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Cystitis - noninfectious

Noninfectious cystitis is irritation of the bladder that is not caused by a urinary tract infection .

Alternative Names

Abacterial cystitis; Radiation cystitis; Chemical cystitis; Urethral syndrome - acute; Bladder pain syndrome; Painful bladder disease complex; Interstitial cystitis

Causes

The exact cause of noninfectious cystitis is often unknown. It is common in women of childbearing age.

The problem has been linked to:

  • Use of bubble baths and feminine hygiene sprays
  • Use of spermicidal jellies
  • Radiation therapy to the pelvis area
  • Certain types of chemotherapy medications
  • History of severe or repeated bladder infections

Certain foods, such as tomatoes, artificial sweeteners, caffeine, chocolate, and alcohol, can cause bladder symptoms.

A related condition is interstitial cystitis .

Symptoms

Common symptoms include:

Other symptoms may include:

Exams and Tests

A urinalysis may reveal red blood cells (RBCs) and some white blood cells (WBCs). Urine may be examined under a microscope to look for cancerous cells.

A urine culture (clean catch) is done to look for a bacterial infection.

A cystoscopy (use of lighted instrument to look inside the bladder) may be done if you have:

  • Symptoms related to radiation therapy or chemotherapy
  • Symptoms that do not get better with treatment
  • Blood in the urine

Treatment

The goal of treatment is to manage your symptoms.

This may include:

  • Medicines to help your bladder contract and empty. These are called anticholinergic drugs. Possible side effects include slowed heart rate , low blood pressure, increased thirst, and constipation.
  • Muscle relaxers to reduce the strong urge to urinate or need to urinate frequently.
  • A medicine called pyridium to help relieve bladder pain
  • Analgesic medicines to help reduce pain
  • Anti-inflammatory medicines or the drug, Elmiron to help with symptoms
  • Surgery is rarely done. It may be performed if a person has symptoms that do not go away with other treatments, trouble passing urine, or blood in the urine.

Other things that may help include:

  • Avoiding foods and fluids that irritate the bladder. These include spicy foods and alcohol, citrus juices, and caffeine, and foods that contain them.
  • Performing bladder training exercises to help you schedule times to try to urinate and to delay urination at all other times. One method is to force yourself to delay urinating despite the urge to urinate in between these times. As you become better at waiting this long, slowly increase the time intervals by 15 minutes. Try to reach a goal of are urinating every 3 to 4 hours.
  • Pelvic muscle strengthening exercises called Kegel exercises to help relieve symptoms of urgency.

Outlook (Prognosis)

Most cases of cystitis are uncomfortable, but the symptoms most often get better over time.

Possible Complications


When to Contact a Medical Professional

Call your doctor or nurse if:

  • You have symptoms of cystitis.
  • If you have been diagnosed with cystitis and your symptoms get worse, or you have new symptoms, especially fever , blood in the urine, back or flank pain , and vomiting .

Prevention

Avoid products that may irritate the bladder such as:

  • Bubble baths
  • Feminine hygiene sprays
  • Tampons (especially scented products)
  • Spermicidal jellies

If you need to use such products, try to find those that do not cause irritation for you.

References

Hanno PM. Painful bladder syndrome (interstitial cystitis) and related disorders.In: Wein AJ, ed. Campbell-Walsh Urology. 10th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 12.

Carter C, Stallworth J, Holleman R. Urinary tract disorders. In: Rakel RE, ed. Textbook of Family Medicine. 8th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 40.

Updated: 3/26/2014

Sovrin M. Shah, MD, Assistant Professor, Department of Urology, Albert Einstein College of Medicine, New York, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.


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