Acute cystitis is a condition characterized by inflammation of the bladder, where urine is stored. It primarily occurs due to the abnormal proliferation of bacteria within the bladder and is so common that 3 out of 10 women experience it at least once in their lifetime. Key symptoms include urinary symptoms such as frequent urination (pollakiuria), urgent urination (urgency), and a sensation of incomplete bladder emptying (tenesmus). Additionally, a burning or stinging pain may occur during urination. Pain may also be present in the pubic bone, lower abdomen, and pelvis. In severe cases, blood may mix with urine, causing the urine to appear red, or blood may be found on toilet paper after urination.
The cause of cystitis is primarily known to originate from ascending infections, and it occurs more frequently in women. While approximately 80% of cases are caused by Escherichia coli (E. coli), it can also be caused by other bacteria such as Staphylococcus and Enterococcus. If not treated appropriately, symptoms can persist and recur, potentially progressing to chronic cystitis. Therefore, early diagnosis and proper treatment are crucial.
A urine test is essential for diagnosing acute cystitis. This is to check the leukocyte concentration in the urine and the presence of inflammation. It is also important to confirm whether there is hematuria (blood in the urine). Furthermore, performing a culture test is paramount. If inflammation is identified and antibiotics are prescribed based solely on a urine test without a culture test, the causative bacteria may not be clearly identified, leading to ineffective treatment. Therefore, if acute cystitis is suspected, the type of bacteria must be accurately identified through a culture test.
Particularly, acute cystitis and overactive bladder often present with similar symptoms, necessitating an accurate diagnosis. Urolithiasis (urinary tract stones) can also cause symptoms similar to cystitis, making differential diagnosis important. If the diagnosis is ambiguous based solely on the patient's symptoms and urine test results, examinations such as X-rays, bladder and kidney ultrasounds can aid in diagnosis. If hematuria persists in urine tests after cystitis treatment, it is advisable to look for other causes through examinations such as cystoscopy or abdominal CT.
The most crucial aspect of cystitis treatment is antibiotic therapy, which typically shows effectiveness after about 3 to 5 days of treatment. As mentioned earlier, it is important to use antibiotics appropriate for the specific bacteria, so a culture test should be performed to identify the suitable antibiotic. In some cases, certain causative bacteria may have resistance, making treatment with oral medication difficult. In such instances, antibiotic injection therapy should be considered.
Prevention is also extremely important for cystitis. Maintaining a healthy lifestyle and strengthening immunity are essential. Increasing urine volume through sufficient fluid intake can help prevent bacteria from adhering to the bladder wall. For women who frequently experience cystitis after sexual intercourse, taking prophylactic antibiotics may be beneficial. Furthermore, it is advisable to wipe from front to back when cleaning after defecation. Excessive vaginal douching should be avoided as it can eliminate normal vaginal flora, thereby increasing the risk of infection.
Dr. Choi Ho-cheol, director of Goldman Urology Clinic Dongtan Branch, stated, "Acute cystitis is a common condition, but it is characterized by the fact that it should never be taken lightly. If appropriate diagnosis and treatment are not received early, symptoms can persistently recur, potentially progressing to chronic cystitis. Therefore, if you experience any suspicious symptoms, we recommend visiting a nearby urology clinic for consultation and treatment."