I have a problem with recurring inflammation of the bladder
A recurring inflammation of the bladder means that it recurrs after having previously been cured. In the course of just one year recurring urinary tract infections affect 36% of young women and 53% of women above 55 years of age. Risk factors include, unfortunately, an increase in sexual intercourse over a period of one month, a family predisposition, a new sexual partner or the use of spermicide.
Nevertheless, the risks for complicated urinary tract infections are different: immunosuppression, diabetes, a kidney transplant, repeated catheterization, cystocele (anterior vaginal prolapse) or multiple sclerosis.
How the problem is diagnosed
Typical symptoms include frequent urination, urging and a burning sensation during urination. Women with these symptoms have a likelihood of infection of 50%. If possible, we wait on the treatment until the results of a urine cultivation are know, as these can even reveal the sensitivity of the possible infection to antibiotics.
How the problem is treated
There is no recommended approach. Treatment of the first recurrent uroinfection is the same as in the case of a singular random uncomplicated infection. Apart from a drinking regime, it consists of using antibiotics (nitrofurantoin or trimetoprim/sulfametoxazol).
Women suffering recurring urinary tract infections should undergo a consultation with a professional.
Antibiotic prophylaxis for 6-12 months is an option. This can be daily use or post-coital application (i.e. antibiotic tablet after sexual intercourse).
In this second case it is sometimes recommended to urinate after intercourse.
In certain cases it is possible to allow a woman, who is experienced with the early symptoms of a urinary tract infection, to deploy antibiotics herself. If, however, no effect is seen within 48 hours, she should consult a professional.
Another option, however, which is debatable, is the use of cranberries in various forms.
Some studies recommend the use of vaginal estrogen (in tablet or gel form).
Any genitourinary anatomical abnormality (prolapse, constriction of the urethra,...) should be treated.
Another option is so-called immunostimulant drugs. An example is an extract - lysate from Escherichia coli bacteria. The bacteria are broken down and disposed of, but contact with their structures stimulates the immune system. It is usually taken once a day for 3 months.
One of the newest options is the injection (so-called instillation) of hyaluronic acid directly into the bladder. Hyaluronate increases the glycosaminoglycan (GAG) layer on the inner surface of the bladder, thus providing a barrier. Application is done once a week for 4-6 weeks and then once a month for a total of eight doses.
Laser therapy is a currently debated approach. It has been suggested as it stimulates tissue repair and restores normal vaginal function. Small studies show that around 90% of women observe a positive effect. The results are supported by the observed microscopic (histological) changes in the tissues. The effect of the treatment is observed very quickly. Over the next 4 months, there is an improvement in vaginal dryness, burning, itching, pain during intercourse and urinary problems. However, sufficient long-term results are not yet available.
Application of hyaluronic acid
Laser therapy