Cystitis literally means inflammation of the bladder and may not necessarily be due to an infection. The bladder may also become inflamed in response to chemicals, food, or radiation.

By definition, a urinary tract infection (UTI) implies that there are microorganisms (usually bacteria) in the urine causing inflammation of the bladder or kidneys.

  • How is Cystitis Treated? Open or Close

    Individuals with mild symptoms can help themselves by:

    • Increasing fluid intake to flush the bacteria out of the system
    • Drinking cranberry juice (this does not work for everyone)

    If symptoms are particularly severe, it is advisable to see your doctor who will probably prescribe a course of antibiotics. If you have repeated infections, where there is no underlying cause, it is worth trying a prolonged course of low dose antibiotics for a period of three to six months. In some cases it may be necessary for women to take low dose antibiotics indefinitely.

    Women who have gone through the menopause may also benefit from using oestrogen which comes as a cream or pessaries (a small tablet) which are inserted into the vagina.

    Despite these measures, some women will continue to get recurrent infections and they may benefit from a course of bladder instillations. This is where a special solution is inserted into the bladder to replace the damaged protective layer lining the inside of the bladder.

  • How is Cystitis diagnosed? Open or Close

    Not all infections require investigation. If you see your doctor with a suspected urine infection, he/she will probably perform a dipstick test on your urine. Your doctor may also send a sample of your urine to the laboratory to confirm whether there was an infection or not. This mid-stream sample of urine is more accurate than the dipstick.

    Some women, despite taking all the necessary precautions, suffer with repeated infections. This can affect women of all ages. In these cases, it is thought that the protective lining of the bladder has become particularly damaged to allow bacteria to penetrate deep into the bladder wall. A simple course of antibiotics is usually sufficient to get rid of enough bacteria to alleviate symptoms but some bacteria survive and multiply to give rise to a further infection and so the vicious cycle continues. This requires further investigation which usually involves:

    • Cystoscopy - this is an examination of the inside of your bladder with a fine telescope which is passed through your urethra, the tube through which you pass urine. It is often performed using local anaesthetic gel, but sometimes a general anaesthetic may be required. A tissue biopsy (a sample of the inside lining of the bladder) can be taken at the same time.

    • Xray, Ultrasound or CT scan - these are to look for a structural abnormality of your urinary tract, evidence of incomplete bladder emptying, any unusual swelling or stones which may be the cause of the recurrent infections.

  • How is Cystitis prevented? Open or Close

    In some cases when the trigger for cystitis/UTI is known one can take preventative measures. For example:

    • Avoid strong soaps, bubble bath, etc.
    • Do not douche.
    • Ensure an adequate fluid intake
    • Pass urine before and after sex, especially if sex is a trigger.

  • Am I at risk of cystitis/UTIs? Open or Close

    Cystitis/UTIs can affect anyone. Some women may be more at risk than others and certain factors or activities may act as triggers. For example:

    • Structural abnormalities of the urinary tract
    • Stones in the urinary tract
    • Weak natural bladder defences
    • Urethral catheter
    • Diabetes
    • Insertion of surgical instruments into the bladder
    • Incomplete emptying of the bladder
    • The menopause - oestrogen is thought to play a role in preventing infections
    • Sexual intercourse (this is thought to be a mechanical effect)
    • Contraceptive diaphragm (mechanical effect)
    • Spermicides
    • Prolapse of the vagina or womb
    • Bubble baths, soaps, perfumes
    • Douching or aggressive cleaning of the vagina

    Cystitis can present with a variety of symptoms:

    • Urgency to pass urine
    • Having to pass urine frequently
    • Burning or stinging or pain when passing urine
    • Difficulty passing urine (passing small amounts)
    • Cloudy or smelly urine
    • Pain in the lower abdomen
    • Blood in the urine

  • Where do the bacteria come from? Open or Close

    Cystitis/UTIs are common in women. Bacteria live all over our bodies without causing us harm. The vagina, perineum (area between the vagina and back passage) and bowel contain many bacteria and their close anatomical relationship allow bacteria to migrate into the urethra and then the bladder. Most urine infections are caused by bacteria from the bowel. It is easier for microorganisms to get into the female than male bladder as the urethra is shorter in the female. Not everyone with bacteria in the urine will develop an infection, but we do not understand why.