Treatment of chronic cystitis by obstetrician-gynecologist Irina Ivanovna Kulbach in the city of Dnipro

Patients often present with frequent urges to urinate, discomfort in the lower abdomen, pain during urination, or recurrent symptoms that interfere with daily life.

The doctor conducts a thorough clinical evaluation, analyzes complaints and medical history, and, if necessary, orders additional tests to clarify the condition.

The patient receives a clear action plan: what to do at the moment, which examinations are needed, and how to monitor their condition over time.

A key aspect of the physician’s work is differential diagnosis of the causes, dynamic monitoring, and prevention of exacerbations, which helps ensure a systematic approach to treatment.

When to See a Doctor

Chronic cystitis often causes unpleasant sensations and complaints that can worsen your quality of life and cause concern. To understand when to consult a specialist, it is important to pay attention to typical symptoms and situations that require medical advice. You should make an appointment with an obstetrician-gynecologist if, with chronic cystitis, you notice:

• Frequent urges to urinate, especially if they occur without an obvious reason
• Pain or burning during urination
• Constant discomfort or a pulling sensation in the lower abdomen
• Periodic appearance of cloudy or foul-smelling urine
• Worsening of symptoms after exposure to cold or stress
• Recurring symptoms that do not go away or return shortly after disappearing
• Sleep disturbances due to frequent urges or pain
• Feeling unwell, interfering with daily activities
• No improvement after self-care measures or previously prescribed treatment
• The need to adjust therapy for chronic conditions
• Appearance of symptoms for the first time or after a recent infection
• Exacerbation against the background of other illnesses or changes in the body

Seeing a doctor under such circumstances will help clarify the causes of symptoms and select an appropriate monitoring and treatment plan if necessary. If your condition changes or symptoms recur, it is important not to delay consultation to avoid possible complications and maintain a comfortable state of health.

Emergency Conditions or When You Need to See a Doctor Immediately

• Sudden severe pain in the lower abdomen that rapidly worsens
• Sharp increase in temperature accompanied by chills and severe weakness
• Intense burning and pain during urination, accompanied by discharge with an unpleasant odor
• Combination of pain, high fever, and worsening overall condition
• Blood in discharge or significant changes in the color of urine

If you experience any of these symptoms, do not wait for a scheduled appointment—seek emergency medical help. At our clinic, you can call a doctor to your home for prompt assessment and necessary care.

Causes and Risk Factors of Chronic Cystitis

This section outlines the probable causes of chronic cystitis and the main risk factors that may influence the development and exacerbation of the condition. Understanding these aspects helps to know what to check and what to pay attention to together with a doctor.

Main Causes / Mechanisms (Briefly)

• Inflammatory processes in the bladder that may recur or not fully resolve
• Disruption of the normal urinary tract microflora, promoting bacterial growth
• Frequent infections of the lower urinary tract that were not completely eradicated
• Mechanical irritation or damage to the bladder lining
• Immune response disorders that weaken protection against infections

Risk Factors

• Pelvic area hypothermia, contributing to inflammation development
• Insufficient fluid intake or irregular urination habits
• Stress and emotional overstrain, affecting overall immunity
• Chronic diseases that weaken the body’s defense functions
• Urinary tract anatomical features that increase susceptibility to infections
• Recurrent acute bladder infections in medical history
• Use of certain medications affecting the mucous membrane and immunity
• Age-related changes leading to decreased resistance

Reversible Causes That Should Be Excluded

• Inflammatory processes caused by nonsteroidal anti-inflammatory drugs or allergens
• Inadequate hygiene promoting bacterial proliferation
• Diseases provoking symptoms resembling chronic cystitis (e.g., vaginitis)
• Injuries or irritations of the bladder lining

Chronic cystitis requires a comprehensive evaluation of causes and risk factors. Therefore, accurate understanding of the condition necessitates consultation with a healthcare provider and, if needed, additional examinations.

Diagnostics

Diagnostics for chronic cystitis aim to identify the cause of symptoms and develop a plan for further examination and treatment. The physician conducts a comprehensive assessment to select the necessary tests and personalized management approach.

Diagnostic Approach

• Taking a detailed medical history: reviewing complaints, medical background, and previous treatments
• Physical examination to evaluate overall condition and possible signs of inflammation
• Ordering basic laboratory tests as indicated: urinalysis, complete blood count
• If necessary – additional studies, such as pelvic ultrasound or other methods determined individually
• Discussing results and formulating a plan for further examination or treatment
• Monitoring the course of the condition during follow-up visits

Typical Tests as Indicated

In diagnosing chronic cystitis, the following may be prescribed:

• Urinalysis and urine culture
• Ultrasound of the bladder and kidneys
• Cytological examination of urine
• Cystoscopy (inspection of the bladder’s inner surface) – upon physician’s recommendation
• Additional tests to rule out concomitant diseases

What to Bring to the Appointment

• Results of previous tests and examinations, if available
• List of current medications
• Symptom diary indicating timing, frequency, and characteristics of symptoms
• Information about chronic diseases and past infections

Diagnosing chronic cystitis requires a comprehensive and individualized approach, so it is important to undergo evaluation by a physician to select the optimal strategy and monitor the condition.

Treatment

The treatment of chronic cystitis is aimed at reducing symptoms and improving the patient's quality of life. The therapy plan is tailored individually, taking into account the specific condition and the results of examinations.

Therapy Goals

• Reduce the severity of pain and discomfort
• Correct factors contributing to the development of chronic inflammation
• Maintain normal bladder function and prevent complications
• Prevent exacerbations and monitor the condition’s progression

Main Treatment Approaches

• May include medications as indicated to reduce inflammation and symptoms
• Primary focus on non-pharmacological support methods, including lifestyle modification and diet
• Physiotherapy procedures are applied based on individual indications to improve the condition
• In complex cases, additional interventions may be recommended after physician evaluation
• Therapy is always adjusted according to changes in the patient’s condition and the effectiveness of applied methods

Physician’s Role

• Selects and adjusts the treatment plan considering individual patient characteristics
• Assesses the presence and influence of comorbidities
• Monitors possible side effects and therapy tolerance
• Explains to the patient the criteria for evaluating treatment effectiveness
• Coordinates work with other specialists if necessary

What to Expect: Plan and Monitoring

• Symptom dynamics and condition are evaluated regularly, typically during follow-up visits
• The treatment plan is adjusted depending on the response to therapy and changes in condition
• Repeat examinations and tests are scheduled as needed to monitor progress
• It is important to inform the physician about any new symptoms or lack of improvement for timely adjustment

To receive an individualized treatment plan, schedule a consultation with Dr. Irina Ivanovna Kulbach.

Prevention

Prevention plays an important role in reducing the risk of exacerbations in chronic cystitis. A preventive plan is selected individually, taking into account health characteristics and risk factors.

Key Primary Prevention Measures

• Maintaining an appropriate fluid intake regime to prevent urinary bladder stasis
• Avoiding cooling of the pelvic area, especially during cold seasons
• Managing chronic diseases that may affect the condition of the urinary tract
• Regular personal hygiene without using irritating products
• Reducing stress and maintaining emotional balance

Screening and Secondary Prevention / Regular Monitoring

• Regular medical check-ups and symptom monitoring according to an individualized plan
• Laboratory urine tests as indicated to monitor inflammation
• Discussing and adjusting treatment of comorbidities with specialized healthcare providers
• Assessing the effectiveness of preventive measures during scheduled visits

Practical Advice

• Monitor the frequency and characteristics of urination to promptly notice any changes
• Discuss with your doctor possible adjustments in lifestyle and diet to support bladder health
• Avoid prolonged wearing of wet clothing or underwear
• Maintain moderate physical activity as recommended by your healthcare provider
• Inform your doctor about any new symptoms or changes in your condition
• Schedule regular appointments with your doctor to evaluate your condition and adjust prevention strategies

Preventive measures in chronic cystitis help reduce the risk of exacerbations; individual assessment and regular communication with your healthcare provider are essential.

Important to Know

Chronic cystitis requires a careful approach to identifying the cause and the factors that trigger flare-ups. Treatment is aimed not only at relieving symptoms but also at eliminating the root causes, which helps control the condition and reduce the risk of complications. Early assessment of the condition and regular monitoring allow for adjustments to the treatment plan, taking into account the characteristics of the body and any accompanying diseases. It is important to avoid self-treatment, as this may complicate diagnosis and affect the effectiveness of therapy. For a comprehensive understanding of the issue and available treatment options, you can refer to the detailed information on our page.

• Identifying the cause helps select appropriate therapy, not just eliminate symptoms
• Early consultation reduces the risk of progression and complications
• Continuous monitoring is necessary to control treatment effectiveness and make timely adjustments
• Stress, chronic diseases, and sleep patterns can influence the course of the condition
• Self-treatment can mask symptoms and cause side effects
• The doctor evaluates the situation comprehensively, considering all factors and patient characteristics
• Control and support from a specialist are essential for maintaining a stable condition

For detailed information on the features of chronic cystitis and its treatment, we recommend visiting the main page of our section.

Self-Care Before the Appointment: What You Can and Cannot Do

Before visiting Dr. Irina Ivanovna Kulbach, it is important to know which safe steps can help ease your condition and what should be strictly avoided to prevent complicating diagnosis and treatment. If your symptoms worsen, seek medical help immediately.

What You Can Do Before the Appointment

• Write down when and how your symptoms started, and what makes them better or worse
• Bring a list of all medications and supplements you are taking
• Measure and record your body temperature if you know how to do it
• Keep a symptom diary: note intensity, time of day, and possible reasons for worsening
• Drink plenty of water to avoid dehydration
• Reduce physical activity and allow yourself to rest before the consultation
• Use simple methods to relieve discomfort if they are generally safe and there are no contraindications
• Pay attention to factors that may trigger symptoms (for example, exposure to cold)

What You Should Not Do Before the Appointment

• Do not stop or change medications without consulting your doctor
• Do not start taking new medications or remedies on your own
• Do not use folk remedies without discussing them with your doctor
• Do not ignore worsening symptoms or the appearance of new alarming signs
• Do not try to interpret test results or examinations by yourself
• Do not choose therapy based on unverified information found on the internet
• Do not use strong medications without medical supervision
• Do not delay seeing your doctor if your condition worsens

If you notice signs of deterioration or emergency symptoms, contact Dr. Irina Ivanovna Kulbach without delay.

How I Can Help as a Doctor with Chronic Cystitis

During a consultation for chronic cystitis, I can assist you in systematically understanding the causes of your condition and propose a reasonable action plan to improve your quality of life. Together, we will assess your current symptoms and the impact of the disease, while taking into account all important aspects of your health.

Here is how I can help during a chronic cystitis consultation:

• Analyze symptoms and medical history to identify possible causes
• Evaluate the severity of symptoms and risk factors affecting the course of the disease
• Review current prescriptions and assess medication tolerance
• Develop a plan for next steps: indicated examinations, treatment, and monitoring results
• Consider comorbidities and concurrent medications to adjust therapy accordingly
• Provide lifestyle and routine recommendations tailored to your condition
• Discuss criteria for ongoing observation and when to seek follow-up care
• Conduct an initial assessment and differential diagnosis of symptom causes
• Adjust therapy in case of insufficient effect or emergence of side effects

Medical care for chronic cystitis is not just about prescribing medication, but a comprehensive approach that considers your complaints, condition, and risk factors. The consultation helps to build a consistent treatment and monitoring strategy to reduce the likelihood of exacerbations and complications, as well as to enhance your overall comfort and quality of life.

What questions can you ask a doctor about chronic cystitis

During your appointment regarding chronic cystitis, you can discuss the following situations with Irina Ivanovna Kulbach:

• Recurring pain and burning during urination
• Frequent urges to use the bathroom that interfere with sleep or work
• Discomfort and heaviness in the lower abdomen
• Symptoms that do not go away or return after treatment
• Lack of effect from previously prescribed medications
• Need to adjust current treatment or get a second opinion from a specialist
• Associated problems with the urinary tract or immune system
• Questions about preventing relapses and maintenance therapy

In case of sudden severe pain, high fever, or the presence of blood in the urine, urgent medical attention is required—do not wait for a scheduled appointment.

Questions you can discuss during the appointment:

• What is happening to me and what could it be?
• Why did these symptoms appear right now?
• How can I distinguish chronic cystitis from other bladder problems?
• What examinations are necessary in my particular case?
• Which tests and investigations are mandatory, and which can be skipped?
• How should I properly prepare for examinations and the doctor’s visit?
• What treatment options are available for my condition?
• Is it possible to completely get rid of symptoms, or is this a chronic condition?
• What should I do if the treatment does not work?
• Is it possible to manage without medication or surgery?
• How long does treatment usually last, and how often do I need follow-up appointments?
• By what signs can I tell if my condition is improving or worsening?
• What should I do in case of sudden worsening or symptom flare-up?

During the consultation, you will receive detailed explanations as well as recommendations tailored to your condition. If symptoms worsen, it is important to seek timely assistance to avoid complications and to select the appropriate treatment plan.

How the Consultation Proceeds

A consultation with the doctor begins with a thorough review of your complaints and an assessment of your overall condition. It is important to emphasize that the scope of examinations is determined individually and only as indicated, so there is no need to worry in advance about multiple tests. During one appointment, the doctor conducts an initial evaluation and outlines a further plan of action, without promising an immediate definitive diagnosis.

1. Clarifying complaints and visit goals: the doctor asks what exactly is troubling you, when the symptoms appeared, what worsens or relieves your condition, and what your expectations are.
2. Taking medical history, including possible risk factors and health specifics affecting bladder condition.
3. Reviewing previous examinations and treatments, if any, with a request to provide existing documents and a list of medications being taken.
4. Performing an examination and basic tests as indicated to assess the current situation and determine the need for further investigations.
5. Discussing preliminary conclusions: which conditions may be causing the symptoms and what is important to rule out.
6. Formulating a plan of examinations, which may include general urine analysis, ultrasound of pelvic organs, cystoscopy, and other methods if necessary.
7. Developing an overall treatment and management plan, reflecting the main directions of care without technical details.
8. Providing instructions for monitoring the condition, discussing the timing of follow-up visits, and situations that warrant earlier consultation.

If this is your first visit, the focus will be on clarifying symptoms and searching for causes. If therapy has been previously prescribed but ineffective, the consultation will help analyze reasons for the lack of improvement and adjust the treatment strategy.

Preparation for the Appointment

To prepare for your appointment with an obstetrician-gynecologist regarding chronic cystitis and to speed up the diagnosis, it is important to gather necessary information in advance and follow simple recommendations.

• Bring a list of all current medications, including names and dosages (if known).
• Take results of previous tests, including general urine analysis, bacteriological culture, and pelvic ultrasound.
• Write down your main complaints: when the symptoms started, and what worsens or alleviates your condition.
• Do not stop taking prescribed medications without consulting your doctor.
• Come with clean underwear and maintain personal hygiene before your visit.
• If there are any special preparation instructions (e.g., do not apply creams or cosmetics), follow them.
• Arrive 10–15 minutes before your appointment to complete any paperwork.
• If you are unsure about preparation details, clarify the information when scheduling by phone.

If fasting is required: do not eat or drink for 8–12 hours before the appointment, unless otherwise advised; confirm this when booking.

When preparing for the consultation, it is important to have all available information about your health and treatment so the doctor can accurately assess your situation and suggest the best plan. Do not change your medication regimen without consultation—this is important for your safety and treatment effectiveness.

About the Doctor

Irina Ivanovna Kulbach is an obstetrician-gynecologist of the highest category with over 40 years of experience. She specializes in the comprehensive treatment of chronic cystitis, working with patients at different stages: during initial visits, recurring symptoms, and cases where previous treatments have been ineffective.

In her practice, Irina Ivanovna pays special attention to the differential diagnosis of causes and monitoring the condition dynamically. Patients receive a detailed analysis of their situation and a clear plan of further actions to maintain their health.

Why Patients Choose Dr. Irina Ivanovna Kulbach

Choosing a doctor for chronic cystitis requires confidence in consistency and attention to detail. Irina Ivanovna’s work focuses on precise diagnosis and dynamic monitoring of the condition, which is especially important in recurrent symptoms and complex cases. Patients appreciate her approach, which combines reviewing previous treatments with consideration of accompanying illnesses. This helps to create a clear and tailored treatment plan that takes into account the real needs of each individual.

• Clear treatment plan: what we do now → what we monitor → when the follow-up appointment is
• Examinations based only on indications, without unnecessary tests and time spent
• Consideration of comorbid diagnoses and medications for safe and effective management
• Monitoring progress and timely adjustment of therapy if no effect is observed
• Reviewing already completed tests and results to minimize repeated procedures
• Explaining the treatment plan and effectiveness criteria in simple and accessible language
• Emphasis on preventing exacerbations and reducing the risk of complications
• Experience managing complex and chronic forms of cystitis with a comprehensive approach

Such a systematic and transparent approach helps patients better understand the treatment process and feel more confident. The doctor maintains ongoing communication, allowing for quick responses to changes and treatment adjustments as needed.

Case Studies

Initial Consultation for Frequent Painful Urination

A middle-aged patient presented with complaints of frequent urges and discomfort during urination, which interfered with daily life. It was important to rule out serious infections and other pathologies of the urinary tract. After a comprehensive examination and medical history assessment, a diagnostic program was prescribed, including laboratory tests and ultrasound. Over the course of several weeks, a reduction in symptom severity and improvement in overall condition were observed. The patient continued follow-up care at the clinic with a maintenance approach aimed at preventing relapses.

Treatment Adjustment Due to Lack of Effect from Previous Therapy

A young woman sought help after multiple courses of therapy that failed to provide significant relief from chronic cystitis symptoms. The physician thoroughly reviewed previous prescriptions and assessed drug tolerability. Diagnostic methods were revised and the treatment plan adapted based on new information. At the follow-up visit, partial improvement and stabilization of the condition were noted. The further strategy included regular monitoring and adjustment as needed.

Chronic Course with Comorbidities

An elderly female patient presented with a long-standing history of bladder inflammation against the background of chronic diseases. Special attention was given to a comprehensive evaluation of comorbid factors influencing her condition. The physician developed a plan considering interactions with other therapies and medications. It was important to monitor symptom dynamics and avoid complications. Over several months, a stable state was maintained aimed at preserving comfort and quality of life.

Symptom Exacerbation and Prevention Plan

A patient came with a sudden worsening of condition characterized by severe pain and frequent urges following a recent cold. Timely assessment allowed for exclusion of serious complications. The physician prescribed adaptive treatment measures and formulated an individualized prevention plan for exacerbations. Over the following weeks, the patient’s condition improved, after which regular check-ups were scheduled to monitor and prevent new episodes.

Recurrent Symptoms Without Clear Therapeutic Effect

A young woman with recurring complaints of pelvic discomfort and inefficacy of previous treatments sought a second opinion. The physician conducted a detailed medical history and proposed additional investigations to clarify the causes. After adjusting the treatment approach, a positive shift in symptom dynamics was observed. The patient received recommendations for long-term monitoring and condition management.

How long does the consultation last?

The consultation lasts approximately 30–60 minutes; please confirm the exact duration when booking.

How should I prepare for the appointment?

It is recommended to write down your main complaints, prepare a list of medications you are taking, and bring previous examination results.

What should I bring to the appointment?

Bring your test results, imaging, discharge summaries, and a list of current medications, if available.

Do I need to come on an empty stomach?

Usually no, unless the doctor advised otherwise when you made the appointment.

How many visits are usually required?

The number of visits depends on the complexity of the case and treatment plan—ranging from several visits to a few months of follow-up.

When can I expect the first results of the treatment?

This is individual and depends on the course of the disease and the chosen therapy.

What should I do if my condition worsens before the appointment?

If your condition worsens with severe pain, high fever, or blood in the urine, seek emergency medical care.

Can treatment be combined with medications I am already taking?

Discuss your list of medications during the appointment; do not change your therapy on your own.

Is it possible to have an online consultation?

Yes, online consultations are possible provided you have the necessary data and examination results.

Can I come with tests and examinations already done?

Yes, test results and examinations are accepted and taken into account during your care.

Do I need to come for follow-up visits, and how often?

Follow-up visits are scheduled individually based on the control plan and condition dynamics.

Can I get a second opinion?

Yes, reviewing and discussing previous treatment is possible during a separate consultation.

What should I do if symptoms return after improvement?

Consult your doctor for evaluation and, if necessary, adjustment of the treatment.

What examinations are usually prescribed for chronic cystitis?

The approach depends on symptoms and medical history; the doctor will determine necessary tests individually.

How do I know when to see the doctor again?

If symptoms worsen, treatment is ineffective, or new complaints appear.

Can treatment be carried out without examinations?

Examinations are prescribed as needed for accurate diagnosis and appropriate therapy.

What if I am unsure about the correctness of the diagnosis?

You may come for a second opinion and review of your medical data.

Are there any restrictions before seeing the doctor?

There are usually no special restrictions unless otherwise specified when booking.

Can I schedule an appointment on weekends?

Please check the clinic’s working hours and availability when booking.