Cystitis overview
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Steven C. Campbell, M.D., Ph.D.
Overview
Cystitis is inflammation of the urinary bladder. The condition more often affects women, but can affect either gender and all age groups.
Historical Perspective
Urinary tract infections have been described since ancient times with the first documented description in the Ebers Papyrus dated to c. 1550 BC. In 1836, Philadelphia surgeon Joseph Parrish published the earliest record of interstitial cystitis by describing three cases of severe lower urinary tract symptoms without the presence of a bladder stone.The term "interstitial cystitis" was coined by Dr. Alexander Skene in 1887 to describe the disease.[1]
Classification
Cystitis may be classified according to the etiology and therapeutic approach into 5 subtypes: traumatic, interstitial, eosinophilic, hemorrhagic cystitis, and cystitis cystica. For the purpose of treatment, cystitis may also be classified into acute uncomplicated, complicated, and recurrent cystitis.
Pathophysiology
Cystitis occurs when the normally sterile lower urinary tract (urethra and bladder) is infected by bacteria, which leads to irritation and inflammation. Females are more prone to the development of cystitis because of their relatively shorter urethra. Bacteria does not have to travel as far to enter the bladder, which is in part due to the relatively short distance between the opening of the urethra and the anus. The pathogenesis of complicated cystitis include obstruction and stasis of urine flow. Obstruction leads to overdistension and bacterial growth is facilitated by the residual urine. Stasis of urine flow allows entry of pathogens into the urinary tract.[2]
Causes
More than 85% of cases of cystitis are caused by escherichia coli ("E. coli"), a bacterium found in the lower gastrointestinal tract. Other causes of cystitis include certain medications, diabetes, Crohn's disease, iatrogenic causes, endometriosis, pelvic inflammatory disease, urinary obstruction, and bladder incontinence.
Differential Diagnosis
Epidemiology and Demographics
Risk Factors
Natural History, Complications, and Prognosis
Diagnosis
History and Symptoms
Physical Examination
Laboratory Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Because of the risk of the infection spreading to the kidneys (complicated UTI) and due to the high complication rate in the elderly population and in diabetics, prompt treatment is almost always recommended.
Prevention
References
- ↑ Interstitial Cystitis. Wikipedia.https://en.wikipedia.org/wiki/Interstitial_cystitis#History Accessed on February 8, 2016
- ↑ Hooton TM (2000). "Pathogenesis of urinary tract infections: an update". J Antimicrob Chemother. 46 Suppl A: 1–7. PMID 10969044.