What Is Acute Cystitis?

Acute cystitis is an acute inflammatory disease of the bladder wall caused by non-specific bacterial infections. It is a common disease of the urinary system. It is characterized by acute onset, with severe bladder irritation and mild systemic reactions. The normal bladder has defensive measures such as antibacterial urine, antibacterial mucosa, mechanical irrigation of the urine, and bladder neck sphincter and external urethral sphincter bacteriostasis. Whether the bacteria entering the bladder can multiply depends on the defense ability of the bladder mucosa, the number and toxicity of bacteria, and The patency of urinary tract discharge. The most common pathogenic bacteria are Gram-negative bacilli, which are usually Escherichia coli, Pseudomonas aeruginosa, Clostridium perfringens, and Proteus. Gram-positive cocci (mainly Staphylococcus aureus and Streptococcus) are rare and can be mixed infections. The infection is mainly caused by the above infection routes. Few descending infections, and direct spread of hematologic, lymphatic, or adjacent tissue infections are rare.

Basic Information

English name: acutecystitis
Visiting department: Urology
Multiple groups: female

Common causes: E.coli
Common symptoms: Frequent urination, urgency, dysuria, bladder, urethra spasm, cloudy urine, pus cells in urine, hematuria,

Causes of acute cystitis

Mostly caused by bacterial infections. Most of its pathogenic bacteria are E. coli. It usually occurs in women, because women's urethra is shorter than men's urethra and close to the anus, and E. coli is easy to invade. Cystitis is caused by a variety of factors: intrinsic factors of the bladder, such as stones, foreign bodies, tumors and indwelling catheters in the bladder, destroy the defense ability of the bladder mucosa, which is conducive to bacterial invasion. The urinary tract obstruction below the neck of the bladder causes dysuria and loses the flushing effect of urine. The residual urine becomes a good medium for bacterial growth. Neurological damage, such as neurological diseases or extensive pelvic surgery (hysterectomy or rectal surgery), damage the nerves that govern the bladder, causing difficulty in urination and causing infection.

Clinical manifestations of acute cystitis

Urinary tract irritation

Sudden onset of symptoms, obvious urinary frequency, urgency, dysuria, bladder, urethra spasm, severe urinary incontinence, often can not leave the toilet, unbearable. Burning sensation in the urethra, increased pain at the end of urination, pain in the perineum, suprapubic area, and mild tenderness in the bladder area. In severe cases, acute prostatitis may be complicated, but general systemic symptoms are not obvious.

2. Urine test

Turbid urine, pus cells in the urine, terminal hematuria is common, and sometimes full hematuria.

3. Simple cystitis

Inflammation is confined to the mucosa, often without fever, with no increase in white blood cell count, and without systemic symptoms. Fever only occurs when acute pyelonephritis or prostatitis and epididymitis occur.

Acute cystitis examination

Laboratory inspection

Urine test: Urine routine white blood cell count 10 / HP, may have red blood cells, but no tube type: Urine sediment smear Gram stain, WBC 15-20 / HP; Urine urine culture, colonies 10 ⁸ / L.

2. Other auxiliary inspections

If there is purulent urethral discharge, a smear test should be performed to rule out Neisseria gonorrhoeae infection. If necessary, cystoscopy can be performed after the acute phase of infection or after infection control, or by ultrasound and X-ray examination after the onset Etiological factors such as urinary tract stones or inducing and concurrent factors.

Differential diagnosis of acute cystitis

Acute pyelonephritis

Mainly manifested as urinary tract irritation symptoms such as frequent urination, urgency, dysuria, etc. Urine tests may have pus and red blood cells, but often accompanied by systemic infections such as fever, back pain and renal tenderness.

2. Trichomonas cystitis

Mainly manifested as urinary tract irritation symptoms such as frequent urination, urgency, and dysuria, but patients often have a history of unclean sex. There are many secretions in the urethra, and trichomonas can be found in the secretion examination.

3. Acute prostatitis

Mainly manifested as urinary tract irritation symptoms such as frequent urination, urgency, dysuria, and suprapubic pain. Patients often have difficulty urinating to varying degrees, and digital rectal examination can reveal enlarged prostate with tenderness.

4. Interstitial cystitis

Mainly manifested as urinary tract irritation symptoms such as frequent urination, urgency, dysuria, and suprapubic pain. Pain and tenderness in the bladder area above the pubic bone are particularly pronounced, which intensifies when the bladder is full. Routine urine tests are mostly normal with very few pus.

5. Glandular cystitis

Clinical manifestations include frequent urination, urgency, dysuria, dysuria, and hematuria. B-ultrasounds can show non-specific signs such as mass lesions in the bladder or thickening of the bladder wall. Cystoscopy and mucosal biopsy can help Identification.

6. Lower ureteral stones

Bladder irritation can also occur when ureteral stones fall to the bladder wall. If concurrent infection, it is not easy to distinguish from cystitis. KUB plain film and IVU can show the location of the stones and determine whether there is a combined obstruction.

Acute cystitis treatment

Rest in bed, drink plenty of water, avoid irritating food, hot water bath or hot compresses on the pubic bone can improve local blood circulation and reduce symptoms. Oralize sodium bicarbonate or potassium citrate to reduce urinary tract irritation. Flavonolate (Urin), Belladonna, Atropine can relieve bladder spasm.

According to the genus of pathogenic bacteria, select appropriate antibacterial drugs. Before the susceptibility test, compound sulfamethoxazole, cephalosporins, and quinolones can be used. After treatment, the condition generally improves rapidly, pus cells in urine disappear, and cell culture turns negative. Short-term 3-day therapy should be used as much as possible to avoid unnecessary long-term medication to avoid drug resistance or increase side effects, but measures to prevent relapse should be strengthened. If the symptoms do not disappear, the urine pus cells continue to exist, and the culture is still positive, bacterial resistance and infection inducement should be considered, and more appropriate antibacterial drugs should be adjusted in time to extend the application time to achieve complete cure.

Urinary tract infections often occur after menopause and are easily reinfected. Lack of estrogen causes decreased lactobacillus in the vagina and increased reproduction of pathogenic bacteria is an important factor in infection. Estrogen replacement therapy to maintain a normal intravaginal environment, increase lactobacilli and eliminate pathogenic bacteria, can reduce the occurrence of urinary tract infections.

Prognosis of acute cystitis

Acute cystitis can be quickly cured after timely and appropriate treatment. For chronic cystitis, if it can clear the original lesion, remove the obstruction, and treat it symptomatically, most cases can be cured, but it takes a long time.