Cystitis

Question 1

What is cystitis?

Answer 1

Inflammation of the bladder

Question 2

What are some causes of cystitis

Answer 2

UTI
Parasites
In-dwelling catheters
Interstitial (Aseptic) cystitis
Cystitis cystica

Question 3

What is the main parasite that can cause cystitis?

Answer 3

Schistosomiasis haematobium

Question 4

How does schistosomiasis cause cystitis

Answer 4

Fresh water snails release the water-borne parasite into rivers or lakes
S. haematobium penetrates the skin of a person swimming and lays its eggs in the bladder
This causes persistent inflammation as the body isn’t good of getting rid of eggs

Question 5

What is a possible complication of schistosomiasis?

Answer 5

Persistant inflammation due to eggs can lead to squamous metaplasia and eventually squamous cell carcinoma (SCC)

Question 6

How does schistosomiasis present?

Answer 6

• Haematuria
• Hydronephrosis
• Renal failure
• SCC

Question 7

Describe the histology of schistosomiasis

Answer 7

Schistosome eggs with surrounding granulomatous inflammation, haemorrhage or ulceration

Question 8

What is a risk of in-dwelling catheters?

Answer 8

• an result in persistent inflammation
• Persistence of injury → scarring, metaplasia and SCC

Question 9

Who is most at risk of SCC in cases of in-dwelling catheter cystitis

Answer 9

Hugely problematic if paraplegic for example - lack of sensory feedback of irritation

Question 10

What is thought to be the cause of interstitial cystitis?

Answer 10

may be hypersensitivity reaction or autoimmune

Question 11

How does interstitial (aseptic) cystitis present and show on investigation?

Answer 11

• Persistent symptoms of dysuria and frequency
• Persistently negative cultures and urinalysis
• Variable pathology - some inflammation, congestion, mast cells

Question 12

What is cystitis cystica?

Answer 12

• Descriptive term, doesn’t identify any cause
• Reactive infolding of bladder mucosa into cysts