Cystitis Health Article

Definition

Cystitis is inflammation of the urinary bladder. Urethritis is an inflammation of the urethra, which is the tube that connects the bladder with the exterior of the body. Sometimes cystitis and urethritis are referred to collectively as a lower urinary tract infection (UTI). Infection of the upper urinary tract involves the spread of bacteria to the kidney and is called pyelonephritis.

Cystitis in women

Cystitis is a common female problem. It is estimated that 50 percent of adult women experience at least one episode of dysuria (painful urination); half of these people have a bacterial UTI. Between 2 percent and 5 percent of women's visits to primary care physicians are for UTI symptoms. About 90 percent of UTIs in women are uncomplicated but recurrent.

Cystitis in men

UTIs are uncommon in younger and middle-aged men but may occur as complications of bacterial infections of the kidney or prostate gland.

Cystitis in children

In children, cystitis often is caused by congenital abnormalities (present at birth) of the urinary tract. Vesicoureteral reflux is a condition in which the child cannot completely empty the bladder. The condition allows urine to remain in or flow backward (reflux) into the partially empty bladder. In addition, cystitis can also be caused by wiping forward instead of backward after a bowel movement, especially in girls that are newly toilet trained.

Demographics

The frequency of bladder infections in humans varies significantly according to age and sex. The male/female ratio of UTIs in children younger than 12 months is four to one because of the high rate of birth defects in the urinary tract of male infants. Urinary tract infections are fairly common in young girls. In adult life, the male/female ratio of UTIs is one to 50. After age 50, however, the incidence among males increases due to prostate disorders.

Causes and symptoms

The causes of cystitis vary according to gender because of the differences in anatomical structure of the urinary tract.

Females

Women and teens with two or more UTIs within a six-month period sometimes are given prophylactic treatment, usually nitrofurantoin or trimethoprim for three to six months. In some cases the woman is advised to take an antibiotic tablet following sexual intercourse.

Other preventive measures for women include drinking large amounts of fluid; voiding frequently, particularly after intercourse; and proper cleansing of the area around the urethra. Children with UTIs should be encouraged to drink plenty of fluids and wipe themselves properly after a bowel movement.

In 2003, clinical trials in humans tested a possible vaccine for recurrent urinary tract infections. The vaccine was administered via a vaginal suppository.

Males

Most UTIs in adult males are complications of kidney or prostate infections. They usually are associated with a tumor or kidney stones that block the flow of urine and often are persistent infections caused by drug-resistant organisms. UTIs in men are most likely to be caused by E. coli or another gram-negative bacterium. Risk factors for UTIs in men include lack of circumcision and urinary catheterization. The longer the period of catheterization, the higher the risk of contracting a UTI.

The symptoms of cystitis and pyelonephritis in men are the same as in women.

Children

In children, cystitis causes pain and tenderness in the lower abdomen, frequent urination, blood in the urine, and fever. However, some foods, including citrus juices, caffeine, and carbonated beverages, can irritate the lower urinary tract and mimic the symptoms of an infection.

Hemorrhagic cystitis

Hemorrhagic cystitis, which is marked by large quantities of blood in the urine, is caused by an acute bacterial infection of the bladder. In some cases, hemorrhagic cystitis is a side effect of radiation therapy or treatment with cyclophosphamide. Hemorrhagic cystitis in children is associated with adenovirus type 11.

When to call the doctor

A doctor or other healthcare provider should be contacted whenever urination becomes painful or the voided urine is cloudy or bloody, or when a child complains of pain when voiding urine.