Skin, ears and urinary
Cystitis & urinary problems
For painful urination, frequent urination and a feeling of incomplete emptying
with a medical interpreter
24 hours a day, 365 days a year
OK to consult together
payment information
About
About Cystitis & urinary problems
We treat pain when urinating, frequent urination and a feeling of incomplete emptying caused by cystitis and similar conditions. We also help people who get it repeatedly.
Why it happens
Most cystitis occurs when bacteria from the bowel enter the bladder through the urethra and cause inflammation. Women are thought to get it more easily because their urethra is short and close to the anus. Triggers can include not drinking enough, holding urine for a long time, fatigue and getting cold. If the inflammation reaches the kidneys (kidney infection), it comes with fever and back pain and needs more careful treatment.
What's happening in the body
Most cystitis occurs when bacteria from the bowel travel through the urethra into the bladder. Normally, urine regularly flushes the bladder and stops bacteria from multiplying. But if you don't drink enough and pass less urine, or hold it in so urine stays in the bladder for a long time, bacteria have time to multiply. When bacteria stick to the bladder lining and multiply, inflammation develops there. An inflamed, sensitive bladder sends the signal that it needs emptying even when it holds only a little urine, so you keep needing the toilet. Pain at the end of urination occurs because the inflamed part of the contracting bladder is irritated. If bacteria travel further up the ureters and reach the kidneys, it becomes a more serious condition with fever and back pain.
Main symptoms
- Pain or stinging when urinating
- Needing to urinate often
- Feeling that the bladder isn't fully empty
- Cloudy urine or a change in smell
- Blood in the urine
- Discomfort or pain in the lower abdomen
- Fever or pain in the back or lower back (possible kidney infection)
When you can wait and see
What you can do yourself
- Drink plenty of fluids so you pass enough urine
- Don't hold in urine
- Keep your lower abdomen and lower back warm
- Avoid getting worn out and rest well
- Finish prescribed antibiotics for the full period instructed, even if symptoms improve
Please consult us
If any of the following apply
- It hurts when you urinate
- You urinate often or feel you haven't fully emptied your bladder
- You've had cystitis before
Seek care right away
If any of the following apply
- A fever of 38°C or higher with back or side pain (possible kidney infection)
- Severe nausea or vomiting, and unable to keep fluids down
- Passing almost no urine, with a swollen, painful lower abdomen
- Feeling faint, drowsiness or confusion, or high fever with shivering
Don't wait for a Cotovia consultation; call the emergency number in your country.
See the emergency guide for each countryIf you're not sure, ask us on LINE
Differential
Telling it apart from similar conditions
Symptoms that look the same may need different care depending on the cause. Use this as a guide to find what's closest to your situation.
Cystitis
Pain when urinating, frequent urination and a feeling of incomplete emptying, with no or only mild fever
After testing, you can discuss treatment options with us
Kidney infection (pyelonephritis)
Fever of 38°C or higher, pain in the back or side, and chills
You need to see a doctor urgently. Hospital admission may be needed
Kidney stones
Sudden severe pain from the side to the lower abdomen, sometimes with blood in the urine
It needs to be assessed with imaging tests
Sexually transmitted infections
Pain when urinating, plus changes in discharge
It needs to be assessed with tests. Treatment for your partner may also be considered
Overactive bladder
No pain, but sudden strong urges to urinate, and needing to urinate more at night
We consider lifestyle adjustments and treatment options
Concentrated urine from dehydration
Dark urine with mild pain
It may improve with more fluids
* This is not a complete list. If you're not sure, please consult us.
When it might be something else
Course
Typical course
This is the general course. Actual progress varies from person to person.
- Onset to day 1
Discomfort when urinating develops into pain and frequent urination
Drink plenty of fluids and don't hold in urine
- Days 1–2
This is when symptoms are at their worst
Check for fever or back pain. If you have them, see a doctor urgently
- 2–3 days after starting treatment
With proper treatment, symptoms usually start to improve
Keep taking the medication for the period instructed, even after symptoms disappear
- If it doesn't improve
We consider the type of bacteria and the possibility of another cause
You need another consultation and tests to check
Local Insight
For people living in Southeast Asia
The climate, healthcare and access to medication differ from Japan. Here are points specific to this region.
In hot, humid regions where you sweat a lot, if your fluid intake doesn't keep up, urine becomes concentrated, which may raise the risk of cystitis and kidney stones. Also be aware that in air-conditioned offices you feel less thirsty and tend to drink less.
A cold lower body from air conditioning, and dampness in the genital area in a humid climate, can trigger it to come back.
Antibiotic-resistant bacteria are a problem in this region. Buying antibiotics at a pharmacy on your own and not taking a full course can make the infection harder to treat and lead to resistant bacteria.
Many people find it hard to see a urologist or find a female doctor locally. Starting with a consultation in Japanese and then being referred to a suitable facility as needed can help.
Care
What Cotovia can do
- A consultation, and referral for a urine test if needed (testing is at the doctor's discretion)
- Prescriptions such as antibiotics (prescribing is at the doctor's discretion)
- Referral to in-person care if you have a fever or back pain
Tests you may have
Not knowing what will happen can make people hesitate to seek care, so here's what actually takes place.
Urine test
Checking for white blood cells, bacteria and blood in the urine
Urine culture
Identifying the bacteria causing it and which medications work
Blood test
Assessing whether inflammation has reached the kidneys
Abdominal imaging
Checking for stones or problems with urine flow
Treatment options
Antibiotics
Treats the bacteria causing it
It needs to be continued for the period instructed, even after symptoms disappear. Prescribing is at the doctor's discretion
Drinking fluids
Increases urine output and flushes out bacteria
During treatment, making a special effort to drink fluids is recommended
Painkillers
Eases pain when urinating
Considered according to your symptoms
Lifestyle adjustments
Prevents it from coming back
Examples include not holding in urine, drinking fluids and choosing breathable clothes
* Tests, procedures and prescriptions are decided by the doctor after a consultation. Services may vary by country and location.
Preparation
Before your visit
When seeing a doctor abroad, simply organizing what you need to say makes a big difference.
What to bring
- Passport or residence card
- Insurance card and your insurer's contact details
- Your medication record and the medication you take
- Records of any past treatment for the same symptoms
What to tell us
- When symptoms started and what they are
- Whether you have fever, back pain or chills
- How much you drink in 1 day and how often you use the toilet
- Whether you've had the same symptoms repeatedly
- Whether you could be pregnant
Self Care
What you can do yourself
Along with seeing a doctor, here are things to keep in mind in daily life.
Prevention
- Drink fluids regularly (make a conscious effort in hot conditions)
- Wipe from front to back after using the toilet
- Choose breathable underwear and avoid trapped moisture
- Urinate and keep clean before and after sex
How to Consult
How to be seen
Choose from 3 ways to be seen, depending on your symptoms and schedule. If you're not sure, we'll guide you on LINE.
Online consultations
See a doctor by video call from home or the office. Medication delivered or from a pharmacy.
Available for this symptom
In-person care
In-person consultations at our clinics and partner hospitals, including tests and procedures.
Available for this symptom
Cotovia Counter
Support with an interpreter for visits to general hospitals.
Available for this symptom
If an online consultation finds that tests or procedures are needed, we'll guide you to in-person care or Cotovia Counter.
From consultation to receiving medication
Add us on LINE and consult
Tell us your symptoms, and we'll recommend the right way to be seen.
Book and be seen
See a doctor online or at the nearest location, with an interpreter present.
Receive your medication
Have it delivered or pick it up at a pharmacy or the clinic (varies by country).
Follow-up
You can also consult us on LINE about how you're doing afterward.
Special Care
People who need extra care
Pregnant women
A urinary tract infection during pregnancy can affect the pregnancy. Some medications can't be used, so be sure to tell us you're pregnant
Children
They may not be able to describe symptoms, and fever may be the only sign
Men
Because it's less common, there may be another underlying cause. An assessment is recommended
People who get it repeatedly
If it keeps coming back, it's worth looking into the causes and lifestyle factors
FAQ
FAQ
Common questions before a visit, and common assumptions that lead people to judge for themselves.
QI'd like medication right away.
The doctor prescribes medication if they judge it necessary based on your symptoms. If you have a fever or back pain, it may be a kidney infection, and we may refer you for tests or in-person care.
QIt keeps coming back.
Besides lifestyle factors such as fluid intake and urination habits, there may be another underlying cause. If it keeps coming back, please talk to us about it in detail.
QWhere can I get a urine test?
This varies by location. After an online consultation, if a test is needed, we'll refer you to a medical facility where you can get one.
Common misconceptions
Myth If you drink less, you won't need the toilet
Fact Drinking less makes urine more concentrated, which actually makes it easier for bacteria to grow
Myth You can stop the medication once symptoms disappear
Fact Bacteria may remain, and stopping makes it more likely to come back
Myth You can take leftover antibiotics from before
Fact The bacteria and the medication needed may be different. It can also lead to resistant bacteria
Myth Cystitis is common, so you can leave it
Fact If the inflammation reaches the kidneys, it can become serious, with fever
Myth Men don't get cystitis
Fact It's less common, but it does happen. In men, assessing the cause is especially important
Feel free to ask us on LINE first
It's fine to contact us even if you're not sure you need to see a doctor. We're available in Japanese 24 hours a day, 365 days a year.
- Symptoms
- When it started
- Your country of residence
- How you'd like to be seen
Sending these 4 things helps us respond faster. It's fine if you don't have them all.
Ask us on LINE