Bladder infections

11. May 2021

Not just a women’s issue

Not just a women’s issue

Most people believe that common bladder infections only affect women. Far from it. The generally accepted view is that bladder infections are typically the result of a reduction in abdominal temperature which weakens the bladder’s immune system. That’s only half the story, however.

Bladder infections should never be underestimated; if left untreated, they can have harmful consequences such as an irritable bladder, gallstones, incontinence, urinary tract infections and, in the worst-case scenario, bladder cancer.

The book “Blase gut – alles gut” (Bladder fine, everything fine”) has brought our attention to this matter. Prof. Dr. med. Stephan Roth, Director of the Department of Urology at the University Hospital Wuppertal and Professor of Urology at the University of Witten/Herdecke, who news magazine ‘Focus’ selected as one of Germany’s top physicians, has recently published his book “Blase gut – alles gut” on Books on Demand.

A bladder guide 

The book’s 288 pages are essentially a universal guide to the bladder. You’ll find accumulated knowledge about the bladder and how you, or a physician, can treat it in the event of inflammation, incontinence, frequent urination and other discomfort.

Unfortunately, the hope of a magic pill to simply combat this problem is often in vain, Roth writes. His book is designed to remove the stigma associated with bladder problems and encourage us to visit the doctor before it’s too late. More information about abdominal care is available at www.blasendoktor.de

Bladder infections should be taken seriously

Although bladder infections are often triggered by different causes in men and women, the first signs of a bladder infection for either gender include a constant need to urinate, a burning sensation while urinating and abdominal pain. An unpleasant burning sensation is typically felt while urinating, sometimes with severe pain, that leaves the individual feeling as though they constantly need to dash to the toilet. 

The urine is often cloudy and can even contain blood in more severe cases, accompanied by abdominal pain or cramp. This can then lead to gallstones. “Gallstones” generally form when the bladder does not fully empty itself, i.e. residual urine remains inside the bladder,” explains Dr Feigl, Senior Physician at the Clinic for Urology at the Klinikum München-Bogenhausen Hospital, to Apotheken-Umschau magazine.

A matter we don’t like to discuss

Many people are unaware that bladder infections are one of the most common types of infection that allergy sufferers deal with, along with respiratory illnesses. We believe that this could be due to the fact that people don’t like talking about it.

It’s understandable that people don’t like to discuss their bladder among friends or acquaintances, preferring to stay silent and suffer alone. However, the topic must be taken seriously as, if left untreated, it can lead to harmful consequences.

A bladder infection (cystitis) is an inflammation of the bladder whereby discoloured urine is usually the first sign that something is not right with the bladder. In order to find out whether it is indeed a bladder infection, you can take a urine test at home (available from the pharmacy). If the test indicates a bladder infection, you should visit the doctor without delay. Rapid tests can be carried out in medical practices to detect bacteria in the urine.

Women are four times more likely to experience bladder infections than men. Half of all women will experience it at least once during their lifetime. It affects women of all ages: young girls, women and over-60s.

The most common cause of bladder infections in women is Escherichia coli and enterococci. These can enter the body through contaminated drinking water or eating contaminated food. Enterococci often cause bladder infections. When the bacteria leaves the intestines and enters the bladder, this causes inflammation of the ureter, bladder and urethra.

Bacteria causes 95% of bladder infections. “The most common cause is Escherichia coli. It forms part of the natural intestinal flora and performs an essential function,” says General Practitioner Petra Rudnick at the TK-ÄrzteZentrum medical centre. The urethra and anus are naturally closer together in women than men. The female urethra is several centimetres shorter, enabling bacteria to enter the bladder more easily.

More uncommon causes can include poor hygiene or sexual contact. However, this cannot be ruled out. Bladder infections used to be almost exclusively treated with antibiotics, but this is now advised against. Antibiotics are only prescribed in serious cases. For mild discomfort, doctors recommend using anti-inflammatory pain relief such as Ibuprofen.

Other alternatives are available

Recovery from a bladder infection can be accelerated by drinking plenty of fluids to flush out the urinary tract and by covering the bladder with a hot-water bottle or warm compress and taking a bath. Cranberry and blueberry juice can also help. Generally, you should drink plenty of fluids such as bladder and kidney tea to aid recovery. Citrus juice, coffee and alcohol should be avoided.

Urologist Schultz-Lampe highlights: “Cranberry is currently the most effective prevention for frequent bladder infections.” The contents of the berry paralyse the tiny hair cells of the bacteria, making it harder for them to latch onto the bladder mucosa, explains the doctor to Stuttgarter Nachrichten. Drinking cranberry juice significantly reduces the amount of bacteria in the urine.

Herbal remedies

Herbal remedies such as mustard oils from nasturtium or horseradish are used and recommended to treat uncomplicated urinary tract infections such as frequent bladder infections as they are well tolerated. In 2017, they were added to the updated German S3 guideline for treating uncomplicated urinary tract infections.

If gallstones have already formed, these can be treated using medication (litholysis). Larger stones are identified using an ultrasound scan, broken down using shock waves and then passed via the urine.

Bladder cancer

If a bladder infection is left untreated for many years, this increases the risk of bladder cancer. Around 22,000 men and 7,000 women in Germany suffer from this each year.

Men are around three times more likely to be affected than women. In terms of new diseases, bladder cancer is one of the most frequent forms of cancer in Germany. The treacherous thing about bladder cancer is that it grows slowly over 15 to 30 years without you noticing.

Bladder cancer is difficult to detect in the early stages as there are no clear signs of bladder cancer and no specific symptoms. According to the Cancer Information Service, there is a statutory cancer screening programme, however bladder cancer is not one of the recognised tumour types due to a lack of scientifically proven test procedures.

If it spreads to the neighbouring abdominal organs such as the prostate in men or the uterus in women, this becomes an issue. If bladder cancer is detected too late and has already infected the muscle and lymphatic tissue, bladder removal will not help as the result is fatal. 4,000 patients die of a bladder tumour each year in Germany.

The risk of developing bladder cancer increases with age. However, younger people can also be affected. 

The exact cause of bladder cancer is uncertain, although several risk factors have been detected. These include smoking, chemical substances, certain medications (including the painkiller phenacetin) and the chemotherapy medication cyclophosphamide, chronic bladder infections and gallstones. 

Straight to the doctor

It is important to consult a doctor at the first signs of blood in the urine. If left untreated, the tumour can penetrate the deeper layers of the bladder. This can be prevented by visiting the doctor in good time: in seven out of ten cases the bladder cancer is still present in the mucous membrane and can be easily treated. 

The doctor will first carry out a consultation with the patient followed by a blood and urine sample. Should these appear suspicious, the doctor will arrange additional measures such as an ultrasound and cystoscopy to eliminate or confirm the suspicion of bladder cancer.

Once the doctor has the results of all the tests, they can determine what stage the cancer is at, how the illness will develop and whether they can treat the cancer.

Bladder cancer is not necessarily fatal, however if left untreated life expectancy will be reduced. The earlier the diagnosis is made, the better the chances of recovery. 70 percent of individuals affected recover. If the bladder cancer is superficial and has not yet spread, the chances of recovery are almost 80 percent. The patient must attend regular check-ups to detect if any carcinomas have returned.

So remember: bladder fine, everything fine and stay healthy!

Sources:

Academy of German Urologists, working group on Urolithiasis (Arbeitskreis Harnsteine), version dated 2015

Urology portal, German urologist websites; http://www.urologenportal.de

S3 guideline for uncomplicated urinary tract infections – Update 2017 (Interdisciplinary S3 Guideline on “Epidemiology, Diagnostics, Therapy, Prevention and Management of Uncomplicated, Bacterial and Community-acquired Urinary Tract Infections in Adult Patients,” AWMF Register No. 043/044)
Uncomplicated to problematic, diagnosis and therapy of urinary tract infections. In: Deutsche Apotheker Zeitung, no. 18, May 2014, pp. 42–55.
Glucosinolates against bacterial infections. In: Deutsche Apotheker Zeitung. No. 25, June 2010, pp. 105–107.