Cystitis

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Contents 1 More Specific Terms 2 Introduction 3 Etiology 4 Epidemiology 5 Pathology 6 Clinical-manifestations 7 Laboratory 8 Management 9 More General Terms 10 Additional Terms 11 References

More Specific Terms

• fungal cystitis
• interstitial cystitis

Introduction

• Inflammation/ infection of the urinary bladder.

Etiology

• urinary tract infection

• colonic bacteria ascending through the urethra

• interstitial cystitis
• pharmaceutical agents
• radiation

Epidemiology

• particularly common in women

Pathology

• frequency of infection in women is mainly because of the much shorter urethra, which provides less of a barrier to bacteria
• in men, infection is usually associated with obstruction to the flow of urine, such as prostate gland enlargement

Clinical-manifestations

• dysuria
• urinary frequency
• nocturia
• suprapubic pain/tenderness
• hematuria
• malodorous & cloudy urine*
• urinary urgency
• urinary incontinence

• * according to ref 2, does not constitute evidence of infection, nonetheless may be the symptom that prompts a urinalysis

Laboratory

• see urinary tract infection
• bacteruria in the absence of pyuria is common if the specimen remains at room temperature for a prolonged time prior to analysis
• pyuria & bacteruria indicates infection

Management

• see urinary tract infection
• empiric treatment of bacteruria & pyruria associated with symptoms of cystitis prior to culture:

• Bactrim
• fluoroquinolone for complicated UTI
• ciprofloxacin clearly superior to cefpodoxime [4]

• pregnant women with cystitis are treated 3-7 days with amoxicillin or nitofurantoin
• asymptomatic bacteriuria does not need treatment

More General Terms

• urinary bladder disease

Additional Terms

• bacteriuria
• urinary tract infection (UTI)

References

1. Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996, pg 552-553
2. UCLA Intensive Course in Geriatric Medicine & Board Review, Marina Del Ray, CA, Sept 12-15, 2001 a) Ouslander et al, Ann Intern Med 122:749, 1995 b) Ouslander et al J Am Geriatr Soc 44:420, 1996
3. Medical Knowledge Self Assessment Program (MKSAP) 15, American College of Physicians, Philadelphia 2009
4. Hooton TM et al. Cefpodoxime vs ciprofloxacin for short-course treatment of acute uncomplicated cystitis: A randomized trial. JAMA 2012 Feb 8; 307:583. PMID: [1]

cystitis