Cystitis refers to inflammation of the bladder, specifically, inflammation of the wall of the bladder.
Bacteria called Escherichia coli fasten to the lining of the bladder by means of thread-like structures (pili).
Cystitis usually occurs when the urethra and bladder, which are normally sterile (microbe free) become infected by bacteria - the area becomes irritated and inflamed.
Cystitis is a fairly common lower urinary tract infection, which affects people of both sexes and all ages. It is more common among females than males.
Approximately 80% of all urinary tract infections are caused by Escherichia coli. These bacteria form part of the healthy intestinal flora. However, virulent types may get into the bladder via the urethra and cause urinary tract infections. Urinary tract infections account for a large proportion of hospital-acquired infections, especially among patients using urinary catheters.
Contents of this article:
Causes of cystitis
There are many possible causes of cystitis:
- When women insert a tampon there is a slight risk of bacteria entering via the urethra.
- When a urinary catheter is changed there may be damage to the area.
- There is a higher incidence of cystitis among women who use the diaphragm for contraception, compared to sexually active women who don't.
- The patient does not empty his/her bladder completely, creating an environment for bacteria to multiply in the bladder. This is fairly common among pregnant women, and also men whose prostates are enlarged.
- Sexually active women have a higher risk of bacteria entering via the urethra.
- Part of the urinary system may be blocked.
- Other bladder or kidney problems.
- Frequent and/or vigorous sex increases the chances of physical damage or bruising, which in turn makes the likelihood of cystitis developing higher.
- During the menopause women produce less mucus in the vaginal area. This mucus stops the bacteria from multiplying. Women on HRT (hormone replacement therapy) have a lower risk of developing cystitis compared to menopausal women not on HRT.
- During the menopause the lining of a woman's urethra gets thinner as her levels of estrogen drop. The thinner the lining becomes, the higher the chances are of infection and damage.
- A woman's urethra opening is much nearer the anus than a man's. Consequently, there is a higher risk of bacteria entering the urethra from the anus.
Experts say that the majority of women will have at least one incidence of cystitis during their lives. A sizeable number have more than one incidence. Doctors say a woman should see her GP (general practitioner, primary care physician) when she gets cystitis for the first time, as should any woman who has cystitis three or more times within a twelve-month period.
Health professionals recommend that all men and children should see their doctor if they have cystitis.
When men get cystitis it tends to be potentially more serious than when women get it. Male cystitis is more likely to be caused by some other serious underlying condition, such as a prostate infection, cancer, an obstruction, or an enlarged prostate. In most cases of male cystitis early treatment is effective and the problem is solved. However, untreated male bladder infection can lead to kidney or prostate infections and/or damage. Men who have sex with men are more likely to have cystitis than other men.
Symptoms of cystitis
The following are common signs and symptoms of cystitis:
- Urine may have traces of blood
- Urine is dark and/or cloudy
- Urine has a strong smell
- Pain just above the pubic bone
- Pain in the lower back
- Pain in the abdomen
- Only small amount of urine is passed each time
- Frequent need to urinate
- Burning sensation when urinating
- Older women may feel weak and feverish but have none of the other symptoms mentioned above
- When children have cystitis they may have any of the symptoms listed above, plus vomiting and general weakness.
Other illnesses or conditions may have the same symptoms as cystitis. They include:
- Urethritis (inflammation of the urethra)
- Urethral syndrome
- Some bacterial infections
- Prostatitis (inflammation of the male prostate gland)
- Candida (thrush)
On the next page we look at the diagnosis of cystitis, the available treatments and the options for helping prevent cystitis.