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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

Noninfectious cystitis is most common in women of childbearing years. The exact cause is often unknown. However, it has been associated with the use of:

  • Bubble baths
  • Feminine hygiene sprays
  • 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.

Symptoms

Other symptoms may include:

Exams and Tests

A urinalysis may show red blood cells (RBCs) and some white blood cells (WBCs) in the urine. The 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.

Treatment 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
  • Medicines to help reduce pain
  • Anti-inflammatory medicines to help improve symptoms

Surgery is rarely performed unless a person has:

  • Severe symptoms that do not respond to other treatment
  • Urinary retention
  • A lot of blood in the urine

Your doctor or nurse may also recommend the following self-care steps:

  • Avoiding foods and fluids that irritate the bladder. These include spicy or acidic foods such as alcohol, citrus juices, and caffeine.
  • Doing 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 skilled at waiting this long, gradually increase the time intervals by 15 minutes until you are urinating every 3 to 4 hours.
  • Strengthening the pelvic muscles with Kegel exercises to help relieve symptoms of urgency.

Outlook (Prognosis)

Although cystitis is uncomfortable, 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.
  • You have been diagnosed with cystitis and symptoms get worse or you develop new symptoms such as fever , blood in the urine, back or flank pain , and vomiting .

Prevention

Avoid using products that with irritants such as scented bubble baths, feminine hygiene sprays, tampons, and spermicidal jellies.

If you need to use these items, try to find those that do not cause you irritation.

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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