Cystitis: Lawrence Pike
Cystitis: Lawrence Pike
Cystitis: Lawrence Pike
Lawrence Pike
Incidence
Dysuria
Frequency
Nocturia
Urgency of micturition.
Other symptoms include suprapubic pain,
cloudy or foul smelling urine and
haematuria.
Causes
Pregnant
Under age 12
Males
Systemically ill (fever, sickness, backache)
Catheterised patients
Kidney or bladder stones
Investigation
Urine dipstick
can be done in the surgery and will be positive for nitrates and
leucocytes (leukocyte esterase test). This helps to differentiate
those with UTI from the 50% with urethral syndrome.
Urine microscopy and culture reveals significant
bacteruria (usually >105 /ml).
Asymptomatic bacteruria
is present in 12-20% of women aged 65-70 years and does not
impair renal function or shorten life so no treatment
in 4-7% of pregnant women and associated with premature
delivery and low birth weight and always requires treatment.
Differential Diagnosis
Urethral syndrome
Bladder lesion e.g. calculi, tumour.
Candidal infection
Chlamydia or other sexually transmitted disease.
Urethritis
Drug induced cystitis (e.g. with
cyclophosphamide, allopurinol, danazol,
tiaprofenic acid and possibly other NSAIDs)
Complications and Prognosis