Cystitis

Last revised by Joshua Yap on 11 Apr 2023

Cystitis refers to inflammation of the urinary bladder. It may occur in isolation or be associated with inflammation of other parts of the urinary tract such as ureteritis or pyelonephritis.

Cystitis is more common in females due to the short length of the urethra and its close proximity to the anus, predisposing to urinary tract infection 1.

Patients typically present with local symptoms such as suprapubic pain, frequency, dysuria, hematuria, and urgency. In addition, patients may have systemic symptoms like fever, chills, rigors, and fatigue.

Serum inflammatory markers may be elevated. Urinary dipstick analysis typically shows positive leukocytes and nitrites in the setting of a urinary tract infection.

Cystitis has a variety of causes 1:

Typical imaging features include 1:

A bladder neoplasm, foreign body, or diverticulum may be seen in chronic cystitis.

In cystitis secondary to tuberculosis, chronic fibrosis may result in a contracted “thimble bladder”.

CT or MRI is useful to assess for the presence of a fistula, particularly in the setting of recurrent cystitis.

  • T2: hyperintense bladder mucosa 3

  • T1 C+ (Gd): shows increased enhancement of the affected bladder wall (but less enhancement than a bladder neoplasm), also useful in characterizing a bladder abscess

Antibiotics are the first-line treatment 4.

Chronic cystitis may result in 5:

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