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| Chronic Cystitis |
| Etiology •The common bacterial agents are Escherichia coli, Proteus, Klebsiella and Enterobacter. •Less common infectious agents are Mycobacteria, Candida, Schistosoma, Chlamydia and virus. •Chemotherapeutic agents such as cyclophosphamide and busulfan may cause cystitis. •Radiation therapy will cause chronic cystitis. |
| Pathogenesis •The pathogenesis of chronic cystitis is diverse since the etiologies are many., |
| Epidemiology •The epidemiology is diverse, dependent upon the inciting agent. •Bacterial cystitis tends to be more frequent in women than men probably due to the differences in urethral anatomy. |
| General Gross Description •The bladder may show no significant gross abnormalities. •Cystoscopically the mucosa may appear red, granular or ulcerated. •Long standing chronic inflammation may cause the bladder to become thickened and fibrotic. |
| General Microscopic Description •The urothelial mucosa of the bladder shows chronic inflammatory cells in the lamina propria. •Long standing cases may show varying degrees of fibrosis. •Most of the inflammatory cells are lymphocytes which occasionally form aggregates and develop germinal centers. •The urothelium may show varying degrees of denudation and ulceration. |
| Clinical Correlation •Clinically, signs and symptoms are not particularly reliable. •Patients may be asymptomatic. •Patients may experience dysuria, frequency, urgency and suprapubic pain. •Urine may be grossly cloudy. |
| References • Cotran RS, Kumar V, Robbins SL: Robbins Pathologic Basis of Disease. 5th ed. Philadelphia, W.B. Saunders, 1994, pp. 995-996. • Harrison's Principles of Internal Medicine, 13th Ed: Isselbach et. al. (eds). New York, McGraw-Hill, 1994, pp. 538-543. |
| Chronic Cystitis |
| Synopsis by: Harold Yamase M.D. (T74000M43000)[187] |
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