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Cystitis

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Cystitis

Written by Mr John Macfarlane, consultant urological surgeon and Dr Paul Klenerman, specialist

What is cystitis?

Cystitis is an infection of the bladder, but the term is often used indiscriminately and covers a range of infections and irritations in the lower urinary system. It causes burning sensations during urination and a frequent need to urinate.

How do you get cystitis?

Infection from intestinal bacteria is by far the most frequent cause of cystitis, especially among women, who have a very short urethra (the tube through which the urine passes from the bladder to the outside). Normally, urine is sterile (there are no micro-organisms such as bacteria present). Between 20 to 40 per cent of women will get cystitis in their lifetime.

However, it is possible to have bacteria in the bladder without having any symptoms (especially in the elderly). There can be several reasons for the bacteria settling in the bladder. Inadequate emptying resulting in stagnation of urine may lead to infection. This may be caused by some drugs (for example, antidepressants), immobility, abnormal bladder control and constipation. Even the small drop which is always left behind may contain bacteria. Conditions that may make it easier for the bacteria to travel through the urethra include those listed below.

Toilet hygiene Particularly common among females, as they have a shorter urethra than males and it is situated relatively close to their anus (back passage). Women and girls must dry themselves from front to back, towards the anus - not the other way around - to avoid leading bacteria from their intestine into their urethra.

Congenital deformity in the urinary system

In the case of repeated infections of the urinary system, particularly among boys and young men, the individual should be checked for a congenital (present from birth) deformity somewhere in the urinary system which prevents the complete emptying of the bladder.

People with a catheter

Everyone with a catheter (to drain urine) will have bacteria in their bladder, usually without symptoms. During the change of catheter, small lesions (damaged areas) may appear, which may increase the danger of infection (cystitis) and possible blood infection.

Men with an enlarged prostate

An enlarged prostate (male sex gland) in teh older male prevents the bladder from emptying completely.

Other conditions like prostatitis (infection in the prostate) and urethritis (infection in the urethra) may give rise to similar symptoms in the younger male.

Pregnant women

If pregnant women have bacteria in their urine, their urine should be cultured twice, regardless of whether or not they have any symptoms. If the same strains of bacteria occur, they should be treated. Otherwise, there is the risk of kidney infection and pre-term delivery (if near the due date).

Other causes

'Honeymoon' cystitis Cystitis in women related to increased frequency of sexual activity.

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