by Julie Chacko, M.D.

• Definition: Infection of the bladder

• Overview: Acute cystitis is one of the more common reasons for patient visits.
· It is one form of UTI (urinary tract infection) though cystitis more specifically refers to the bladder being the site of infection.
· Approximately 90% of infections can be cleared with a single course of antibiotics as typically the infection is a bacterial infection and the most common organism is E. Coli.
· There are factors that lead to some women being more susceptible to infection than others.

• Types of infections:
· Bacterial
· viral
· fungal
· non-infectious (see Painful Bladder Syndrome)

• Symptoms:
· Dysuria (burning during urination)
· Frequency of urination
· Urgency to urinate and often small volumes urinated
· Pain in the bladder (felt as discomfort in the lower abdomen) is often present

• Complications:
· Fever
· Upper urinary tract infection (see pyelonephritis)
· Hematuria (blood in the urine)

• Clinical Findings/signs: Generally very few signs are found on physical examination.
· Tenderness just above the pubic bone, overlying the bladder, can sometimes be appreciated.
· Diagnosis is made preliminarily based on history and urinalysis and confirmed when indicated by a positive culture result.
· Fungal and viral infections are relatively rare and may be missed on the urine initial culture.

• Treatment:
Medication:
· Antibiotics are the mainstay of therapy for Bacterial infection.
· Urinary agents that help to relieve the burning sensation are often used as well but do not by themselves treat the infection.
· Antispasmodics for the bladder can also be prescribed for symptomatic control if severe.

Lifestyle:
· Prevention of infection is believed to be aided by proper hygiene (wiping oneself from front to back therefore moving the fecal organisms away from the urethra)
· Adequate fluid intake and bladder emptying.
· Post-Coital (after intercourse) urination helps to clear bacteria as well.
· Surgery: rarely indicated except in rare circumstances of recurrent infection.

• Prognosis: Excellent.
· Symptoms generally begin to resolve within 1-2 days though may last longer than the course of antibiotics due to residual inflammation.
· This residual inflammation should resolve within 5-7 days though can last longer.
· Repeat culture may be indicated to check if the organism was sensitive to the prescribed antibiotic if resolution does not occur quickly.