Urology
Cystitis
방광염
Inflammation of the bladder mucosa (usually bacterial)
- How common
- Women >50% lifetime
- Typical age
- Sexually active women common
What is it?
Enteric bacteria invade bladder mucosa via the urethra causing inflammation.
Commonly affected: Bladder mucosa
How it develops
- Periurethral colonizationE. coli colonizes
- AscentShort female urethra eases ascent
- Bladder adhesionP-fimbriae bind urothelium
- Mucosal inflammationLeukocyte infiltration, petechiae
Symptoms
- DysuriaBurning urination
- Frequency/urgencyFrequent small voids
- Suprapubic painLower abdominal pain
- Hematuria~30% gross hematuria
How it is examined
- Urine dipstickLeukocyte esterase, nitrites positive
- Physical examNo CVA tenderness → simple cystitis
Imaging
Imaging not needed for simple cystitis.
- Clinical diagnosis
Cystoscopy or imaging if recurrent/complicated.
- Cystoscopy: hyperemic mucosa
Non-surgical care
- Nitrofurantoin 100 mg bid x 5dFirst-line simple cystitis
- TMP-SMX DS bid x 3dRegions with <20% resistance
- Fosfomycin 3 g single-doseConvenient single dose
- Hydration + phenazopyridineSymptom relief
- ProphylaxisPostcoital void, cranberry, low-dose abx
Conservative options are generally tried first. Medications listed here can have side effects — discuss them with your prescriber.
When surgery is considered
Usually none needed
Procedures that may be discussed
- Cystoscopy if recurrent
- Stone removal if associated
Outlook
95% cured with antibiotics.