What is cystitis?
Cystitis refers to inflammation of the bladder, specifically, inflammation of the wall of the bladder.Bacteria called Escherichia coli fasten to the lining of the bladder by means of thread-like structures (pili).Cystitis usually occurs when the urethra and bladder, which are normally sterile (microbe free) become infected by bacteria - the area becomes irritated and inflamed.Cystitis is a fairly common lower urinary tract infection, which affects people of both sexes and all ages. It is more common among females than males.According to the medical survey,approximately 80% of all urinary tract infections are caused by Escherichia coli. These bacteria form part of the healthy intestinal flora. However, virulent types may get into the bladder via the urethra and cause urinary tract infections. Urinary tract infections account for a large proportion of hospital-acquired infections, especially among patients using urinary catheters.
The types of cystitis
There are several medically distinct types of cystitis, each having a unique etiology and therapeutic approach:
Traumatic cystitis is probably the most common form of cystitis in the female, and is due to bruising of the bladder, usually by abnormally forceful sexual intercourse. This is often followed by bacterial cystitis, frequently by coliform bacteria being transferred from the bowel through the urethra into the bladder.
Interstitial cystitis (IC) is considered more of an injury to the bladder resulting in constant irritation and rarely involves the presence of infection. IC patients are often misdiagnosed with UTI/cystitis for years before they are told that their urine cultures are negative. Antibiotics are not used in the treatment of IC. The cause of IC is unknown, though some suspect it may be autoimmune where the immune system attacks the bladder. Several therapies are now available.
Eosinophilic cystitis is a rare form of cystitis that is diagnosed via biopsy. In these cases, the bladder wall is infiltrated with a high number of eosinophils. The cause of EC may be attributed to infection by Schistosoma haematobium or by certain medications in afflicted children. Some consider it a form of interstitial cystitis.
Hemorrhagic cystitis, can occur as a side effect of cyclophosphamide, ifosfamide, and radiation therapy. Radiation cystitis, one form of hemorrhagic cystitis is a rare consequence of patients undergoing radiation therapy for the treatment of cancer. Several adenovirus serotypes have been associated with an acute, self-limited hemorrhagic cystitis, which occurs primarily in boys. It is characterized by hematuria, and virus can usually be recovered from the urine.
In sexually active women the most common cause of urinary tract infection is from E. coli and Staphylococcus saprophyticus.
Cystitis cystica is a chronic cystitis glandularis accompanied by the formation of cysts. This disease can cause chronic urinary tract infections. It appears as small cysts filled with fluid and lined by one or more layers of epithelial cells.These are due to hydropic degeneration in center of Brunn's nests.
There are two diagnostic approach.
A urinalysis may reveal white blood cells (WBCs) or red blood cells (RBCs).
A urine culture (clean catch) or catheterized urine specimen may be performed to determine the type of bacteria in the urine and the appropriate medicine for treatment.
