Cystitis

Definition

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

Description

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 4:1 because of the high rate of birth defects in the urinary tract of male infants. In adult life, the male/female ratio of UTIs is 1:50. After age 50, however, the incidence among males increases due to prostate disorders.

Cystitis in women

Cystitis is a common female problem. It is estimated that 50% of adult women experience at least one episode of dysuria (painful urination); half of these patients have a bacterial UTI. Between 2–5% of women's visits to primary care doctors are for UTI symptoms. About 90% 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 is often 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. It allows urine to remain in or flow backward (reflux) into the partially empty bladder.

Causes and symptoms

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

Females

Women with two or more UTIs within a six-month period are sometimes given prophylactic treatment, usually nitrofurantoin or trimethoprim for three to six months. In some cases the patient 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
• proper cleansing of the area around the urethra

Males

The primary preventive measure for males is prompt treatment of prostate infections. Chronic prostatitis may go unnoticed, but can trigger recurrent UTIs. In addition, males who require temporary catheterization following surgery can be given antibiotics to lower the risk of UTIs.