The role of the pelvic floor in abacterial cystitis: causes, symptoms, and treatments
Abacterial cystitis is a condition that affects a large number of people, but it occurs more frequently in women. This higher incidence is attributable to a combination of factors:
- Anatomical, related to the structure of the female urinary tract and pelvic floor.
- Hormonal, with variations influencing the balance of the urinary tract during different life stages, such as the menstrual cycle, pregnancy, and menopause.
- Physiological, such as the increased sensitivity of the bladder to external stimuli and irritations.
These factors make women more predisposed to developing chronic inflammations such as abacterial cystitis, a condition that can significantly impact quality of life. Chronic pain, the frequent urge to urinate, and the emotional distress associated with symptoms negatively affect daily activities, social life, and personal relationships. For this reason, it is essential to address abacterial cystitis with a comprehensive approach that considers not only the treatment of physical symptoms but overall well-being.
Main causes of abacterial cystitis
Abacterial cystitis can be caused by various factors, often difficult to pinpoint precisely. This diagnostic complexity arises from the fact that it is NOT a bacterial infection but an inflammatory condition linked to multiple triggering causes. Among the most common causes are:
- Chemical irritants: exposure to irritating substances, such as harsh intimate cleansers, spermicides, or other chemical products, can disrupt the protective barrier of the bladder mucosa, causing inflammation and the characteristic symptoms of cystitis.
- Pelvic floor dysfunctions: the presence of hypertonic pelvic floor muscles can lead to pain, inflammation, and urinary disturbances, contributing to the development of abacterial cystitis.
- Interactions with medications or treatments: certain drugs, such as chemotherapy agents, can irritate the bladder wall and trigger an inflammatory response, even in the absence of a bacterial infection.
- Hormonal changes: hormonal variations, particularly during menopause, can weaken the bladder mucosa and alter the balance of the urinary and vaginal microbiota. The reduction in oestrogen levels, in particular, makes the bladder more vulnerable to irritation and chronic inflammatory states.
- Autoimmune or neurological causes: abacterial cystitis can sometimes be associated with immune system dysfunctions or neurological issues, which contribute to chronic inflammation of the bladder.
- Stress and lifestyle: stress can affect the functioning of the immune and muscular systems, leading to pelvic tension and increased bladder susceptibility. Additionally, habits such as poor hydration or a diet rich in irritant foods (caffeine, alcohol, spices) can worsen symptoms.
Pelvic floor Vs. abacterial cystitis
One of the main causes of abacterial cystitis is linked to pelvic floor dysfunctions, particularly the presence of muscle hypertonia. Pelvic floor hypertonia is a condition where the muscles in this area are excessively tight or tense on a constant basis. This chronic tension can impair the normal functioning of pelvic muscles, which are crucial for supporting pelvic organs, regulating urinary functions, and ensuring sexual well-being. When pelvic muscles are overly contracted, they can cause:
- Difficulty urinating: tight muscles prevent proper bladder emptying, resulting in a sensation of fullness or incomplete voiding.
- Pelvic pain and a feeling of pressure: continuous tension can create pelvic heaviness or pain in the affected area, often worsening during urination or the menstrual cycle.
- Frequent urinary disturbances: persistent bladder irritation leads to urgency and the frequent need to urinate, without the release of an adequate amount of urine.
Diagnosis and treatment in the presence of pelvic dysfunction
Identifying the relationship between recurrent cystitis and pelvic floor dysfunction requires a comprehensive evaluation by specialists from various fields. The diagnostic process begins with a urological consultation, essential for ruling out bacterial infections or other bladder-related conditions. Once infections or other urinary tract issues have been excluded, the next step involves consulting a professional specialising in pelvic rehabilitation.
This consultation is crucial for initiating a personalised physiotherapy programme aimed at resolving pelvic floor dysfunction and preventing recurrences. The pelvic physiotherapist conducts a detailed assessment of the pelvic muscles, evaluating the presence of any tension, weaknesses, or dysfunctions. Using manual techniques and diagnostic tools, the physiotherapist identifies the primary cause of the dysfunction and develops a tailored therapeutic plan. This plan may include relaxation exercises, strengthening routines, and stretching, depending on the patient’s specific condition.
One of the techniques used in pelvic physiotherapy is biofeedback, which helps patients become more aware of their pelvic muscles. This approach allows for better monitoring and control of muscle tension, teaching patients how to consciously relax their pelvic muscles, thereby improving pelvic floor function and alleviating symptoms associated with abacterial cystitis. The treatments employed by the pelvic physiotherapist are further complemented by:
- Relaxation techniques and stress management: practices such as meditation, yoga, and deep breathing are effective in reducing muscle tension caused by stress, thereby improving pelvic floor well-being and fostering greater body awareness.
- Lifestyle modifications: adopting healthy habits, such as maintaining proper posture and engaging in suitable physical activity, helps to keep the pelvic floor balanced and avoid strain or tension. It is equally important to reduce or avoid alcohol consumption, smoking, and overly spicy or seasoned foods, which can irritate the bladder and exacerbate symptoms.
- Psychological support: since abacterial cystitis and its chronic effects can have a significant emotional impact, psychological support is crucial to help patients address the emotional aspects of the condition, thereby contributing to an overall improvement in quality of life.
The contents of this page are for informational purposes only and should in no way replace the advice, diagnosis, or treatment prescribed by your physician. Responses to the same treatment may vary from patient to patient. Always consult your doctor regarding any information related to diagnoses and treatments, and meticulously follow their instructions.
