f Post graduate mcqs and discussion : CYSTITIS

Saturday, March 31

CYSTITIS


Inflammation of the bladder mucosa due to different causes.

Fig: CYSTITIS

Causes :

Acute bacterial cystitis
Chronic cystitis due to tuberculosis, syphilis
Interstitial cystitis
Radiation cystitis
Cystitis due to schistosomiasis
Postmenopausal atrophic cystitis


Predisposing Factors:



Congenital urinary tract anomalies

Short urethra in females may cause ascending infection and cystitis.

Initial period of sexual contact in females can cause cystitis—Honeymoon cystitis.

Catheters, instrumentation.

Bladder stone.

BPH, carcinoma prostate.

Cystocele, bladder diverticulum.

Stricture urethra, bladder neck obstruction.

Bladder tumours.

Pregnancy.

CNS diseases, spinal injury.


 Clinical Features: 



Painful urination, frequency, strangury, incomplete emptying, with often retention.
Occasionally haematuria can occur.
Burning urine, discoloured foul smelling urine.
Fever, chills, rigors, suprapubic pain and tenderness and often loin pain.
Septicaemia can develop in severe cystitis.


Investigations :


Total count will be raised.
Urine will show pus cells and culture will reveal the organisms.
X-ray may show a stone.
IVU, cystogram are also helpful.
U/S abdomen will show thickening of bladder mucosa, stone, tumour.
Cystoscopy reveals bladder infl ammation, mucosal changes.


Treatment :


Appropriate antibiotics like quinolones, aminoglyco sides, cephalosporins.

Plenty of water intake to fl ush the bacteria from the bladder.
Often admission and parenteral antibiotics may be needed.
Evaluation and therapy for cause should be done.

Strict aseptic precaution is used while catheterisation, cystoscopy.

Often long-term antibiotics are needed to prevent recurrent infection.



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