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Cystitis - noninfectious

• Overview
• Symptoms
• Treatment
• Prevention

Alternative Names:

Abacterial cystitis; Radiation cystitis; Chemical cystitis; Urethral syndrome - acute

Treatment:

The goal of treatment is to manage the symptoms.

Medical Treatments:

• Anti-cholinergic drugs can help improve bladder contraction and emptying. Possible side effects include slowed heart rate , low blood pressure, increased thirst, and stomach discomfort.
• Muscle relaxants (such as diazepam) and alpha 1-blockers (prazosin) may be used to reduce the strong urge to urinate or need to urinate frequently.
• Surgery is rarely performed unless a person has severe urinary retention or significant blood in the urine .

Diet:

• Avoid fluids that irritate the bladder such as alcohol, citrus juices, and caffeine.

Other therapies:

• Bladder exercises to re-establish a pattern of regular and complete urination may help. Bladder training exercises involve developing a schedule of times when you should try to urinate, while trying to delay urination at all other times. One method is to force yourself to urinate every 1 to 1 and 1/2 hours, despite any leakage or urge to urinate in between these times. As you become skilled at waiting this long, gradually increase the time intervals by 1/2 hour until you are urinating every 3 to 4 hours.
• Pelvic muscle strengthening exercises called Kegel exercises are used primarily to treat people with stress incontinence . However, these exercises may also help relieve symptoms of urgency related to long-term (chronic) noninfectious cystitis. Performing the exercises properly and regularly increases the method's success.
• Electrical stimulation to the pelvis may be used as a treatment for noninfectious cystitis, but this is controversial.

Expectations (prognosis):

Although most cases of cystitis are uncomfortable, they usually resolve over time.

Complications:

• Ulceration of bladder wall
• Urethral stricture
• Diminished bladder capacity
• Bladder cancer
• Anemia

Calling your health care provider:

Call your health care provider if symptoms indicate that cystitis may be present, symptoms worsen, or new symptoms develop, especially fever , back or flank pain , and vomiting .

References:

Walsh PC. Campbell's Urology . 8th ed. St. Louis, Mo: WB Saunders; 2002:572-575. 

Stenchever A. Comprehensive Gynecology . 4th ed. St. Louis, Mo: Mosby; 2001:831.

• Review Date: 5/10/2006
• Reviewed By: Neil D. Sherman, MD, Urologist, Essex County, NJ. Review provided by VeriMed Healthcare Network.

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