CYSTITIS

Inflammation of the urinary bladder

resulting from one of a number of a
distinct syndrome

Causative agents
E.coli

, klebsiella , enterobacter
Candida albicans(less often)
Cryptococcal agents in immunosuppressed
patients
Adenovirus, chlamydia, mycoplasma
Cytotoxic anti tumor drug such as
cyclophosphamide and busulphan
Radiation of urinary bladder

Types of cystitis
1.

2.
3.
4.
5.
6.

Haemorrhagic cystitis
Chronic cystitis / cystitis cystica
Eosinophilic cystitis
Suppurative cystitis
Ulcerative cystitis
Cystitis follicularis

Haemorrhagic cystitis
Hyperemia of the
mucosa associated
with the hemorrhagic
exudates
Microscopic or gross
haemorrhage is seen
along with clots,
leading to urinary
retention

Occurs as a side effect of

cyclophosphamide and radiation
therapy
Adenovirus infection in boys

Cystitis cystica
Persistent infection
accompanied by
the formation of
cyst
Heaping up of the
epithelium
Formation of red,
friable, granular
and sometimes the
ulcerated surface

Chronicity- fibrous thickening of tunica

propria
Consequent thickening and inelasticity
of bladder wall

Eosinophilic cystitis

Rare form of cystitis

Biopsy
Eosinophilic infiltration in the bladder wall
deep into the muscularis mucosa along with
the fibrosis and giant cell
Infection by the schistosoma hematobium

Suppurative cystitis

Accumulation of
large number of
suppurative
exudates

Ulcerative cystitis
Ulceration of large
areas of mucosa
Sometimes entire
bladder mucosa

Cystitis follicularis
Special form of
chronic
inflammatory
reaction
Accumulation of
lymphocyte and
lymphatic follicles
in the bladder
mucosa

Special forms of cystitis

1.

Interstitial cystitis
Chronic cystitis
mostly in women
Inflammation and
fibrosis of all
layers of bladder
wall
Unknown etiology
but thought to be
autoimmune in
origin

2. Malakoplakia

Inflammatory
reaction

Gross: soft, yellow,

slightly raised
mucosal plaques

Microscopic:
- foamy
macrophages
forming plaques
- laminated
mineralized
concretion known as
michaelis- gutman
bodies

Signs and symptoms

Characterised by triad of symptoms
1. Lower abdominal pain i.e in the pubic
bone or in lower back abdomen
2. Frequent urination- polyuria
3. Painful urination- dysuria

Other: weak, feverish,chills, malaise,

dark cloudy and strong smelling
urine

Complication
Prostate enlargement
Cystocele of bladder
Calculi or tumor in bladder