Cystitis tests: what should I take?

Inflammatory diseases of internal organs are pathologies, the diagnosis of which is based on the results of analyzes and instrumental studies, which make it possible to see what is inaccessible to the naked eye. When it comes to the urinary system, in particular the inflammatory process in the tissues of the bladder, laboratory studies come to the fore. Analyzes with cystitis can not only diagnose inflammation in some parts of the body and determine its pathogen, but also assess the condition of other organs associated with the bladder, because the infection tends to spread inside the body.

Little about cystitis

Among the various pathologies of the genitourinary system,  cystitis  is considered one of the most popular diseases. The inflammatory process with localization on the walls of the bladder (that is what doctors mean when they diagnose "cystitis") is associated with getting into the system responsible for the production and excretion of urine, a bacterial infection.

Causes of infection of the bladder can be:

• Inadequate hygiene of the genital organs, because the perineum and genitals in this case become a real breeding ground for infection, which can travel up the urethral canal to the bladder.
• Infectious and inflammatory diseases of other organs of the urinary system, most often the kidneys (in this case, the bacteria need only come down with the urine).
• Chronic or hidden infectious pathologies of other organs and systems (if an infection has entered the body and actively reproduces, it doesn’t cost anything with a blood stream to transfer to any internal organ equipped with blood vessels, discovering all new places of dislocation, one of which may be urinary bubble).
• The lack of regular visits to the toilet when necessary for small needs (rare urinary incites provoke stagnant processes in the bladder, and overstrain of the organ adversely affects the state of its tissues, which results later in inflammation).
• Congenital abnormalities of the bladder and urethral canal, disrupting the normal flow of urine and leading to stagnation of fluid, inflammation of the bladder, stone formation.
• Urinary and renal disease, tumor processes in the bladder and near the ureters (urine outflow may also be disturbed, and concentrated sediment will irritate the walls of the bladder and provoke their inflammation).
• Viral pathologies, including HIV infection, reduced immunity lead to the fact that conditionally pathogenic microorganisms begin to parasitize in the body, which, against the background of the normal functioning of the immune system, are considered safe. The reproduction of such microorganisms is accompanied by intoxication and the development of the inflammatory process in the tissues of the organ where bacteria are operating.
• Overcooling of the pelvic area helps to reduce local immunity, which also provides opportunities for reproduction and parasitism of conditionally pathogenic microflora, which is always present on our body.
• In women, even pregnancy can provoke cystitis, which, due to hormonal alteration of the body, is a strong blow to the immune system. In addition, in the later stages, the bladder constantly experiences pressure of the uterus that increases with each day, which disrupts its normal functioning and can lead to tissue inflammation.
• Infectious and inflammatory diseases of the genital organs, including STDs, are a source of pathogenic microflora, which can leak through the urethra and into the bladder, which often happens in the weaker sex. In men, the source of infection can be an inflamed prostate gland (prostatitis), which has a common exit into the urethra with the bladder.
• Less commonly, drug therapy is causing the inflammation. It, like solid stones in the bladder (mineral salts), scratching and irritating its walls when urine moves, leads to the development of a non-infectious form of cystitis.

The impact of the above factors can lead to the fact that in one not the most beautiful moment a person will have to seek help from doctors complaining of discomfort and pain in the lower abdomen, burning and cramping when urinating, frequent urge for a small need, feeling of heaviness in the bladder during that urine can stand out a little.

Moreover, in the acute phase of the process, the temperature may even rise, and blood is detected in the urine, which is a dangerous sign indicating either severe inflammation with the appearance of erosions on the walls of the bladder or the presence of stones inside the organ.

Acute cystitis usually occurs with pronounced unpleasant symptoms, markedly reducing a person’s quality of life. But timely diagnosis and effective treatment help to quickly get rid of such an unpleasant disease. If the disease is started, it becomes chronic, and although the symptoms in this case are hardly noticeable and practically do not interfere with the person’s life and work normally during periods of calm (remission), there is a great risk of various complications that are more dangerous than cystitis itself.

Symptoms of cystitis can not be called specific, since similar sensations in the form of pulling pain in the lower abdomen and pain when urinating are experienced by patients with venereal diseases. This similarity of symptoms often causes men and women to feel embarrassed about their problem, taking it for an STI, and instead of going to a doctor, they self-medicate, which only aggravates the situation.

You should not try on the role of a specialist urologist or venereologist, because the disease, whatever the kind, is considered a pathology and requires special treatment. But even a doctor has the right to prescribe such treatment only after an accurate diagnosis is established.

[1], [2], [3], [4]

Diagnosis of cystitis

You should not play with your health, especially since it is not that difficult to diagnose cystitis. With the existing complaints, the patient can turn to his therapist, and he will make a preliminary diagnosis on the basis of medical history and laboratory tests and decide which doctor to visit: patient, urologist, nephrologist, gynecologist, venereologist, etc.

Such a scheme of actions is considered more effective than immediately referring to a narrow specialist. Firstly, the patient himself may be mistaken with the diagnosis, and the doctor's verdict (even if of general practice) will be more close to reality than the opinion of a non-expert, which most of us are.

Secondly, it is often not so easy to get an appointment with a specialist. Reception may not be daily, strictly limited in time, etc. All these nuances can significantly delay the moment of the first dose. And this is not only lost time, but also lost opportunities, because on these days and hours of waiting one could pass some general tests that can be prescribed safely by a therapist with cystitis.

In this case, the patient will turn to the narrow specialist for the subsequent diagnosis and prescription of the treatment fully armed, because even the results of general blood and urine tests can tell a lot about the condition of the genitourinary system.

According to the results of the general tests and the patient’s history, the urologist or another doctor can immediately make a preliminary diagnosis and prescribe more detailed studies to help determine not only the localization of the inflammatory process and the extent of organ damage, but also the cause of the disease.

If a complete laboratory examination gives controversial results and does not allow an accurate diagnosis, they resort to instrumental methods of diagnosis, such as ultrasound of the pelvic organs and kidneys. Additionally, cystoscopy and a smear can be assigned to the microflora to detect sexually transmitted infections. The fact is that cystitis is often diagnosed in conjunction with other urogenital diseases, being a complication of them or less often a cause.

[5], [6]

Indications for the procedure of the cystitis tests

Laboratory tests in the diagnosis of cystitis prescribed, regardless of the form of the disease. But what exactly can tell the doctor that the patient has cystitis?

Inflammation of the bladder is very rarely almost asymptomatic, especially when it comes to the acute form of the disease, which is characterized by the following points:

• The sudden appearance of symptoms indicating a pathology already in the first days of the disease.
• Symptoms appear almost immediately after exposure to provoking factors, which are stresses, hypothermia, active sex, a sharp decrease in immunity, usually occurring against the background of viral pathologies, etc.
• A notable symptom of the disease is frequent painful urination, the need to empty the bladder more often than usual, with small portions of urine (it is extremely difficult for patients to hold urine in the urea for more than 3–4 hours).
• Patients with acute cystitis are tormented by quite strong nagging pains in the lower abdomen and in the intervals between urination. The pain may also extend to the perineal region.
• Blood is often detected in the urine of patients with cystitis. In this case, the urine itself becomes more turbid and dark.
• Complicated cystitis caused by pathogens, as well as the transition of inflammation to the kidney area may be accompanied by hyperthermia and chills.

If acute cystitis is triggered, an infectious-inflammatory process can quickly affect not only the bladder, but also nearby organs associated with it: the kidneys (pyelonephritis) or the urethra (urethritis). If the disease is not completely treated, there is a high risk of its transition to the chronic form, which will worsen with each decrease in immunity, exposure to cold, etc., and, eventually, again can cause diseases of other organs, because the bladder will remain a source of infection for the whole body.

An identical situation is observed when self-medication or an incorrect approach to the choice of drugs for cystitis (for example, when infectious cystitis is treated without the use of antibiotics and antifungal agents, or these drugs are inactive against the causative agent of the disease). The latter is often the case when refusal to conduct bacteriological tests for cystitis, allowing to determine the sensitivity of the infection to the drugs used.

Some people, having coped with the symptoms of acute cystitis on their own, believe that they have overcome the disease, and they are very surprised if the symptoms reappear after a while. But now we are talking about chronic cystitis, the symptoms of which will remind of themselves again and again.

This form of pathology is characterized by the following complaints:

• Discomfort in the lower abdomen, aggravated during the recurrence of the disease.
• More frequent than the urge to urinate, because the inflammation in the tissues of the bladder, though it becomes less, but does not disappear completely.
• The act of urination may be accompanied by a slight soreness and discomfort. With exacerbation of the disease, this symptom increases.
• Over time, symptoms of intoxication (frequent headaches, nausea, etc.) appear.

Complaints about the onset of symptoms of acute or chronic cystitis are grounds for prescribing tests. However, in some cases, the inflammatory process in the bladder is detected by chance during the delivery of general urine and blood tests during a physical examination or a visit to a doctor for another disease. So tests can do a good service even in the absence of obvious symptoms of the disease.

Among other things, the doctor may prescribe tests during the treatment of cystitis, which will help assess the effectiveness of treatment and, if necessary, revise the prescription.

Laboratory diagnosis

Cystitis is a disease whose diagnosis relies on the results of laboratory tests more than in other diseases. Doctors prescribe many different tests that allow you to recreate a complete picture of the disease so that its treatment is as effective as possible.

The tests prescribed for cystitis can be divided into general and specific. Both the therapist, and the urologist or other narrow specialist possessing sufficient knowledge for the decision of the given problem can appoint the first. Special analyzes are already the prerogative of narrow specialists. But since those and other studies are important in the diagnosis of cystitis, we will mention all types of tests, ranging from the simplest.

So, what kind of tests do you usually have for cystitis?

A complete blood count, although not particularly revealing when diagnosing cystitis, is indispensable. The inflammatory process in any organ necessarily affects the state of the blood, in which an increased number of white blood cells and high erythrocyte sedimentation rate (ESR) is detected.

But a general or clinical blood test (UAC) helps only to determine the presence or absence of the inflammatory process in the body without indicating its localization and the cause of the inflammation of the tissues. In addition, at an early stage of the disease or in its mild form, a noticeable increase in leukocytes may not occur, which means that other research methods will be required that provide more useful information.

Urinalysis  (OAM) is considered a more informative study. Like the KLA, it allows detecting a high level of leukocytes, but since the study concerns urine, this indicates an inflammatory process in the urinary system (kidney, bladder, urinary tract). At the same time, protein and epithelial cells that are rejected as a result of inflammation can be found in the biomaterial.

With a strong acute inflammation of the urinary system and the formation of calculi in the urine can also be detected red blood cells (blood in the urine). Since cystitis is considered an infectious disease, the OAM results will include data on a bacterial or fungal infection.

But, despite all the important information that OAM provides, the study does not allow to accurately determine the localization of inflammation and to understand whether this process has covered the bladder or the cause of “abnormal” tests are kidneys (although it is possible that both organs are involved).

Urine analysis according to Nechiporenko  is considered a popular special method for diagnosing diseases of the urinary system. Such an analysis is of great value if the results of previous studies were not sufficient for a definitive diagnosis. The study of morning urine using this method allows to determine the exact number of leukocytes, erythrocytes and cylinders.

Urine analysis with the Addis-Kakowski method  is not a popular special study. Nevertheless, its results may be useful in conducting differential diagnostics, since they make it possible to detect a specific symptom of cystitis (the frequent urge to urinate is based on the fact that it is difficult for the inflamed organ to retain a large amount of urine for a long period of time).

A urinalysis according to Zimnitsky is  necessary if a doctor has suspicions of an inflammatory process in the kidneys, which can be detected as a separate disease or accompanying cystitis. This analysis requires not one but several batches of urine collected during the day to determine the total amount of urine and the specific gravity of each portion.

Bacterial urine culture is performed to detect infectious factors in the urine and to identify it, in other words, to identify the causative agent and its quantitative characteristics indicating the severity of the infection.

Cystitis is a pathology without special age and sex restrictions. The disease can be detected in men or women (in women, pathology is diagnosed almost a hundred times more often), in adults and children. But the structure of the genital organs and urethra in people of different sex and age is somewhat different, which is the reason for the different approaches to the appointment and testing for cystitis.

The urinary bladder is the organ of the urogenital system, which is associated with the kidneys through the ureters and opens into the cavity of the urethra. It performs cumulative and excretory functions. When the volume of urine in the bladder reaches 200-400 ml, we begin to experience discomfort and the urge to empty the organ (urination) appears.

The shape, structure and location of the bladder in women and men is almost the same. Differences begin in the area of the urethra, which in men is 5-6 times longer than in women.

[7], [8], [9], [10], [11]

Tests for cystitis in women

Since the female urethra has a small length (the size of the female urethra is about 3-4 mm), but it has a large width, as well as being close to the genitals and the anus, it is not surprising that cystitis has long been considered a female disease among the people. Infection of the bladder is facilitated by natural vaginal discharge, which may contain cells of bacteria and fungi, and the rectum. Short and wide urethra can hardly be considered an obstacle in the path of microorganisms.

Since in women, cystitis is most often infectious in nature (an infection can cause a disease or join later because of the proximity of the source of infection and the urethra and favorable conditions for the reproduction of pathogens), in addition to the above laboratory tests, they may be assigned additional tests:

• Bacteriological study by the method of polydimensional chain reaction (FRC analysis). It allows you to accurately determine the causative agent and its sensitivity to prescribed antimicrobials.
• Cytological examination of the smear with the determination of the composition of the microflora of the vagina (often carried out if the fungal nature of the inflammatory process or the presence of nonspecific pathogens is suspected).
• Examination of a urethral smear (if an infectious urethritis is suspected).

An increase in the number of epithelial cells in the urine is not only characteristic of cystitis or urethritis. An identical picture can also be observed in inflammation and dysplastic processes in the uterus and vagina (especially if there was no necessary preparation for the urine test), therefore the gynecologist will have to examine the woman. If necessary, ultrasound of the small pelvis or of individual organs is prescribed (an ultrasound of the bladder is performed with a filled organ), cystoscopy, biopsy with subsequent histological examination (on suspicion of oncology).

Tests for cystitis in men

The structure of the male body is such that the penis is also the urethra. At the same time, the length of the urethra is large, and the probability of infection penetrating into it is lower than that of women.

In the male bladder, an infection can get from the anus (usually with a lack of hygiene) or with unprotected sex (again, if the hygiene after copulation is not followed). Only the long urethra usually takes a hit, and the infection does not always reach the bladder. This is associated with more modest statistics on cystitis in men.

However, the disease has the same symptoms and causes as the weaker sex, so the indications for testing are not much different. If an infectious cystitis or urethritis is suspected, a HRC analysis and smear from the urethra can be assigned to a man for a microflora test.

Soreness during urination and urine excretion in small portions can also be observed with obstruction of the urethra (narrowing of the organ or blockage with stones), so it is desirable to carry out uroflowmetry. Urodynamic analysis helps eliminate or confirm abnormalities of the bladder sphincter. If blood is detected in the urine, cystoscopy is shown (the apparatus for analysis resembles an endoscope and helps to examine the walls of the urethra and bladder from the inside).

Ultrasound of the bladder and prostate help assess the condition and walls of the bladder, its size, identify structural abnormalities, the formation of stones, etc. Suspicion of tumor processes requires confirmation of a biopsy.

Tests for cystitis in a child

In childhood, cystitis is considered the most common urological infection. Most often, the disease is diagnosed in girls 4-12 years old, which is associated with the structure of their urogenital system.

As in adults, the disease can occur in conjunction with other pathologies of nearby organs of the urinary system (urethritis and pyelonephritis).

The cause of the disease can be:

• Violation of urine outflow (a lot of conditionally pathogenic microorganisms pass through the urinary system, but with regular urination, the liquid clears the bladder from streptococci, staphylococci, Escherichia coli, etc., which circulate in it). Any damage to the bladder mucosa, disruption of the various components of the system, reduced immunity contributes to the delay and reproduction of infection.
• Viral infections in the body of the child, hypothermia pelvis, violate the immune system and microcirculation in the tissues of the bladder.
• Fungal infections (usually develop on the background of reduced immunity in children with HIV infection, pathologies of the urinary system, after antibiotic therapy).
• Nonspecific infections (chlamydia, mycoplasma, ureaplasma and others) are rarely detected and are usually associated with lack of hygiene and the presence of the same type of infection in parents. Pathogens of gonorrhea and trichomonads in the bladder can be found in adolescents, leading active sex life.
• Foreign bodies in the urinary system.

Among other things, the disease can be provoked by some diagnostic procedures (the same cystoscopy), drug treatment with nephrotoxic drugs, dysbacteriosis, helminthiasis, intestinal infections, inflammatory processes in the body of various localization. In girls, gynecological diseases (for example, vulvovaginitis) cause cystitis.

Risk factors are endocrine diseases, hypothermia, changes in urine acidity, and avitaminosis. Do not forget about the lack of hygiene, which is characteristic of careless adolescents (at a child's age this time is controlled by the mother).

What are the symptoms in children can be an indication for laboratory tests, because kids can not always clearly describe their feelings:

• Children of infancy with suspected cystitis become restless (especially at the time of emptying the bladder), may cry and act up, refuse to eat. A child may become sluggish or, on the contrary, overly agitated. The body temperature of the baby will be kept within subfebrile values. You can note a decrease in the number of urination.
• Older children can show their parents and doctor that he has a stomach ache in the suprapubic area. The pain will be stronger during the filling of the bladder or palpation of the abdomen. A child may cry during urination, often go to the toilet in a small way, and there is little or no urine. Sometimes involuntary emptying of the bladder is noted. At the end of urination, you can sometimes see blood drops in the urine.

For the diagnosis of cystitis in children, various methods of laboratory diagnostics are also used: general blood and urine analysis, blood biochemistry, bacpericulture, urine acidity testing, two-glass test, urinalysis according to Zimnitsky and Nechiporenko. Usually, a urine test is taken naturally, but in severe cases a catheter is used.

It is also possible the appointment of ultrasound, as well as cystoscopy and cytography, relevant in chronic cystitis.

When diagnosing acute cystitis, when fast results are needed, rapid methods can also be applied:

• Rapid test for determination of nitrite content in urine by means of indicator strip (nitrite in urine appears under the influence of pathogenic microflora).
• The express strip showing the content in the urine of leukocytes and protein.
• Leukocyte esterase reaction (esterase accumulates in the urine if there is a purulent process in the urinary system).

If a child’s cystitis is suspected, parents should pay attention to the very appearance of the baby’s urine by collecting a small amount of it in a clean, transparent container. When inflammation of the mucous membrane of the bladder urine is dark and not transparent enough, it can be detected light flakes and blood.

Preparation

So that the results of laboratory tests of urine and blood were reliable, and the doctor was able to make an accurate diagnosis using them, not only the professionalism of the nurse in the manipulation room and the time of analysis, but also the correct preparation for it, are important. Consider the question of how to properly prepare and pass blood and urine tests prescribed for cystitis.

Complete blood count is a laboratory test of blood taken from a patient’s finger, which in cystitis can show a moderate inflammatory response. This study does not require special preparation. The only thing that it is recommended to spend in the morning on an empty stomach, at least, you can eat a light breakfast an hour before the test. During the same hour, doctors ask not to smoke.

With regard to food for 1-2 days before the analysis, it is better to abandon spicy and fried foods, as well as the use of alcohol and drugs. You can not donate blood after x-rays and physical procedures.

A urine test for cystitis may have to be taken repeatedly. This is a very important study that should be given special attention. The delivery of urine collected in a jar in the toilet of a medical facility without prior preparation is unlikely to facilitate the correct diagnosis, because it may contain additional components that distort the result of the research.

What measures to prepare for the delivery of a general urine test, on the basis of which a presumptive diagnosis is made, should be taken:

• A day or two before the urine tests, you need to adjust your diet somewhat, refusing to use products that urine tint. These include: vinaigrette beets, carrots, strawberries, i.e. Any fruit and vegetables that have a bright color.
• An important indicator of urine analysis is its acidity. In order for this indicator to remain reliable, on the eve of the analysis it will be necessary to exclude sour drinks, juices, mineral water, and salt products.
• The smell of urine also plays a role in the diagnosis. Some products can strengthen it, therefore strong ammoniac aroma, characteristic of cystitis, will be felt. In this regard, it is not recommended to eat onions, garlic, asparagus and other foods with a strong aroma the day before.
• Before the analysis it is necessary to refrain from taking certain types of drugs (diuretics and laxatives (including extracts of senna), Biseptol, sulfonamides).
• For women, there is a particular limitation regarding menstruation. It is better to pass the test after it ends, so that the blood from the menstrual flow does not enter the urine, because this situation can be observed with acute cystitis and stones in the urinary system, which only distorts the real diagnosis.

If the analysis is needed urgently, after hygiene procedures it will be necessary to close the entrance to the vagina with a swab.

• The material for urinalysis should be fresh, i.e. Collected in the morning before surrender. Otherwise, change the composition of urine and acidity under the influence of air. Alkaline urine may indicate inflammation of the bladder and kidneys, even in their absence.
• If you need to collect the urine of a small child, you can not relieve yourself of the task, trying to squeeze the biomaterial from the diaper or cotton wool, under the baby, the old pot, the used diaper (it is not as simple as it seems, besides, the result of the analysis may be questionable). Do not use unsterilized baby food jars to collect urine. Urine should be collected directly from the source into a sterile container. For infants use special garbage bags, attached to the perineum (they can be purchased at the pharmacy).

Now with regard to the rules for passing urine analysis, which are markedly different for men and women. Common to all patients is the preliminary preparation of containers for analysis. You can wash and sterilize a jar with a volume of no more than 250 ml, as was done before. But now in pharmacies you can buy a special sterile plastic container that is designed to collect urine. In private clinics such containers are issued at the time of sending for analysis.

How to collect urine for women:

• The structure of the female genital organs is such that in the area of the urethra outside conditionally pathogenic microorganisms and physiological vaginal discharges that do not have to get into the studied biomaterial regularly accumulate. Therefore, it is very important for a woman to carry out hygienic procedures before collecting urine, which provide for thorough cleansing of the external genital organs, trying to cover all skin folds and the entrance to the vagina. Hygiene of the genital organs is carried out with the use of toilet or children's (not antibacterial) soap and water. It is better to use cotton pads or a clean cloth.
• It is more convenient to carry out hygienic procedures immediately on the toilet, after washing hands with soap and water. The direction of movement of the arm when flushing should be from front to back (ie, from the urethra to the anus), but not vice versa.
• After the hygienic procedures, we take the prepared container, trying to hold onto only the outer walls.
• With our free hand, we separate the labia and release a few milliliters of urine into the toilet (the first urine will wash the microbes that remain on the surface of the genitals).
• Still holding the labia, inserts the container under the stream of urine and collect biomaterial into it (the volume of urine should be in the range of 50-100 ml, no longer needed).
• Tightly closed containers should be delivered to the laboratory within half an hour. Urine retains its properties during the day, if it is placed in a closed vessel in a refrigerator in case you cannot take the material on time.

Preparing for urine analysis for men is easier, and yet several recommendations can be given:

• The collection of urine must be carried out with clean hands. It is also desirable to wash the penis with warm water.
• Take the penis in your hand and move the foreskin back (this is irrelevant for circumcised men who are hygienic enough). A small portion of the first urine is lowered into the toilet, and the middle one is collected in a container, sending a stream to it.
• During urine collection, care should be taken to ensure that the penis does not touch the walls of the container.
• Next, do the same as written in the rules for women.

If the urine is taken from a child for analysis, the parents themselves must carry out hygienic procedures, because this requirement is mandatory for all. Teenagers can perform the hygiene of the genital organs independently, and the task of parents is to tell their daughter or son how to do it correctly and how to collect urine for analysis.

If the urinalysis shows abnormalities, the doctor prescribes a urine analysis according to Nechyporenko. The physician pays attention to the number of leukocytes, erythrocytes and cylinders. The biomaterial is the average portion of morning urine.

On the eve of the analysis, it is recommended to abandon the use of urine-coloring products, antibiotics, anti-inflammatory drugs, diuretic and laxatives. On the eve is to limit the amount of fluid you drink.

After awakening we carry out hygienic procedures. Further follows the instructions for collecting urine for general analysis. The first portion of urine is lowered into the toilet and take 25-50 ml of the middle portion. Finish urination also in the toilet.

The biomaterial should be in the laboratory within the first two hours. There, a small amount of mixed urine is poured into a test tube and sent to the centrifuge for 3 hours. The study is subject to the resulting precipitate, placed in the counting chamber of the microscope. The result at the end must be multiplied by the corresponding coefficient.

If kidney inflammation is suspected, a urine analysis is performed according to Zimnitsky, which reveals the functioning of the kidneys in different periods of time. To do this, urine is collected at intervals of 3 hours during the day, including at night. Morning urine, released immediately after waking up, is flushed down the toilet.

Urine collection begins at 9 am. Collect all the urine excreted during urination. Next, the collection is carried out at 12, 15, 18, 21, 24, 3 and 6 hours, i.e. 8 containers will need to be prepared in advance. The urine collected during the day is stored in the refrigerator and is taken to the laboratory in the morning.

Fluid intake during urine collection should be in the range of 1.5-2 liters. The laboratory calculates the total volume and density of urine, the amount of urine released during the night and daytime.

The biomaterial for bakposeva urine is collected identical to OAM and Nechiporenko analysis. The first time it is given before the start of treatment with antibiotics, the second time - at the end of treatment, which allows to evaluate the effectiveness of the treatment.

In order to identify exactly where the infectious process is taking place: in the kidneys or bladder, a test is performed in Polymyxin (Neomycin can also be used). First you need to empty your bladder. Then, using a catheter, an antibiotic solution is injected into it. After 10 minutes, take a urine test. The absence of live microbes in the analysis suggests that the process is localized in the bladder.

A urine test is carried out according to the following scheme:

• first the urine is examined under a microscope
• further, urine culture is directly performed in conditions suitable for the reproduction of bacteria (usually 2-3 media are used),
• when the number of bacteria grows, study their properties and determine the type of pathogen.

The results of this analysis can be obtained after 4-5 days, at about the time as the modern express method allows to draw conclusions in just 2 days.

Preparation for urine collection in all cases is identical. But to identify the causative agent of the disease, it is especially important not to use antibacterial detergents and medications that distort the result of the research.

Raising and lowering of values

Any tests prescribed for cystitis are aimed at clarifying the diagnosis or evaluating the effectiveness of the treatment. For an ignorant person, the appearance and smell of urine can tell you little, while for a specialist, any changes matter.

So, what do cystitis tests show? To begin with, in a healthy person, the urine may be light yellow or take on the color of straw. If acute inflammation is present in the bladder, it becomes darker and acquires an orange or reddish hue due to blood entering the biomaterial from the damaged organ walls. Color will vary depending on the amount of blood secreted.

Normally , red blood cells (red blood cells) may be present in the urine, but not more than 2 units in the field of view. An increase in this indicator indicates an acute inflammatory process with bladder tissue damage. Usually, the blood enters the urine at the end of urination, so for the general analysis it is better to take the last drops.

Turbidity of the urine is also caused by inflammation, as a result of which microbes, leukocytes, and epithelium cells enter the urine. Turbidity of urine in a healthy person is possible only with a lack of hygiene.

The inner surface of the bladder and urethra is lined with epithelial cells, which are periodically updated. In the urine of a healthy woman, such cells should be no more than 5-6 per field of view (for men, not more than 3). Otherwise, it is an inflammatory process characterized by increased epithelial cell rejection. This process is due to the presence of mucus in the urine.

The presence of bacterial infection in the urine and its metabolic products cause the appearance of protein and some other components in the biomaterial, which lead to alkalization of the physiological fluid.

Bacterial components in urine with cystitis can be found in different amounts depending on the degree of inflammation.

The level of protein in the urine with cystitis varies slightly. It can rise to 1 g per liter. A further increase in protein suggests kidney problems.

An increase in leukocyte levels once again confirms the diagnosis of inflammation. Normally, a healthy woman in the field of view should determine no more than 6 defense cells, which ensure the fight against infection (for men, this indicator is lower - 3-4 units). The increase in the number of leukocytes suggests that the body is activated to combat the disease.

If there are a lot of leukocytes and an admixture of pus can be seen in the urine, this indicates pyuria (purulent inflammation), which is considered a particularly serious condition.

In case of cystitis, analyzes remain unchanged: specific gravity, glucose level, bilirubin, ketone bodies, urobilinogen, mineral composition (its change may indicate urolithiasis), number of cylinders.

Urine analysis according to Nechiporenko allows you to determine not only the diagnosis of inflammation, but also the localization of the disease. When deciphering this analysis, urine pays attention to the number of leukocytes and red blood cells (normally the first should be no more than 2000 per ml, and the second 2 times less), as well as hyaline cylinders, the number of which in cystitis should remain unchanged (20 per ml). The increase in the level of hylaiacin cylinders and the appearance of other epithelial components not characteristic of the mucous membrane of the bladder indicate renal pathologies.

In the tank sowing results I will indicate the types of identified microorganisms, and quantitative indicators will provide an opportunity to assess the quality of the biomaterial. With cystitis, the CFU should be within 100 per ml. With an increase in this indicator can be suspected improper collection of urine. If this figure is 10 thousand and above, then we are talking about pyelonephritis.

Additionally, an analysis is made of the sensitivity of the identified culture to antibiotics, which is reflected in the results. The best is the drug that will destroy the maximum number of bacterial cells in the study.

A urinalysis according to Zimnitsky is necessary if there is a suspicion that the inflammatory process also involved the kidneys. Here pay attention to the increase and decrease values.

For example, the amount of urine released per day should be in the range of 1.5-2 liters. If the figure is above 2 liters, this indicates polyuria, characteristic of diabetes of any type and renal failure.

If the amount of urine is less than 1.5 liters during a normal drinking regime, this indicates fluid retention and edematous syndrome caused by progressive renal failure.

In the daytime urine should be allocated more than at night. Night urine should be only a third of the total. In case of heart failure, the amount of night urine will be greater than daytime or slightly higher than normal. But about the violation of the kidneys will indicate approximately equal amounts of urine collected during the day and at night. In this case, the result indicates a lack of response of the kidneys to changes in the activity of the organism.

Now for the urine density. It should be in the range of 1.012 to 1.025 g / ml, due to the difference in the amount of liquid drunk during the day. Reduced urine density may indicate pyelonephritis, chronic renal failure, heart failure, diabetes insipidus. This condition is called hypostenuria.

Hyperstenuria (increased density of urine) is detected in pregnant women with toxicosis, diabetes mellitus, glomerulonephritis.

Cystitis tests are the most important diagnostic procedure, allowing not only to make an accurate diagnosis, but also to identify comorbidities that also need treatment. Such studies are also of great value for evaluating the effectiveness of treatment, which makes it possible to avoid the chronicity of the infectious-inflammatory process due to an improperly developed treatment regimen or unsuitable drugs.

[12], [13], [14], [15], [16]