Cystitis

1

• Causes
• Infection with gram ve organisms, esp E. coli
• Other Proteus spp., Klebsiella, S.
  saprophyticus (young ?), Enterobacter,
  Mycobacteria, Candida, Mycoplasma, adenovirus

• Symptoms
• Can be asymptomatic
• Acute/chronic
• Urinary frequency, dysuria, abdo pain, haematuria

• Pathogenesis
• Ascending infection most common, 2 to
  urethral colonisation (FgtM)
• Instrumentation/obstruction
• Vesico-ureteric reflux
• Haematogenous less common

• Morphology
• Nonspecific acute /or chronic infection
• Ulceration
• Epithelial metaplasia to squamous/glandular
• Fibrosis of wall

Cystitis
Special Types (6)
Infection of the bladder

• Granulomatous
• TB, intravesical BCG following instrumentation
  for TCC

• Malacoplakia
• Rare inflammatory condition, mottled yellow/grey
  soft plaque or nodule
• In IC pts w/def. Macrophage Fn

• Schistosomal/ Eosinophilic
• S. haemotobium
• Predisposes to bladder cancer

• Cystitis cystica cystitis glandularis
• Contain eosinophilic material lined by cuboidal
  or flattened urothelium

• Interstitial
• aka Hunners ulcer
• Autoimmune/ allergic?
• Pain on filling, relief on empty

• Iatrogenic
• Radiation or chemo drugs (cyclophosph-amide
  haemorrhagic cystitis)