Rigi10™ Malleable Penile Prosthesis
Also Known As
Bladder infection, lower urinary tract infection (UTI), acute cystitis, bacterial cystitis, hemorrhagic cystitis, interstitial cystitis (specific type)
Definition
Cystitis refers to inflammation of the lower urinary tract, or more specifically, the urinary bladder.1 It may be broadly categorized as either uncomplicated or complicated.2 Uncomplicated cystitis refers to lower urinary tract infection (UTI) in either men or non-pregnant women who are otherwise healthy. Acute cystitis is typically caused by a bacterial infection of the urinary bladder.3 Complicated cystitis is associated with risk factors that increase the virulence of the infection or the potential of failing antibiotic therapy.4 Women are particularly susceptible due to the close proximity of the rectum to the urethral meatus as well as the relatively short urethral length in females.5
Clinical Context
Cystitis is diagnosed clinically in patients with signs and symptoms consistent with a lower UTI in combination with laboratory evidence of pyuria and/or nitrites.1 Common symptoms include dysuria, urinary frequency, urgency, suprapubic pain, and hematuria.2 Fever, flank pain, nausea, and vomiting are more suggestive of pyelonephritis (kidney infection).3
Urinalysis is the most important laboratory test in diagnosing a UTI, with pyuria (presence of at least 10 white blood cells/HPF) almost always present.4 Urinary dipsticks detect the presence of leukocyte esterase and nitrites, with a positive predictive value of 85% when both are positive.5 Urine culture is beneficial for identifying etiologic pathogens and determining antimicrobial susceptibility profiles, especially in complicated cases.6
Treatment involves antibiotic therapy, with first-line agents including nitrofurantoin, sulfamethoxazole-trimethoprim (if local resistance is <20%), and fosfomycin.7 Treatment duration varies from 3-5 days for uncomplicated cystitis to 7-14 days for pyelonephritis.8 Patients with complicated cystitis who do not respond to appropriate antimicrobial treatment may require further evaluation through radiographic imaging of the upper urinary tract.9
Risk factors for uncomplicated cystitis include female gender, sexual intercourse, spermicide use, new sex partner within the past year, previous UTI, strong family history of UTI, and post-menopausal state.10 Approximately 60% of women will experience a bladder infection during their lifetime, with 20-40% experiencing recurrence.11