Cystitis

By:    Published: December 14, 2011

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Cystitis refers to the inflammation of the bladder and may cause frequent and painful urination. In young children, cystitis is often associated with sudden onset of daytime wetting. The most common cause for cystitis is a bacterial infection. However, an array of noninfectious agents such as radiation therapy, adverse reaction to certain drugs, or the use of potential irritants (i.e feminine hygiene spray or spermicidal jellies) may also cause inflammation of the bladder. Treatment for cystitis can vary depending on the underlying cause. If untreated, bacterial cystitis can spread to your kidneys and cause serious health problems.

Symptoms

Symptoms of cystitis may include:

  • Frequent urination or urgent need to urinate
  • Painful urination
  • Passing frequent, small amounts of urine
  • Dark, cloudy or strong smelling urine
  • Malaise
  • Pressure in the lower pelvis
  • Need to urinate at night
  • Traces of blood in urine
  • Dark, cloudy or strong smelling urine
  • Lower back or abdomen pain

In young children, bacterial cystitis may cause new bouts of accidental wetting.

Subtypes And Their Causes

There are several distinct types of cystitis, each of which are caused by a unique factor.

  • Bacterial cystitis or urinary tract infection. Bacterial cystitis is the most common type of cystitis and typically occurs when bacteria colonizes the urinary tract through the urethra. Bacterial cystitis is most commonly caused by E. Coli or Staphylococcus saprophyticus. Bacterial bladder infections often occur in women as a result of sexual intercourse. During sexual activity, bacteria is introduced into the bladder through the urethra. However, women who are not sexually active can also contract bacterial cystitis because the female genital area often contains bacteria that can cause a urinary tract infection.
  • Interstitial cystitis. This type of cystitis can cause chronic and painful bladder inflammation. The cause of interstitial cystitis is currently unknown, although some believe it may be caused by an autoimmune disorder. This condition is typically difficult to diagnose and treat.
  • Drug-induced cystitis. This type of cystitis can be caused by certain medications, in particular chemotherapy drugs.  As the broken down by-products of these drugs are excreted via the urine, they can cause inflammation of the bladder.
  • Radiation cystitis. Radiation treatment of the pelvic area can cause inflammation of the bladder tissue.
  • Foreign-body cystitis. Extended use of a catheter may make you more prone to bacterial infections and to tissue damage, both of which contribute to bladder inflammation.
  • Chemical cystitis. Hypersensitivity to chemicals contained in certain products, such as bubble bath, feminine hygiene sprays or spermicidal jellies, may cause an allergic-type reaction within the bladder, causing inflammation.
  • Eosinophilic cystitis. This is a rare form of cystitis that is caused by an accumulation of eosinophils (a type of white blood cell) in the bladder wall.

Risk Factors

Risk factors for developing cystitis include:

  • Being a woman. Women have a shorter urethra than men, which minimizes the distance bacteria must travel to reach the bladder from the anus.
  • Women who are sexually active. Sexual intercourse can push bacteria into the urethra causing an infection.
  • Using a diaphragm.
  • Pregnancy.
  • Obstructing urine flow.  This may be caused by stones in the bladder or an enlarged prostate, in men.
  • A lowered immune system.
  • Prolonged use of bladder catheters.

Diagnosis

In order to diagnose cystitis your doctor will initially perform a comprehensive medical exam and take a complete medical history. Your doctor may also order the following tests:

  • Urine analysis. A urine sample is provided to determine whether bacteria, blood or pus is in your urine.
  • Cystoscopy. A thin tube with a light and camera attached are inserted through the urethra into the bladder to examine the extent of bladder inflammation. Additionally, if your doctor feels it is necessary, a biopsy can also be taken for further analysis.
  • X-ray or ultrasound.  These imaging tests may be used in order to rule may help rule out other possible causes of bladder inflammation, such as a tumor.

Treatment

The treatment regimen for cystitis may vary according to the specific cause.

  • Antibiotics. This is the first line defense utilized to treat bacterial cystitis. Symptoms of bacterial cystitis will usually subside within a couple of days of treatment. However, it is important to complete the full course of antibiotics prescribed.

The following treatments are used to ameliorate the symptoms associated with interstitial cystitis.

  • Pentosan polysulfate sodium (PPS). This drug, which is taken orally helps to repair or restore the lining tissues in the bladder.
  • Bladder distension. This procedure stretches the bladder and has been found to reduce symptoms in approximately 20%-30% of people with interstitial cystitis. When it is effective, the relief of symptoms persists for three to six months after the procedure.
  • Nerve stimulation. Mild electrical pulses are delivered to relieve pelvic pain and, in some cases, reduce urinary frequency.

Treatment of cystitis that develops as a result of chemotherapy or radiation therapy involves:

  • Pain management.
  • Hydration. This is utilized to flush out any irritants.

This form of cystitis will usually resolve itself once the chemotherapy or radiation treatment is completed.

For chemical cystitis it is recommended to discontinue the use of irritating products such as bubble bath or spermicides in order to prevent future episodes of bladder inflammation.

Sources:

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