on 6.7.05 with 0 comments

Cystitis: refers to inflammation (acute or chronic) of the bladder; very common in young females and older population. Cystitis can be asymptomatic or more usually presents with urinary symptoms…

  • Frequency

  • Dysuria

  • Abdominal pain

Also, may be associated with hematuria and systemic symptoms (e.g. development of pyelonephritis and associated complications); though resolution is common (antibiotics, treatment of underlying causes etc.)

Aetiology: cystitis is most commonly due to infection…

  • Bacterial infection (most common): e.g. E. coli, Proteus, S. Faecalis

[Most bacteria causing UTI originate in the bowel.]

  • Viral infection: adenovirus may cause haemorrhagic cystitis in children

  • Parasite: Schistosoma haematobium, which is common in Africa

  • Fungi: Candida

Occasionally caused by physical agents e.g. radiation or mechanical irritants


Risk factors:

  • Urinary retention: due to obstruction e.g. prostatic enlargement, bladder paralysis, foreign body, calculi, and tumours.

  • Infection of adjacent structure, e.g., prostatitis, urethritis.

  • Diabetes mellitus

  • Pregnancy

  • Trauma e.g. catheterization

Also vesico-ureteric reflux predisposes to extension to kidney

Routes of infection:

  • Ascending infection: (commonest) lower vagina and periurethral mucosa distal urethra ascend the urethra into the bladder (cystitis); may extend to the ureters and renal parenchyma (pyelonephritis).

Note: F>M incidence because females have a shorter urethra

Other less common routes:

  • Descending infection: from the kidney e.g. renal tuberculosis

  • Direct spread: from adjacent organs e.g. diverticulitis

  • Haematogenous: from distant focus rare

  • Lymphatic: extremely rare


  • Non-specific acute or chronic inflammation

  • Ulceration of bladder mucosa

  • Epithelial metaplasia

  • Fibrosis of wall

Special types of cystitis:

  • Cystitis cystica and cystitis glandularis

  • Granulomatous (TB, intravesical BCG, following instrumentation)

  • Eosinophilic

  • Interstitial (Hunner ulcer) – clinicopathological entity

  • Iatrogenic (following radiation or chemotherapy)

  • Malacoplakia (usually chronic E coli or Proteus infection)

Category: Medicine Notes



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