Chronic cystitis

Description of the disease

Cystitis – inflammation of the bladder. Chronic cystitis is inflammation of the bladder that does not resolve even with treatment for several weeks or when episodes of acute cystitis recur more than twice in half a year.

Most commonly, chronic cystitis is of infectious origin, caused by various bacteria. Typically, the causative agent of the disease is Escherichia coli (intestinal bacteria), which enters the bladder from the outside through the urethra. In rarer cases, non-infectious cystitis occurs, which develops due to the use of certain medications, radiation, or hygiene products (acting as irritants causing inflammation).

Women are more often affected. This is due to several reasons: anatomical features (bacteria enter the bladder more easily in women because the female urethral opening is very close to the vagina), hormonal factors (infections occur more frequently in women after menopause).

Cause of the disease

Chronic cystitis is most often secondary, meaning the infection constantly recurs due to various urinary system diseases. A comprehensive examination is usually required to investigate possible neoplastic diseases, bladder stones, urethral strictures, and other pathological conditions that may lead to constant urinary retention. For some women, cystitis is triggered by sexual intercourse.

Symptoms

The following symptoms are characteristic of the disease:

Normal or slightly elevated body temperature,
Frequent urge to urinate,
Painful urination (burning sensation when urinating),
Abdominal or lower back pain.

Diagnostics

The disease is diagnosed by identifying the symptoms and characteristics of the course of the disease. A urine test is performed to detect leukocytes, sometimes erythrocytes (red blood cells), and bacteria. Bacterial growth may be detected in a urine culture. During chronic cystitis, cystoscopy is also recommended to identify the cause of recurrent inflammation.

Treatment

Once the cause of the disease is determined, it is necessary to eliminate it. Antibacterial treatment is prescribed. It is important to properly treat the exacerbation of the disease, as the infection can reach the kidneys and cause pyelonephritis. If cystitis recurs after sexual intercourse, it is advisable to take antibiotics before and after intercourse. It is also recommended to urinate after sexual intercourse.

Source | Author Doctor Nikas Samuolis, reviewed by Prof. Virginijus Šapoka | Vilnius University | Faculty of Medicine | Head of the Department of Internal Medicine, Family Medicine, and Oncology