ciprofloxacin.

In the "Federal Guidelines for Physicians on the Use of Medicines in Russia" in Section 5 "Antimicrobial Agents", the following drugs are recommended as the main antibacterial agents for acute cystitis in children and adults (see).

It should be noted that ciprofloxacin and norfloxacin are fluoroquinolones, which are used in pediatric practice only for health reasons, and their use in cystitis can be considered unjustified.

Some foreign researchers recommend ampicillin for acute uncomplicated cystitis. However, most of the scientific studies carried out in recent years indicate low sensitivity E. coli to ampicillin. Research coordinated by L. S. Strachunsky and N. A. Korovina, conducted in 2000-2001. in eight treatment-and-prophylactic institutions in seven cities of Russia (ARMID), showed a high level of resistance (51.5%) of E. coli to ampicillin and amoxicillin. Taking into account the obtained data, at present in Russia it is inappropriate to use ampicillin and amoxicillin for empiric therapy of cystitis in children. Their appointment is possible only if the sensitivity of the microflora of the patient's urine to them is confirmed. Ampicillin and amoxicillin are not indicated for cystitis caused by K. pneumoniae, Enterobacter spp., due to the natural resistance of these microbes to aminopenicillins. With cystitis in children, the use of "protected penicillins" based on amoxicillin with clavulanic acid (augmentin, amoxiclav) is justified. High (97%) sensitivity remains to amoxicillin / clavulanate E. coli urine. According to the ARMID study, in patients with community-acquired urinary tract infections, resistance E. coli and K. pneumoniae to amoxicillin / clavulanate is only 3.9% and 11.8%, respectively. Amoxicillin / clavulanate is well absorbed when taken orally, regardless of mealtime. To prevent possible diarrheal syndrome when prescribing amoxicillin / clavulanate, the drug should be used at the beginning of a meal. Usually, mild diarrheal syndrome observed during treatment with amoxicillin / clavulanate does not require treatment, as well as discontinuation of the drug and goes away on its own. According to Fisbach M. et al., 1989, when "protected" penicillins are prescribed to children with urinary tract infection, urine becomes sterile after 48 hours.

In 10 children aged from one to three years with urinary tract infection, we used Augmentin at a dose of 40 mg / kg of body weight per day in three doses. The duration of therapy was seven days. All children had typical clinical and laboratory manifestations of the disease: frequent or rare painful urination, anxiety, low-grade fever, urinary syndrome in the form of leukocyturia from 25 to 45 in the field of view, microerythrocyturia from 2 to 7 in the field of view. By the second or third day of therapy with augmentin, a significant positive trend was observed in the form of a complete disappearance of clinical manifestations, by the fifth or sixth day of the disease, complete normalization of urine analysis was observed. Only one child showed deterioration of stool in the form of increased frequency and changes in consistency (mushy); this complication was stopped after the end of the seven-day course of therapy.

Abroad, co-trimoxazole is considered a standard in the treatment of acute cystitis in children and adults. A meta-analysis of 76 randomized trials (including 32 double-blind) on the effectiveness of co-trimoxazole in UTIs, conducted by the American Society of Infectious Diseases in 1999, showed that the drug in 93% of cases provides a high rate of bacteriuria eradication. In some European countries, co-trimoxazole is considered a first-line treatment for UTIs in children. This drug, which was previously widely prescribed in Russia for UTI, currently has a reduced activity, resistance to it Enterobacter spp., Proteus spp., E. coli, K. pneumoniae is 51.5%, 44.0%, 35.5% and 29.4%, respectively. Taking into account that this inexpensive and rather effective drug is well absorbed when taken orally, penetrates deeply into tissues, reaches a therapeutic concentration in the urinary tract, it can be prescribed for cystitis in children. In addition, co-trimoxazole eliminates E. colicolonizing the anus and vagina (reservoirs of infection), which reduces the likelihood of reinfection. Before starting treatment, it is advisable to conduct a bacteriological study of urine to determine the sensitivity of the isolated flora to antibiotics (antibioticogram of urine).

In acute cystitis in children, it is possible to use oral cephalosporins of the second or third generation - cefuroxime axetil (zinnat), cefaclor (ceclor, alphaacet, taracef, vercef), ceftibuten (cedex).

For the treatment of acute uncomplicated cystitis, monural (fosfomycin trometamol) is effective, which has a bactericidal effect against almost all gram-negative (including Pseudomonas aeruginosa) and gram-positive bacteria, staphylococcus (aureus, epidermal) and streptococci (saprophytic, fecal). The antibacterial effect of Monural is determined by its ability to inhibit the early stages of bacterial cell synthesis by blocking the enzyme pyruvate transferase. The absence of cross-resistance to monural prevents the emergence of resistant bacterial strains. The active forms of the drug are excreted in the urine. The antiadhesive properties of the drug, which prevent the adhesion of bacteria to the urothelium, make it possible to achieve sanitation of the mucous membranes. Monural is excreted by glomerular filtration and persists for a long time in the lower urinary tract. The high efficiency of Monural is also manifested in bacteria that produce β-lactamases. According to the ARMID study, all major uropathogens ( E. coli, K. pneumoniae, Enterococcus spp., Staphylococcus spp.) are highly sensitive to fosfomycin. Small resistance was noted only in Proteus spp. (6%) and Enterobacter spp. (6,1%).

We carried out treatment with monural in 50 patients with acute cystitis. Children over one year old received the drug orally at a dose of 1 g, over six years old - 2 g once. Against the background of one-day therapy with monural, 98% of children showed complete disappearance of clinical manifestations of the disease (dysuria, low-grade fever, pain in the suprapubic region). One patient required parenteral antibiotics due to the combination of pyelonephritis and cystitis. Monural was well tolerated, no side and side effects were recorded.

Ciprofloxacin and norfloxacin are fluoroquinolones, which are used in pediatric practice only for health reasons and are not indicated for acute cystitis in children.

The main criterion for the duration of antibiotic therapy in acute cystitis is the patient's premorbid state, the presence or absence of risk factors for complications of the microbial-inflammatory process. The minimum course of treatment for acute cystitis should be at least seven days. Treatment with a single dose of the drug (for example, co-trimoxazole once) in children is not justified, except for the appointment of Monural, which ensures the elimination of the clinical manifestations of the disease and bacteriuria when the drug is administered once inside.

Thus, when choosing antibacterial drug for empirical treatment of acute uncomplicated cystitis in children, it is necessary to collect information about the sensitivity of the urine microflora to antibiotics in the region where the patient lives. Given the existence of regional features of the microbial flora of urine, the choice of an antibacterial drug for empiric treatment of acute cystitis in children should be determined by the sensitivity of the urine microflora to antibiotics. In the absence of an effect from antibiotic therapy carried out within 48-72 hours, it is necessary to prescribe another treatment and clarify the diagnosis by conducting a more detailed examination.

An additional method of treating acute cystitis in children is herbal medicine. In the course of treatment, herbs are used that have antimicrobial, tanning, regenerating and anti-inflammatory effects. Infusions and decoctions from plants can be used either as independent medicines, or together with other drugs. The composition of the required fees depends on the severity of the clinical symptoms of cystitis, the period of the disease (exacerbation, subsidence, remission) and the presence or absence of bacteriuria. A reasonable choice of herbal remedies contributes to a more rapid elimination of the inflammatory process in the bladder and allows you to achieve long-term remission. Depending on the underlying syndrome, the doctor may choose one of those listed in herbal fees.

Phytotherapy is carried out in the acute period after dysuric disorders decrease, at this time it is recommended to drink abundant drink in a volume of up to 1-1.5 liters. Topically applied "sit-down" herbal baths: oregano, birch leaves, sage, chamomile, lime blossom, marsh caddie.

Treatment of acute cystitis should be comprehensive and take into account etiological factors. The treatment process should provide for the relief of the microbial-inflammatory process, the correction of metabolic disorders, the restoration of microcirculation, as well as the stimulation of regenerative processes in the bladder.

Prevention of cystitis includes measures aimed at increasing the defenses of the child's body, timely treatment of acute infectious diseases. Compliance with the rules of personal hygiene is also important.

For literature questions, contact the editorial office

N. A. Korovina, Doctor of Medical Sciences, Professor
I. N. Zakharova, Doctor of Medical Sciences, Professor
E. B. Mumladze, Candidate of Medical Sciences, Associate Professor
RMAPO MH RF, Moscow

Diseases of the genitourinary system in children are quite common, the ailments are sharply negative, accompanied by severe pain, interfere with the child's normal life. Cystitis is a health hazard for the baby. The disease is an inflammatory process of the bladder that can occur at any age.

How to identify symptoms of cystitis in a baby, what to do next, effective methods treatment of the disease? The answers to the questions are detailed in the following material.

The causes of the appearance of pathology

Cystitis is an inflammation of the bladder, the disease is accompanied by a violation of the normal functioning of the organ. Pathology is often found in young patients, due to the imperfection of the child's body, the presence of many provoking factors. The incidence of cystitis depends on the gender of the baby. In most cases, girls are sick.

The bladder has a special structure, its walls include a mucous membrane, completely lined with blood vessels, nerve endings. Boys have a long urethra lined throughout the penis, it is quite difficult for pathogens to go all the way, to settle in the bladder.

In girls, the urethra is wide, short, and can communicate with the external environment. Any pathogenic microorganisms can penetrate from the genitals through the urethra, get to the bladder. It is these differences that provoke the frequent occurrence of cystitis in girls than in the stronger sex. Boys often suffer from a secondary infection, due to an already existing inflammatory process in the kidneys.

In most cases, the disease is observed in preschoolers and children. younger age... This fact is due to non-compliance with the rules of personal hygiene, poor childcare, and wearing diapers. For the development of the disease, a sufficient number of negative factors are required. In each case, they are individual.

Additionally, a number of unfavorable factors are distinguished that increase the risk of cystitis in children:

• hypothermia;
• decreased immunity, due to the recent transfer of an infectious disease;
• low physical activity (in children it is extremely rare);
• chronic;
• stagnation of urine (untimely emptying of the bladder);
• overwork, exhaustion of the child's body;
• the presence of various kinds of infections in parents.

Characteristic signs and symptoms

How to recognize a disease in children of different ages? The characteristic signs of cystitis in boys and girls do not differ, the clinical picture differs depending on the age of the baby. It is possible to identify the onset of the course of the disease in infants by the following signs:

• the baby often cries for no reason, there is increased anxiety, there are sleep disorders;
• a noticeable increase in body temperature (up to 39 degrees), is observed against the background of nervous tension;
• the color of urine changes (it becomes dark). This aspect can be seen in the marks on the sheet or in the diaper;
• increased urination (up to twenty times a day).

Signs of cystitis in children from three to five years old:

• urinary incontinence, noticeable if the baby has not suffered from such a problem before;
• frequent urination (the child asks to use the toilet up to four times an hour);
• the occurrence of pain in the lower torso: perineum, rectum, abdomen, which intensify during urination;
• the color of urine changes: the discharge becomes cloudy, the appearance of red veins is noted.

The specific symptoms of the manifestation of cystitis depend on the course of the course, the type of disease. The follicular type of the disease is accompanied by the above symptoms. With a bullous or necrotic nature of the course of the disease, there is a deterioration in the general condition of the child, the occurrence of vomiting, and acute pain in the lower abdomen.

With hemorrhagic cystitis, the child has a fever, urination becomes painful. Children at three years old can say about discomfort, older babies insist that the urine has acquired a reddish tint.

Forms of the disease

Depending on the form of the course of the disease, children have chronic and acute cystitis. The first type is characterized by the sudden onset of the disease, the symptoms immediately make themselves felt. This form is well treated, the prognosis is favorable in most cases.

Chronic cystitis in children occurs against the background of a secondary infection, untimely, incorrect treatment of the acute form of the disease, if chronic diseases kidneys. It flows in waves, there are periods of exacerbation and weakening of unpleasant symptoms. It is difficult to cope with a disease in a chronic form, sometimes the disease remains with the patient for life, periodically reminding of itself. It is important to prevent the transition of cystitis in children from an acute form to a chronic one.

Methods and general rules of treatment

How to treat cystitis in children? To cure a baby is a rather difficult task that requires the help of doctors, constant monitoring by parents. Treatment includes several aspects that are aimed at eliminating the cause of the disease (infection, inflammatory process), restoring the normal functioning of the biliary system, and relieving unpleasant symptoms.

Treatment of acute, exacerbation of chronic cystitis in children is carried out in a hospital. If this is not possible, it is allowed to cope with the disease at home. All aspects are decided by the attending physician. Limit physical activity during treatment crumbs: bed rest is shown for four days.

Additionally, a special sparing, diuretic diet is prescribed:

• exclude fried, salty foods, seasonings;
• increase the amount of fluid consumed (it is allowed to lean on juices, fruit drinks, mineral water, decoctions of chamomile, calendula), the last medicines are used as preventive measures with chronic cystitis in children. The specific volume of fluid per day is determined by the pediatrician;
• it is forbidden to cancel breast-feeding;
• the baby is allowed to eat fermented milk products, various cereals with milk, baked fruits, boiled vegetables, low-fat meats.

Drug therapy

How to treat cystitis in children? The choice of the drug lies with the attending physician. For the treatment of cystitis in children, the following medicines are most often used:

• antibiotics for cystitis in children in the form of injections or pills. The specific drug depends on the virus, bacteria. Cases of diseases caused by a non-infectious nature do not require the use of potent medications;
• tablets for cystitis in children Kanefon. The drug has a positive effect on the function of the urinary tract;
• uroantiseptics. Furadonin, Furazolidol, Furagin kill pathogens, normalize the urination process;
• pain are eliminated with the help of antispasmodics (No-Shpa, Baralgin, Riabal).

Note! All medicines are selected by the doctor after conducting specific studies. It is strictly forbidden to treat a child on your own. The use of the wrong means leads to the development of complications, the transition of an acute form to a chronic one.

Folk remedies and recipes

Treatment of cystitis in children at home exclusively folk remedies impossible, treatment requires drug therapy, the help of a qualified specialist. Natural medicines help relieve pain, accelerate the healing process, have a beneficial effect on urinary frequency, and are used as diuretics.

You can cope with cystitis in children with the help of medicinal decoctions from medicinal plants and folk remedies for cystitis:

• hop;
• chamomile;
• yarrow;
• melissa;
• blackberry leaves;
• st. John's wort.

The recipe is very simple: take two tablespoons of finely chopped raw materials per liter of boiling water. Insist for two hours, strain, give the crumbs in the specified dose. The course of treatment usually does not exceed one week. Many drugs are used prophylactically to prevent exacerbations during the course of chronic cystitis.

On the page, find out about the deviations and norms of the weight of newborn children.

You can avoid the occurrence of cystitis in children by adhering to the following rules:

• wash the girls correctly: direct the stream of water towards the anus, it is forbidden to use soap every time, you will disrupt the natural balance of the skin;
• pay special attention to the foreskin of boys after three years. Wash the child's genitals daily, do not skip procedures;
• control the frequency of trips to the toilet. Stagnant urine, constipation negatively affect the health of the child;
• timely eliminate foci of inflammation in the child's body (caries, tonsillitis, and others);
• make sure that the baby consumes a sufficient amount of fluid daily;
• forbid children to sit on cold surfaces, hypothermia of the genitals leads to the appearance of cystitis.

It is quite possible to prevent cystitis in children, do everything possible to implement it. If the disease is still diagnosed, do not panic, immediately take the baby to the doctor, impeccably follow his recommendations.

Medical video guide. Means and methods of treatment of cystitis in children:

Cystitis is an inflammation of the bladder. Pathology brings a lot of unpleasant sensations. Its course becomes more complicated if a child acts as a patient. In young children 3 years old, cystitis occurs as a result of hypothermia and other reasons. The disease in babies is characterized by an unpleasant course and some features.

The mechanism of development of cystitis

Babies rarely get this disease, as they are protected by maternal hormones that are present in breast milk. When breastfeeding is stopped, babies become vulnerable to various types of infections.

The increased risk continues until puberty, when the body can produce its own estrogens.

Inflammation of the bladder can be a separate pathology or develop as a result of various diseases of the internal organs. Pathology in early childhood is usually more difficult. Also, at 2-3 years old, babies have a risk of transition of an acute form of cystitis to a chronic one.

Most often, some infections lead to the development of cystitis in children 3 years old. Bacteria cause inflammation in the bladder more often than other pathogens.

Decreased immunity accelerates the development of infection in the child's body. From birth, he does not work effectively enough. Severe hypothermia and other reasons can lead to impaired immunity, which is a trigger factor for the development of inflammation and pathologies of the bladder.

The spread of infection occurs in the following ways:

1. Hematogenous and lymphogenous. In this situation, bacteria enter the urinary tract and bladder along with blood from distant foci (tonsils, larynx).
2. Downward. Pathogens penetrate from diseased kidneys.
3. Ascending. The spread of infection is carried out from the anogenital zone and urethra.
4. Contact. Pathogenic microflora in the walls of the bladder penetrates from nearby organs.

Signs of cystitis in a 3-year-old child depend on the form of the disease. Most often it occurs due to an ascending infection. This is due to the physiological characteristics of the baby's body.

Forms of the disease

By the nature of the course of the pathology, two forms of cystitis are distinguished in children 3 years old:

• Sharp. The form is characterized by the rapid development of the process of inflammation in the mucous membranes of the bladder.
• Chronic. Pathology affects the muscle layer. The chronic form is a consequence of related diseases (pyelonephritis, phimosis, urethritis).

Signs of cystitis in children are about the same.

What is the cause of the pathology

Cystitis in young babies most often occurs due to infection. The most common pathogens include:

1. Bacteria. These include E.coli, streptococci, chlamydia, ureaplasma.
2. Fungi of the genus Candida.
3. Viruses. These include herpes, adenoviruses, parainfluenza.

The mucous membranes of the bladder have protective qualities, therefore, when pathogenic microflora penetrates, cystitis in children of 3 years does not always occur.

The inflammation process develops:

• In case of violation of the outflow of urine. Occurs with irregular emptying, congenital malformations of the bladder.
• Decrease in the protective functions of the cells of the mucous membranes. This occurs with metabolic disorders, when a significant amount of salt is present in the urine, while taking certain medications.
• With impaired immunity. It occurs with hypothermia, frequent infections, excessive physical exertion and serious chronic pathologies.

Failure to observe personal hygiene also refers to the cause of cystitis. The child's underwear must be changed daily so as not to provoke the development of the inflammatory process.

Pathogens sometimes enter the urethra through the anus and genital tract. Cystitis in girls can cause poor personal hygiene.

Causes of cystitis in girls and boys

Diseases in female children are mainly associated with:

1. With the structural features of the excretory system. The urethra is wider and shorter, making it easier for bacteria to enter the bladder.
2. Lack of hormones. Ovaries in childhood do not produce hormones that provide the protective properties of the mucous membranes of the genitourinary system.

Diseases of the external genital organs can lead to the onset of cystitis in children 3 years old. In girls, it develops against the background of vulvitis or vulvovaginitis.

The main reason for the development of the disease in boys is hypothermia of the organs. Children walk with wet feet, sit on the ground and snow.

The following reasons for cystitis include lack of personal hygiene, phimosis, pyelonephritis. The infection spreads through the urethra and ureters. The development of cystitis of fungal origin is facilitated by high humidity, which is present in the pool, sauna and in case of non-observance of personal hygiene.

Girls are most often susceptible to infection due to the structure of the excretory system.

Disease symptoms

Every parent should be able to recognize signs of cystitis in a 3-year-old child (girl or boy). Timely referral to a specialist will avoid possible complications in the future. It is not easy to identify signs of illness in a baby. The main symptoms include:

• Frequent urination. A sick child sits on the potty several times a day. The baby may wake up at night due to the constant urge to urinate.
• Soreness in the lower abdomen. A 3-year-old child cannot complain of all the symptoms present. You can notice this sign if the parents carefully observe it. They should be concerned if the baby is holding onto the tummy or avoiding touching this area.
• Burning sensation that occurs when urinating. This is not always the case. If a burning sensation occurs during urination, the general condition of the child changes. He is naughty, and cries during urination.
• Discoloration of urine. Parents find this symptom initially when the contents of the pot are poured out. The urine becomes cloudy with the disease. Its smell changes and becomes sour and fetid. These signs usually occur when bacterial form cystitis.
• The general condition is deteriorating. In this situation, the baby becomes moody and apathetic. He plays less with his favorite toys and tries to avoid outdoor games. A sick child has poor appetite and sleep. During the night, he may wake up several times.
• The appearance of puffiness on the body. Such symptoms appear with a severe form of the disease. The appearance of puffiness on the body indicates the accumulation of a large amount of fluid in the body. Chronic cystitis that lasts for a long time can contribute to the occurrence of edema. It is localized under the eyes and on the face.
• Heat... This symptom of cystitis in children 3 years of age is optional. Usually, the temperature readings for this disease correspond to subfebrile values. With a severe form of the disease, it can rise to 38-39 degrees.

It is quite difficult to notice the onset of cystitis, especially in the initial stages of the disease. However, the child is usually noted to have increased anxiety. He practically does not smile and tries not to contact others.

Diagnostics

If signs of cystitis occur in a 3-year-old child, you should immediately contact a specialist. Initially, they are sent for consultation with a pediatrician. A pediatric urologist deals with the treatment of cystitis. These specialists have the necessary knowledge and experience in the treatment of such diseases.

Examination alone is not enough to confirm an accurate diagnosis. Diagnosis of the disease includes a general urine test.

Before urine collection, boys are washed the foreskin, and girls - the entire anogenital zone from the vagina to the anus. Proper preparation contributes to an accurate result.

In the presence of cystitis, a significant increase in the number of leukocytes is found in the urine. In the pathology of the kidneys and urinary tract, the analysis shows the loss of protein or a change in its specific gravity.

To clarify the diagnosis, a specialist may prescribe an ultrasound of the kidneys and bladder. It is necessary to conduct research for medical reasons.

Girls are sent to see a pediatric gynecologist to rule out inflammation of the vagina and genital tract, which leads to ascending cystitis.

General rules of therapy

If signs of cystitis are found in children of 3 years old, then parents should create all the necessary conditions for the sick child to accelerate recovery and prevent possible complications. To achieve such goals, it is necessary to thoroughly follow all the recommendations and prescriptions of the attending physician. The main methods of therapy include:

1. Compliance with bed rest and personal hygiene rules. This helps to reduce the intensity of pain and restore normal bladder function.
2. Compliance with the drinking regime. The child needs to drink twice as much water as before the onset of the disease. Thanks to this, pathogens are removed from the body. In addition to water, it is recommended to drink fruit drinks and juices.
3. Constant change of underwear.
4. Compliance with the diet. Exclusion from the menu of spicy and salty foods.

During the period of treatment of cystitis in children 3 years old, they should not be limited from carrying out water procedures. The water should be warm.

Drug treatment

After confirming the diagnosis, the doctor prescribes medications. Treatment of cystitis in children 3 years old is carried out by the following means:

• "Augmentin". It is necessary to use the medicine in the form of a suspension.
• "Amoxiclav". Has 3 forms of release. The most effective is determined by a specialist.

In case of individual intolerance to the above drugs, the following drugs are prescribed:

• "Zinnat". Antibiotic, it is allowed to take in the form of a suspension.
• "Zedex". A new generation drug that has a minimum of contraindications.

Towards effective medicines include those drugs that are able to fight the pathogens that cause cystitis.

How to treat cystitis in a child at 3 years old? In addition to antibiotics, the attending physician prescribes a uroseptic. Most often in this case, "Kanefron" is used. The drug has antimicrobial and anti-inflammatory effects. It is prescribed as drops. The tool is allowed to be used by children who are prone to allergies.

Physiotherapy

If symptoms of cystitis occur in a child (3 years old), the doctor may prescribe physiotherapy procedures. They will be especially effective in combination with other therapeutic measures.

Physiotherapy methods include:

1. Electrophoresis.
2. Magnetotherapy.
3. Ultrasound therapy.

The doctor may prescribe other methods of physical therapy, based on the complexity of the course of the disease.

Features of monitoring a child after an illness

The child can be observed in the clinic at the place of residence for 1 month after acute cystitis. And at least a year after the treatment of the chronic form of the disease. During this period, a general urine test and other studies are performed, as recommended by a specialist.

Children are vaccinated 1 month after recovery.

Prevention

To prevent the development of cystitis, it is necessary to observe intimate hygiene, timely treat infections and helminthic invasions.

The child needs to improve immunity. This is done by hardening, eating right, and walking regularly.

Conclusion

Cystitis in children 3 years old is a disease that does not pose any particular problems with correct treatment... If therapy is not started on time, it can cause serious complications.

Last updated article: 11.04.2018

Probably everyone will agree with me that the disease of children is carried worst by parents, and not by the baby himself. It is adults who, having repeatedly met with many symptoms of various diseases, know that severe pain can begin, that negative consequences from any disease and its transition into a chronic form cannot be ruled out. Perhaps such knowledge will move the parent in the right direction, that is, he will not postpone a visit to a pediatrician or narrow specialists. One of the serious diseases is children's cystitis in girls. Let's start with the terminology.

Obstetrician-gynecologist

Cystitis Is an inflammatory process of the bladder. It is mistakenly believed that cystitis is a disease of adult women, but in fact, this disease has neither age nor gender. Both adults and children are equally susceptible to it.

Cystitis is common in babies. It must be understood that any cystitis appears when an infection enters the bladder. There can be many ways of multiplying infections.

In different ways, the infection penetrates the urinary tract, and no one "drives it away" there. In general, she becomes comfortable there, and she begins to reproduce. At this time, any person, young and old, feels a burning sensation during urination. Further, the process goes without obstacles into the bladder.

The fact is that in girls, the urethra is quite short, so it does not take long to penetrate the bladder. And due to the fact that this channel is also wide, millions of bacteria can multiply there.

And if there are no defenders from the immune system or the blood supply in this place deteriorates during hypothermia, then the bacteria do not spread anywhere, but remain in place and multiply, and with an excess in the canal, they pass to the bladder mucosa.

There, they attack the entire organ and, without adequate therapy, either rise higher or destroy the mucous membrane and penetrate into the muscle layer. In one case or another, all this leads to disruption of the bladder.

Where does the girl's cystitis come from?

1. Decreased immunity.When the body cannot cope with even small concentrations of infections that come from outside. This also includes hypothermia, vitamin deficiency, the use of drugs that lower protective functions, and chronic diseases.
2. Improper use of diapers. In general, this topic should be approached separately, since improper use of diapers and insufficiently proper care of the genitals can lead to various diseases: cystitis, diaper rash, and so on. Today it is known that changing a diaper is necessary not only after a bowel movement, but also after each urination. This will prevent the formation of harmful microflora and "greenhouse" effect, which aggravate the situation. Parents should make every effort to ensure that at the latest at the age of 2, the girl does not need diapers.
3. Poor hygiene in girls. It is important for parents to understand how to properly wash the baby. It is very important. The structure of the girl's genitals is such that if you wash the child from back to front, then all infections that normally live in the anus will gradually move mechanically into the vagina and urethra, causing an inflammatory process in the urethra. And urethritis always very quickly turns into cystitis due to the structural features of the canal in girls. The fact is that the urethra of the female urinary system is short and wide; in such conditions, any infection quickly enters the bladder. That is why girls get cystitis 6 times more often than boys. It is necessary to teach a baby the skills of personal hygiene from a year, and you can entrust her with the washing process from 6 years old.
4. Mechanical impact. After medical procedures, infection of the bladder with infections is also possible, because a healthy bladder is sterile.

Indeed, sometimes the behavior of a child is not entirely clear, especially if he still does not know how to speak at all. In children under one year old with cystitis, mainly the following symptoms occur:

It is easier with older children - they can already tell where it hurts, although they do not realize the cause of the disease. Therefore, it is important to ask questions correctly and notice everything that he does. Symptoms in children aged two, three years and older are somewhat different:

• frequent urination, pain or cramps may occur during urination;
• pain in the lower abdomen or groin area;
• cloudy urine;
• possible temperature rise;
• urinary incontinence.

In any case, with such symptoms, it is very important not to diagnose yourself, but be sure to contact the clinic, where the child will be examined and adequate therapy will be prescribed.

These symptoms can be a sign of other diseases of the genitourinary system. And each of them requires treatment, since all this speaks of the inflammatory nature of the disease. If they are treated illiterately, then you run the risk of facing serious complications.

Having turned to a doctor, you need to be ready for a complete examination of the child, taking tests and other diagnostic procedures.

Symptoms of acute cystitis:

Such a picture, as a rule, occurs abruptly, often immediately after hypothermia.

With chronic cystitis, girls at 2 - 4 years old complain of:

• periodic pain in the lower abdomen;
• frequent urination, incontinence.

Diagnostics:

1. Pass a urine test. Perhaps, the usual general urine test will not be enough, and then you will need to pass a bacterial urine culture with antibiotic sensitivity, urine analysis according to Nechiporenko. For the analysis to be reliable, you need to properly prepare for delivery. For example, you should wash yourself with soap. If we are talking about a girl who has vaginal discharge, she needs to be covered with a small cotton swab.
2. Make an ultrasound of the bladder and the entire urinary system.

When the diagnosis is confirmed and we can say with confidence that our two to three year old girl has cystitis, then we can already talk about the methods effective treatment.

Much has been written about how to treat cystitis in little girls at 3 years old, 5 years old, 6-7 years old. Today, there are many drugs for effective treatment. In addition to taking medications, treatment also includes a number of important rules:

• taking antibiotics. Antibiotic courses are selected by a strictly treating doctor. It is extremely important to follow all the doctor's prescriptions;
• bed rest or, if possible, rest;
• sedentary warm baths with herbal tinctures (chamomile, sage, oak) for 10 minutes 3 times a day;
• balanced diet. Also, be sure to eat meat and fish! Fresh fruits and vegetables should be present in the diet of a sick child;
• plentiful drink. It is advisable to make fruit drinks with berries for the child (special preference is given to lingonberry berries, they are the most diuretic of all berries), which have diuretic properties. It is advisable to brew fruit drinks and in no case boil, since the child should receive a huge amount of vitamin C with berries. If berries are absent, drinking plenty of water can be combined with drug Kanephron. This medication is composed of herbal herbs that improve the elimination of excess fluid. The drug is suitable for use in children. Usually prescribed 1 - 2 tablets 2 - 3 times a day for 10 days;
• health care. During and after treatment, do not overcool, as this can lead not only to cystitis and its complications, but also to inflammatory diseases in the surrounding tissues.

Treatment of the acute stage of the disease is much easier and faster than the chronic one. The chronic stage is almost impossible to cure. It is important to achieve long-term remission and, at the time of exacerbation, to choose the right therapy.

Appearing for the first time, cystitis can disturb your baby after a while, even if you have completely treated it. This is already a predisposition. Therefore, all prevention methods must be followed.

First of all, you should pay attention to the rules of personal hygiene. The girl should be washed 1 - 2 times a day, the shower jet and the movements of the washing hand should be directed from front to back, and not vice versa. The child's towel must be individual. The use of diapers should be kept to a minimum.

Secondly, it is necessary to ensure that the child does not overcool. In addition, all nutrition must be correct. Minimize the use of unnatural products - sausages, chips, canned food, fried and salted foods. Focus on fresh vegetables, fruits, meat and fish. More outdoor walks.

Thirdly, react as quickly as possible to any ailments or diseases. Since they reduce the immune system and the body's defense mechanisms, which will increase the chances of infection for reproduction.

In addition, you must carefully monitor the behavior of the child, bowel movements. An important factor in the prevention of cystitis is the absence. They lead to a deterioration in blood circulation in the small pelvis (in the intestine and bladder). And this increases the risk of inflammatory diseases. The chair should be regular, therefore, the child's menu should contain fermented milk products, fiber.

Complications

The most dangerous in the disease of cystitis are possible complications.

The first and most formidable complication is pyelonephritis. Ascending, the infection rises through the ureters to the kidneys, where it remains, causing inflammation of the kidneys. Pyelonephritis is difficult to treat and is dangerous for a woman because even after achieving long-term remission, this disease is exacerbated during pregnancy, increasing the risk of negative effects on the fetus.

Vesicoureteral reflux can be another serious consequence of cystitis. IN healthy body the flow of fluid goes only in one direction, and urine is excreted.

With this complication, after inflammation of the bladder mucosa, the muscles can no longer perform the correct emptying of the bladder, and urine can be thrown back into the ureters. And this is dangerous because the infected urine, getting into the ureters, will cause an inflammatory process there.

One of the dangerous and irreversible complications of inflammation of the bladder is interstitial damage to its walls. Interstitial cystitis is an inflammation process that passes from the mucous membrane to the muscle layer and disrupts the work of the entire bladder as a whole.

The symptoms of this disease are the same as in acute cystitis, only the pains are much stronger, and their intensity increases depending on the fullness of the bladder itself. The urge to urinate is frequent and spontaneous, disappearing immediately after emptying the bladder.

All complications are treated with antibiotics and physiotherapy. But despite the immediate start of therapy, there is a chance of encountering complications in the future.

Monotherapy is always ineffective, that is, it will not be possible to treat only with antibiotics, warm baths or diuretic herbs and berries. All treatment should be comprehensive, and then there is a chance of curing this disease.

It is very important to consult a doctor at the first symptoms, follow all the doctor's prescriptions - this is your duty in relation to the child and his health.

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Cystitis in children is an infectious disease that affects the mucous membrane of the bladder and its submucosa. It should be noted that hypothermia or prolonged dampness is quite enough for the onset of an inflammatory process of this nature. However, only a doctor can establish the exact cause of the development of such a disease.

Signs of cystitis in children are quite specific, therefore, as a rule, there are no problems with the diagnosis. However, even with this nature of the clinical picture, it is strongly discouraged to independently compare symptoms and treatment - such activities can lead to the development of complications.

Diagnosis of cystitis in children is based on a physical examination and laboratory and instrumental research methods. Treatment, as a rule, is complex - drug therapy is combined with physiotherapy procedures and diet (if necessary).

Provided that treatment is started in a timely manner, complications can be avoided. In the opposite case, it is possible to attach a secondary infection with kidney damage.

There are no clear restrictions regarding the age group and gender, however, acute cystitis is most often diagnosed in female children in preschool and primary school age.

Etiology

Acute or chronic cystitis in children occurs due to the following etiological factors:

• getting bacteria or infection into the urethra;
• inflammatory process in the genitourinary system due to infection;
• penetration of fungal organisms into the bladder;
• urethral stricture;
• - such a cause of acute cystitis can only be in boys;
• bladder diverticulum;
• decrease in the protective functions of the genitourinary system;
• conducting invasive diagnostic methods;
• disruption of the hormonal background;
• intestinal infections;
• elementary non-observance of personal intimate hygiene (due to the age of the child, this should also be controlled by the parents);
• change in the acid-base balance in the urine;

In addition, a group of etiological factors should be distinguished that are predisposing for the development of such a disease in children:

• decreased immunity against the background of previously transferred infectious or inflammatory diseases;
• hypothermia;
• insufficient amount of essential vitamins and minerals in the child's body;
• chronic;
• visiting public pools or beaches;
• not getting enough physical activity;
• too early onset of sexual activity.

It should be noted that acute cystitis can occur in children even one year old. Only a doctor can determine the exact etiological factor by carrying out the necessary diagnostic measures.

Classification

Cystitis in children is classified according to several parameters - by etiology, by the nature of the course and by pathological changes in the bladder.

So, by the nature of the course, the ailment can be:

• sharp;
• chronic.

By the etiological factor, that is, the nature of the origin of the pathological process:

• infectious (occurs most often);
• non-infectious.

The non-infectious type of cystitis in a child, in turn, is divided into the following types:

• drug;
• chemical;
• toxic.

By the nature of pathological changes in the bladder, the following forms of the disease are distinguished:

• follicular cystitis;
• cystic;
• hemorrhagic cystitis (in children it is quite rare);
• catarrhal;
• bullous cystitis;
• ulcerative;
• polyposis cystitis.

To establish which form of the pathological process takes place, as for changes in the bladder, the doctor can only with the help of instrumental diagnostics.

Symptoms

Due to the fact that the child cannot always accurately depict the clinical picture, and in some cases may be completely silent about the symptoms that disturb him, the diagnosis is often carried out out of time.

In general, cystitis in a child manifests itself as follows:

• the urine turns dark yellow;
• the child becomes restless, often wakes up at night, cries;
• fever (however, it should be noted that the temperature does not always rise with cystitis);
• too frequent or, on the contrary, too rare urination;
• the child may involuntarily urinate under him;
• blood may be present in the urine;
• groin pain;
• each process of urination can be accompanied by sharp pain and burning sensation, while leaving the feeling that the bladder is not completely empty;
• urine may have a pungent, unpleasant odor.

It should be noted that if in the clinical picture there is an increase in temperature and attacks of fever, then it is quite possible that the pathological process has affected the kidneys and develops. However, only analyzes can show this for sure.

Diagnostics

Diagnostics for suspected implies laboratory tests and instrumental research methods. The initial stage is a physical examination of the child, during which a general history and current clinical picture are clarified.

The laboratory part of the diagnostic program involves the following analyzes:

• UAC and LHC;
• general urine analysis;
• biochemical analysis of urine;
• urine pH.

Instrumental diagnostics involves the following manipulations:

• Ultrasound of the bladder;
• Ultrasound of the kidneys;
• cystography;
• cystoscopy.

In view of the fact that the clinical picture, in this case, is rather nonspecific in nature, it may be necessary to carry out differential diagnostics regarding such pathological processes:

• pyelonephritis;
• swelling of the bladder;
• sharp.

Additionally, you may need to consult a pediatric gynecologist and pediatric surgeon.

Based on the results of diagnostic measures, it is possible to determine the form of the disease and, therefore, determine the most effective treatment tactics.

Treatment

How to cure cystitis in a child, the doctor can tell only after an accurate diagnosis. In general, therapy is carried out using conservative methods - taking medications, adhering to a diet and physiotherapy procedures.

The medication part of the home treatment involves taking the following drugs:

• antibiotics;
• non-steroidal anti-inflammatory;
• pain relievers;
• diuretics;
• uroantiseptics;
• derivatives of phosphate acid.

Antibiotics for cystitis in children are prescribed strictly individually. It is impossible to take such drugs on your own, as this can cause irreparable harm to the child's body. In general, tablets for cystitis for children are prescribed in minimal quantities or, if possible, are completely excluded.

Also, the doctor may prescribe the following physiotherapy procedures:

• dry heat on the lower abdomen;
• sessile baths from herbal decoctions - chamomile, eucalyptus, St. John's wort, horsetail;
• magnetotherapy;

Diet for cystitis in children means the following:

• irritating food is excluded - spicy, sour, too salty;
• the diet should be dominated by vegetable and dairy products;
• the volume of liquid drunk per day should be increased by 50%. Fruit drinks, fruit drinks, herbal decoctions, still mineral water are well suited for this.

Treatment of cystitis in children with folk remedies is allowed, but only as an addition to the main course of therapy and in agreement with the attending physician. Traditional drug treatment remains a priority.

Possible complications

Lack of treatment can lead to the following complications:

• cystitis turns into;
• pyelonephritis;
• paracystitis.

It is also possible for the infection to spread to other body systems.

Prevention

Prevention of cystitis in children consists in the following recommendations:

• the child's immune system should be strengthened;
• prevent hypothermia and getting wet feet;
• monitor the child's intimate hygiene.

Children who have suffered an acute form of cystitis should be monitored by a pediatric urologist / gynecologist and undergo preventive medical examinations.

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Urolithiasis (urolithiasis) is a pathological process that leads to the formation of stones in the bladder, ureter, or kidneys. The disease is diagnosed in 3% of the total population. In young people, stones are found most often in the kidneys and ureter. In elderly people, pathology is formed in the bladder region. This ailment has no restrictions as regards age and gender.