Understanding Urinary Bladder Inflammation (Cystitis): Causes & Risk Factors

Cystitis = bladder inflammation. Most commonly infectious (UTI), but noninfectious forms exist.

Infectious Causes

• Bacterial UTI: E. coli (80%), others. Risk: female anatomy, sexual activity, menopause, catheter, obstruction, diabetes.
• STIs: Chlamydia, gonorrhea, trichomonas — urethritis/cystitis.

Noninfectious Causes

• Interstitial cystitis/bladder pain syndrome (IC/BPS): Chronic pelvic pain, urgency, frequency, negative cultures. Etiology: urothelial defect, mast cells, neurogenic inflammation, autoimmunity.
• Chemical irritation: Spermicides, soaps, douches, chemo (cyclophosphamide, ifosfamide).
• Radiation cystitis: Pelvic RT → vascular damage, fibrosis.
• Foreign body: Stent, stone, suture.
• Autoimmune: Behçet’s, SLE, Sjögren’s.

Risk Factors

• Female sex, postmenopausal (low estrogen), diabetes, immunocompromise, neurogenic bladder, stones, catheterization, recent instrumentation.

Diagnosis & Management

Urinalysis, culture. UTI: antibiotics. IC/BPS: multimodal (diet, PT, amitriptyline, pentosan polysulfate, instillations). Identify and treat underlying cause.