ICD 10 acute hemorrhagic cystitis. Acute cystitis urticaria. Approximate set of dishes and products

Acute cystitis is an inflammatory disease of the genitourinary system. Classified according to ICD 10 according to section 14 on pathologies of the genitourinary organs. Includes a number of diseases with symptoms of inflammation. Disease code - N.30.0. There are infectious and non-infectious types.

This ICD 10 code takes into account cystitis in adults and children according to mortality statistics and incidence rates. Attention is also drawn to the social danger if the patient is an adult, since the routes of transmission of the infectious agent are specific.

Code N.30.0. includes a list of inflammatory diseases of the bladder. The main factor in the development of pathology: damage to the mucous membrane and organ tissues by pathogenic flora. The unifying clinical sign is frequent urge to urinate, accompanied by pain and stinging. Urine changes in color, purulent and protein flakes, and blood clots. In other words, hematuria, dysuria, and pyuria develop.

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Acute cystitis may weaken as a result of transition to the chronic or interstitial stage. For all varieties in children and adults, the cause is usually the same - hypothermia of the pelvic organs. Diagnosis and treatment are prescribed based on identification of the source.

Pathogens

Acute cystitis is a multi-etiological disease, as it can be caused by various factors. The main causative agents are bacteria: enteric bacteria (Salmonella), Pseudomonas aeruginosa, Klebsiella, Proteus, etc. In addition to them, mycoplasmas, viruses, chlamydia, Trichomonas, and fungus of the genus Candida can have a destructive effect. The disease sometimes develops due to helminthic infestation (most often in children).

The leading pathogen is E. coli, statistically it appears in 90% of cases. It has high pathogenic potential:

• reproduces quickly;
• produces ammonia, which weakens the immune system;
• disrupts the function of the fibers of the urine excretory tract.

Diagnosis is made through culture of the patient's urine.

Routes of penetration

According to the classification, there are three ways for an infectious agent to enter the body:

• ascending - through the urethra;
• descending - through the kidneys and ureters;
• contact - through blood and lymph.

Most cases are caused by hypothermia, so the disease develops ascending through the urethra. In childhood, contact type of infection is almost impossible.

Main symptoms

The acute form is expressed by clinical symptoms, intensified due to infectious etiology. Frequent pathogens are staphylococcus, streptococcus. Quite rarely, the acute form is caused by a fungus or other bacterial pathogen. Treatment will vary accordingly.

The main signs that appear at this stage are:

• frequent urge to urinate;
• a feeling of heaviness due to the fullness of the bladder;
• low urine output;
• temperature increase;
• general weakness;
• pain and burning in the urethra, genitals;
• cutting pain in the area where the organ is located;
• cloudy urine;
• the appearance of impurities: blood, pus, protein flakes;
• sharp pain in the lower abdomen.

Cystitis in itself is very dangerous, but it can also provoke complications on the kidneys, especially in childhood. Treatment is carried out with a course of antibiotics for 14 days until improvement occurs.

Cystitis code according to ICD 10 No. 30 is quite serious, one of the most common types of diseases of the genitourinary system.

According to statistics, chronic cystitis or acute cystitis is a manifestation that affects up to 35% of the entire world population.

Women are most susceptible to the disease, although there are also many men who have had to deal with cystitis.

ICD-10 is a world system, an international standard for naming forms of diseases, which is a special document in which the names of diseases, all the reasons for which patients turn to medical institutions, the mortality of patients and the factors that caused death are entered. This standard is recognized by all world medical communities.

Eachdisease, indicated in the ICD 10 list, is assigned to a specific class and has its own serial number (individual code) in this class.

Once every ten years, the disease system is reviewed and the most important clarifications needed by doctors are introduced into ICD 10.

International classification of diseases, cystitis in the ICD system

Cystitis ICD 10 is No. 30 in group XIV. The number following the number after the dot in the decoding of the disease is No. 30.1, No. 30.2, etc. - form of the disease.

For clarity of the example, in ICD 10 cystitis is designated as follows:

• No. 30.0 Acute cystitis;
• No. 30.1 Interstitial cystitis (chronic form of cystitis);
• No. 30.8 Other cystitis;
• No. 30.9 Cystitis, unspecified, etc.

Depending on the etiology of the disease and its nature, cystitis is divided by doctors into the following types:

The main reasons for the spread of genitourinary diseases in recent years are weakened immunity and inadequate personal hygiene.

If a patient with cystitis does not receive professional medical care, self-medicates, or refuses to visit a doctor, the condition of the bladder may worsen to the point where its walls burst.

With exacerbations of one or another form of the disease, the patient becomes unable to work and must see a specialist urologist or gynecologist.

Half of all cases of visits to doctors for diseases belonging to the ICD 10 class are acute cystitis. 20% of cases are chronic cystitis. The remaining 30% accounts for other forms of the disease.

There are several times more representatives of the fair half of the population among the sick than men. This phenomenon is associated with the structural features of the male and female genitourinary systems.

Representatives of the fair half, as practice shows, suffer from cystitis in younger years - from 15 to 30 years. In men, on the contrary, cystitis can make itself felt at a more mature age - from 35 and above.

How to treat genitourinary disease

Special treatment for cystitis involves an integrated approach, including:

• antimicrobial medical therapy (taking antibiotics);
• taking painkillers and anti-inflammatory drugs;
• immunotherapy (immunity enhancement);
• observing important hygiene rules.

Drug therapy in the fight against cystitis involves taking antibiotics.

The most popular and effective antibiotics in this case are Flemoklav, Levofloxacin, Erythromycin and some others. They have an antibacterial effect on the body and contribute to the complete destruction of pathogenic bacteria.

Along with antibiotics, anti-inflammatory drugs are prescribed. Among them, the most effective are Urolesan, Cyston, etc. They eliminate pain and help relieve the disease.

Doctors often prescribe vitamins along with these medications. They are able to increase a person’s immunity, which means that the body will be able to cope with the illness that arises much faster.

Remember, cystitis is a disease that, if left untreated, can cause serious damage to the bladder and kidneys.

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It is not uncommon, when receiving a hospital report (especially when undergoing diagnostics in private clinics), in the diagnosis column, you can see a not entirely clear set of numbers and letters. This code is nothing more than the International Classification of Diseases, Tenth Revision, or abbreviated code according to ICD 10. Acute cystitis, like any other disease, has its own specific unique code, which is understandable to any professional physician.

International classification

The ICD is an international system (medical standard) designed to designate various diseases and their forms, founded in 1855 at the Paris International Statistical Congress. Throughout its existence, the system has been constantly improved and refined.

This is a special-use document that contains all the information about the disease: name, causes, number of deaths, factors leading to mortality, and so on. This standardization is accepted in all countries; it contains all diseases known to medicine, each of which is assigned to a specific class and has its own unique code.

Due to the constant development of world medicine, with the introduction of new methods of diagnosis and treatment, as well as the emergence of new diseases, periodic additions to existing standards are required. Such additions are carried out every ten years; one of the latest was the introduction of Latin letters from A to Z.

Acute cystitis in the ICD system

Acute cystitis is a painful inflammation of the bladder mucosa, accompanied by frequent urination. According to the ICD 10 standard, it has the following form - N30.0, where N30 is the general group of all forms, and the number after the decimal point indicates one or another type.

Here's what this classification looks like:

• Genitourinary diseases N00-N99
• Diseases of the urinary system N30-N39
• Cystitis N30
• Acute cystitis N30.0

Now, when you see a diagnosis with a strange code, you will understand that this is just a medical duplication of a particular disease. As a rule, such a code is prescribed not for the patient, but mostly for the specialists involved in his treatment.

• Chronic cystitis in the ICD-10 classification.
• Urinary tract infections in the ICD registry.

This uneven gender distribution is caused by anatomical features - women have a short and wide urethra. This entails an increased risk of infection with any decrease in immunity and frequent complications aimed at the higher organs of the genitourinary system - the ureters and kidneys.

What is cystitis and when is it called acute?

The bladder is a hollow organ, lined from the inside with multilayered epithelium, under which the muscle tissue of this organ is located. Through the ureters it is filled with urine until the urge to urinate appears. When performing this function, the sphincter of the urethra opens, the muscular layer contracts and emptying occurs.

If pathogenic microorganisms penetrate the bladder, inflammation of the inner lining of this organ begins.

Pronounced symptoms and changes in the morphology of bladder tissue indicate acute cystitis. This form of the disease is manifested by severe swelling and hyperemia of the urothelium, increased vascular permeability and the spread of inflammation to the submucosal layer, and other catarrhal and hemorrhagic changes.

The appearance of acute cystitis may be preceded by pathology of the bladder; in some patients it occurs without any prerequisites and is considered primary.

What causes the disease and how does the infection get into the bladder?

For acute cystitis to develop, a combination of several factors is necessary. A prerequisite is the presence of pathogenic microorganisms in the bladder:

• Escherichia coli;
• Enterococci;
• Staphylococcus;
• Proteus;
• Klebsiella;
• Microbial associations.

Normally, a small number of these microbes are always present on the mucous membrane of the bladder. In a healthy person with optimal hormonal balance, a mucopolysaccharide secretion forms on the surface of the mucosa.

This protective layer is called "glycocalyx". It successfully resists the penetration of microbes into the bladder tissue. The hormones estrogen and progesterone play an important role in its successful activity. If the protective layer is broken, infection develops and acute cystitis occurs.

Causes of the disease:

• Regular stagnation of urine due to infrequent urination;
• Hypothermia;
• Immunity impairment;
• Dysbacteriosis and vaginal candidiasis in women and girls;
• Sexual relations with different partners;
• Failure to comply with hygiene rules (rarely changing underwear and sanitary pads, careless and infrequent washing, etc.);
• Bacterial inflammation (herpes, adenovirus, trichomonas, gonococcus, chlamydia, mycoplasma, tuberculosis bacillus);
• Stagnation of blood in the pelvis due to physical inactivity, forced maintenance of a sitting position;
• Hormonal disorders and conditions (menopause, pregnancy), inflammatory diseases of the female genital organs;
• Trauma to the mucous membrane due to instrumental and surgical intervention (catheterization, cystoscopy, urethroscopy);
• Use of daily sanitary pads;
• Consequences of radiation, toxic damage;
• Complications of diabetes mellitus, thyroid disorders;
• In men, as complications of urethritis, prostatitis, orchiepididymitis;
• Metabolic disorders (crystalluria).

Routes of infection:

• Ascending route (from the urethra);
• Descending route (from the kidneys and ureters);
• Contact (through the wall of the bladder);
• Through the lymphatic or circulatory system.

Types of acute cystitis, classification according to ICD-10

According to ICD10 (International Classification of Diseases, Tenth Revision), this disease is assigned code N30.

Depending on the cause of occurrence and type of disease, treatment tactics for bladder inflammation are selected.

Symptoms of the disease

A characteristic symptom of acute cystitis that prevents the patient from leaving the toilet is a frequent urge to urinate. They are accompanied by pain and severe pain in the lower abdomen.

Urination itself is the release of a small portion of urine with the possible manifestation. The pain spreads not only in the bladder area, it is felt in the perineum and in the anal area.

If acute cystitis becomes severe, urinary incontinence and fever may occur. Such manifestations indicate that the process spreads through the urinary tract and pyelonephritis develops. Due to the admixture of blood, urine takes on the color of “meat slop”, becomes cloudy, and flakes of pus appear in it.

Diagnostics – laboratory and instrumental studies

It is impossible to diagnose acute cystitis and prescribe treatment based on patient complaints and medical history. Most often it will not be possible to detect external changes in the patient. The only sign indicating the disease is pain on palpation in the lower abdomen.

The doctor receives the basic information for making a diagnosis from the results of laboratory and instrumental studies. Diagnostic methods:

General urine analysis.

Leukocytoturia with a predominance of neutrophils, bacteriuria, gross hematuria, erythrocyturia, a lot of mucus and squamous epithelial cells are observed.

Urine culture.

Identification of the causative agent of inflammation, its sensitivity to antibiotics.

Ultrasound of the bladder.

An “echo-negative suspension”, the structure of its walls, and the exclusion of neoplasms are revealed.

Urodynamic examination.

Neurogenic bladder dysfunction is detected.

Diagnosis and treatment of acute cystitis in women is carried out after receiving the results of microscopy of a vaginal smear and culture to detect STDs. Differential diagnosis – diseases with similar symptoms:

• Paraproctitis;
• Acute appendicitis;
• Acute pyelonephritis;
• Bladder tumors;
• Bladder stones.

How to treat acute cystitis?

The main place in the treatment of the disease is occupied by etiotropic therapy, that is, the use of drugs to eliminate or weaken the main cause of the pathology.

Main groups of medications

From the group of fluoroquinolones for antimicrobial therapy - Norfloxacin, Ciprofloxacin.

Anti-inflammatory.

Means to reduce swelling and pain - Nimesil, Diclofenac, Ibuprofen.

Antispasmodics.

To relieve tension and soreness of muscle tissue - No-shpa, Baralgin, Papaverine.

Immunostimulants.

Viferon, Lykopid, Uro-Vaxom.

Uroseptic drugs.

Canephron, Urolesan, Cyston.

Antihistamines.

Drugs that help suppress various allergic reactions.

Treatment is prescribed by a urologist after laboratory diagnostics, and he also monitors the cure. Self-medication can lead to complications, the transition of the disease to.

The course of antibiotics lasts no more than 3-7 days. If the patient has intolerance to fluoroquinolones, as an exception, antibiotics from the groups of nitrofurans or cephalosporins, chloramphenicol are prescribed.

Herbal medicine is used as an adjunct to treatment. Herbal mixtures with a diuretic and antimicrobial effect are selected - knotweed, kidney tea, lingonberry leaf, bearberry.

Physio

A good effect is obtained from the use of physiotherapeutic procedures:

• Electrophoresis;
• Magnetotherapy;
• Laser therapy;
• Inductothermy.

If it is not possible to attend physical therapy, you can alleviate the condition. To do this, apply dry heat to the area of ​​projection of the bladder, sitz baths in a warm decoction of medicinal herbs (+37+38⁰C). General hot baths for acute cystitis are contraindicated.

Diet for acute cystitis

Correcting the diet will help shorten the treatment period for cystitis; if you follow the principles of dietary nutrition, the symptoms of the disease will be less pronounced.

Diet functions:

• Reduce irritation of the bladder mucosa;
• Reduce body intoxication;
• Prevent the spread of infection to other parts of the genitourinary system;
• Facilitate the process of urination;
• Increase general and local immunity;
• Reduce the possibility of relapses.

When prescribing a diet, the doctor will definitely tell you about the drinking regime during the illness. It is recommended to drink at least 2 liters of liquid. This can be ordinary purified water, but it is better if the patient drinks berry fruit drinks with a diuretic effect.

Fruit juice made from rose hips, lingonberries, cranberries, and currants also exhibits an antibacterial effect, that is, it will be possible to solve several problems at once - rinse the bladder and remove some of the pathogenic bacteria from it.

In addition to berry fruit drinks, mineral water, homemade compotes, herbal teas and unsweetened tea are used. Drinking alcohol, as well as strong tea, coffee, carbonated drinks, juices from sour fruits and citrus fruits is strictly prohibited.

Basic principles of diet for cystitis:

• Minimum salt and protein;
• A complete ban on eating fatty foods;
• Refusal of sugar and its substitutes, pickles and canned foods;
• Gentle culinary processing of dishes (foods are boiled or steamed).

The goal of dietary nutrition is to increase the flow of urine, which removes infection from the genitourinary system. A dairy-vegetable diet with a balanced combination of proteins, fats and carbohydrates is used.

An approximate set of dishes and products:

• Fresh vegetables and fruits (cucumbers, zucchini, carrots, grapes, pomegranate, watermelon, melon);
• Boiled lean meat and fish;
• Vegetable soups;
• Boiled vegetables (especially beets);
• Fermented milk products (after relief of acute symptoms);
• Porridge with water or a mixture of water and low-fat milk.

When choosing bread, it is better to give preference to products made from wheat flour; rye bread is contraindicated. Sugar can be replaced with a small amount of honey, and it is better not to use spices for the time being. Following the recommendations will help avoid relapses and the transition of the disease to the chronic stage.

Disease prevention

To avoid the appearance of cystitis or prevent complications of the disease, you need to take preventive measures:

First.

Dress according to the air temperature, avoid hypothermia in the cold season due to clothes that are too thin or short.

Second.

Do not restrain the urge to urinate, so that stagnation of urine does not provoke inflammation.

Third.

Maintain optimal water balance in the body by consuming a sufficient amount of fluid (at least 1.5 liters, this volume can be increased in hot weather).

Fourth.

Restore immunity in a timely manner, promptly treating infectious and somatic diseases.

Fifth.

Wash daily with running water at least 2-4 times using soap without fragrances or fragrances. When having sexual intercourse, it is advisable to wash yourself before and after sex. It is advisable that the partner also adheres to this rule.

Sixth.

Accustom yourself and your children (girls) to wipe themselves after visiting the toilet in the direction from the vagina to the anus, and not vice versa. Otherwise, intestinal bacteria easily enter the external genitalia, and then into the urethra.

Seventh.

During menstruation, use sanitary pads rather than tampons to avoid mechanical compression of the external opening of the urethra.

If symptoms of acute inflammation of the bladder appear, you should consult a urologist for diagnosis and determine treatment tactics. The use of medications, diet, physiotherapy, and preventive measures will quickly eliminate the cause of the disease and prevent complications.

For the development of acute cystitis, the presence of pathogenic microflora in the bladder and the presence of certain factors are necessary. In most cases, acute cystitis is caused by gram-negative pathogens (in 80% of cases - E. coli, as well as Proteus, Klebsiella), gram-positive (enterococci, staphylococci), as well as microbial associations.
In the occurrence of acute hemorrhagic cystitis, the role of a predisposing factor is played by adenoviral, herpetic, parainfluenza infections, causing disruption of microcirculation and innervation of the bladder with the subsequent development of bacterial inflammation. In some cases, acute cystitis is caused by a combination of chlamydial, mycoplasma or ureaplasma infection and bacterial microflora. There are specific acute cystitis of gonorrheal, trichomonas, tuberculosis etiology.
In a healthy person, the urinary tract is cleaned due to the regular outflow of urine; in addition, the inner lining of the bladder is very resistant to infection due to the production of a special mucopolysaccharide secretion. Forming a thin protective layer (glycocalyx) on the surface of the bladder, it prevents the adhesion and penetration of pathogenic microorganisms into the bladder wall, promotes their inactivation and elimination during urination. The hormones estrogen and progesterone participate in the regulation of the production of the protective layer.
Various changes in the mucin layer of the bladder lead to the loss of its protective function, against which the development of acute cystitis is possible. Thus, impaired urodynamics in a neurogenic bladder contributes to its insufficient cleansing and stagnation of urine. Acute cystitis can be associated with injuries to the inner lining of the bladder during instrumental and surgical interventions (bladder catheterization, cystoscopy, ureteroscopy); decreased local immune defense due to vitamin deficiencies, frequent acute respiratory viral infections; exposure to radiation, toxic and chemical substances.
In girls, primary acute cystitis is usually caused by insufficient hygiene rules and vaginal dysbiosis. Boys often develop secondary acute cystitis against the background of anatomical and functional pathology of the vesicourethral segment (urethral stenosis, sclerosis of the bladder neck or diverticulum, phimosis, neurogenic dysfunction). Of no small importance in the occurrence of acute cystitis is stagnation of blood in the pelvis, leading to impaired circulation in the wall of the bladder; metabolic disorders (crystalluria).
A relatively high percentage of cases of acute cystitis in women is associated with structural features of the female urethra, hormonal disorders, frequent genital inflammations (vulvitis, vulvovaginitis), which contribute to the entry of microflora into the lumen of the urethra and bladder. Acute cystitis in men almost always occurs against the background of prostatitis, urethritis and orchiepididymitis. An active sexual life provides a greater likelihood of infection in the bladder.