THE MOST WOMEN IN THE POST-SOVIET SPACE ARE familiar with the phrase “Don’t sit on a stone – you’ll chill your kidneys”, which was uttered first by grandmothers and mothers, and then by teachers and even strangers in the park or on the street. We talked with the urologist and urogynecologist Alexei Tolmachev and tried to figure out where kidney and bladder diseases come from and whether they are related to the fact that someone is sitting on cool steps.
Can the kidneys “freeze”?
The kidneys are located quite far from the surface, under several layers of tissue. The temperature inside the human body is maintained at an optimal level, and when it drops even by a couple of degrees, pronounced and unpleasant symptoms of hypothermia arise : from an increased heart rate and a slight lack of coordination to a decrease in reflexes and coma. It is clear that in such a state a person is unlikely to continue to sit on the stone floor and continue to do what he was doing – and vice versa, students who reread lectures in a clear conscience, sitting on the steps, are not threatened with hypothermia. Internal organs can cool if a person slept for several hours in the cold without clothes – and then medical attention will most likely be needed not only for the urinary system.
Back in 1988, Minnesota conducted a study of the effect of extreme temperatures on the kidneys of rats: isolated kidneys were heated to 41 degrees and cooled to 30. Even in such a form, far from the actual exposure to temperatures, the structure and function of the kidneys were much more impaired when heated; the low temperature did little harm. That is, it can be assumed that the cold is not as bad for the kidneys as is commonly believed, especially since it is almost impossible to really reduce their temperature.
In general, it is well known what factors affect the functioning of the kidneys: among them there are various medications, tumor processes, increased blood pressure and others, but cold is not among them. Inflammation of the kidneys – pyelonephritis – can develop either when bacteria enter them (from the bottom up, from the bladder), or when the outflow of urine is impaired, for example, a stone stuck in the ureteral cavity. This is not such a common disease, in contrast to inflammation of the bladder (cystitis) or urethra (urethritis), which every fifth woman in the world has encountered at least once in her life .
Can cystitis develop from cold?
No, he can not; cystitis in the vast majority of cases is caused by a bacterial infection. Most often, E. coli gets into the bladder, but sometimes other bacteria also become the cause; in this case, we are usually talking about microbes that normally inhabit the human body, and not about exotic infections. The urinary tract is normally sterile, and inflammation can develop if bacteria enter it, for example from the intestines or from the surface of the skin. Of course, there are cases when cystitis is caused by a fungal infection or specific sexually transmitted diseases.
Most often, microbes enter the urethra, from which they then rise into the bladder, in case of problems with personal hygiene or during sex – in the latter case, we can talk about the microbial flora of both the woman herself and her partner. In women, the urethra is short, wide and located near the vestibule of the vagina – and this anatomy , unfortunately, promotes infection. Sometimes acute cystitis occurs after a change of partner – this is how the urethra can react to a new, unusual microflora.
Cystitis is also non-infectious; it can be caused by certain medications, radiation, allergy to spermicides or bubble baths. Sometimes the inflammation is caused by trauma – for example, after a catheter is inserted into the bladder. There are certain factors that increase the risk: these are the presence of sexual activity, anatomical congenital abnormalities, pregnancy and menopause (due to hormonal changes), urinary retention. At the same time, exposure to cold does not apply to either the reasons or risk factors for cystitis and urethritis.
Then why does it happen after swimming in cold water?
And yet it happens that it is after exposure to cold that a person notices the typical symptoms of cystitis: pain and discomfort in the lower abdomen, pain during urination, frequent urge to go to the toilet, sometimes even blood in the urine or fever. In this case, we can talk about an exacerbation of chronic cystitis – and its cause is an infection that was once untreated. There is no definitive evidence that cold can trigger an exacerbation: in one experiment , a link was found between hypothermia of the legs and the onset of symptoms of cystitis, but the design of this study is questionable, if only because of the very low number of participants.
It is quite possible that in many cases, sitting on the cold or bathing becomes only a mental landmark and cystitis would arise or worsen in any case, but it is remembered precisely as something that happened after exposure to cold. You need to understand that very often “after” does not mean “because of”. Don’t blame yourself for your lack of discipline; it is better to see a doctor as soon as possible, undergo an examination and figure out the best treatment option.
What to do and how to treat?
In acute cystitis, a broad-spectrum antibiotic is usually prescribed, it is recommended to drink plenty of fluids and refuse sex until the inflammation has passed – such treatment can be prescribed by a general practitioner. If cystitis often recurs, it is better to consult a urologist for additional examinations – for example, using ultrasound or cystoscopy (examination of the bladder using a special device). For chronic cystitis, longer treatment may be prescribed; the doctor may also recommend taking an OTC antibiotic on his own in case of an exacerbation, so as not to run to the clinic every time.
Consultation with a gynecologist does not hurt either: it is possible that cystitis is often exacerbated due to the specific position or increased mobility of the urethra. During pregnancy, the risk of urethritis and cystitis is increased due to changes in hormonal status, and women prone to these infections need to pay special attention to personal hygiene and use condoms. But about sitting on a cold one, you can not worry – statements about its danger are exaggerated.