Cystitis - noninfectious: MedlinePlus Medical Encyclopedia

P Cystitis is a problem in which pain, pressure, or burning in the bladder is present. Most often, this problem is caused by germs such as bacteria. Cystitis may also be present when there is no infection.

T Causes
P The exact cause of noninfectious cystitis is often unknown. It is common in women of childbearing age.
P The problem has been linked to:
- Use of baths and feminine hygiene sprays
- Use of spermicide jellies, gels, foams, and sponges
- Radiation therapy to the pelvis area
- Certain types of chemotherapy drugs
- History of severe or repeated bladder infections
P Certain foods, such as tomatoes, artificial sweeteners, caffeine, chocolate, and alcohol, can cause bladder symptoms.
P The same symptoms are present with something called painful bladder syndrome or interstitial cystitis.

T Symptoms
P Common symptoms include:
- Pressure in the lower pelvis
- Painful urination
- Frequent need to urinate
- Urgent need to urinate
- Problems holding urine
- Need to urinate at night
- Abnormal urine color, cloudy urine
- Blood in the urine
- Foul or strong urine odor
P Other symptoms may include:
- Pain during sexual intercourse
- Penile pain
- Flank pain
- Fatigue

T Exams and Tests
P A urinalysis may reveal red blood cells (RBCs) and some white blood cells (WBCs). Urine may be examined under a microscope to look for cancerous cells.
P A urine culture (clean catch) is done to look for a bacterial infection.
P A cystoscopy (use of lighted instrument to look inside the bladder) may be done if you have:
- Symptoms related to radiation therapy or chemotherapy
- Symptoms that do not get better with treatment
- Blood in the urine

T Treatment
P The goal of treatment is to manage your symptoms.
P This may include:
- Medicines to help your bladder contract and empty. These are called anticholinergic drugs. Possible side effects include slowed heart rate, low blood pressure, increased thirst, and constipation.
- Muscle relaxers to reduce the strong urge to urinate or need to urinate frequently.
- A medicine called pyridium to help relieve bladder pain.
- Medicines to help reduce pain.
- Surgery is rarely done. It may be performed if a person has symptoms that do not go away with other treatments, trouble passing urine, or blood in the urine.
P Other things that may help include:
- Avoiding foods and fluids that irritate the bladder. These include spicy foods and alcohol, citrus juices, and caffeine, and foods that contain them.
- Performing bladder training exercises to help you schedule times to try to urinate and to delay urination at all other times. One method is to force yourself to delay urinating despite the urge to urinate in between these times. As you become better at waiting this long, slowly increase the time intervals by 15 minutes. Try to reach a goal of are urinating every 3 to 4 hours.
- Pelvic muscle strengthening exercises called Kegel exercises to help relieve symptoms of urgency.

T Outlook (Prognosis)
P Most cases of cystitis are uncomfortable, but the symptoms most often get better over time.

T Possible Complications
P Complications may include:
- Ulceration of bladder wall
- Urethral stricture
- Diminished bladder capacity
- Anemia

T When to Contact a Medical Professional
P Call your health care provider if:
- You have symptoms of cystitis.
- If you have been diagnosed with cystitis and your symptoms get worse, or you have new symptoms, especially fever, blood in the urine, back or flank pain, and vomiting.

T Prevention
P Avoid products that may irritate the bladder such as:
- Bubble baths
- Feminine hygiene sprays
- Tampons (especially scented products)
- Spermicidal jellies
P If you need to use such products, try to find those that do not cause irritation for you.

T Alternative Names
P Abacterial cystitis; Radiation cystitis; Chemical cystitis; Urethral syndrome - acute; Bladder pain syndrome; Painful bladder disease complex; Dysuria - noninfectious cystitis; Frequent urination - noninfectious cystitis; Painful urination - noninfectious

T References
P Carter C. Urinary tract disorders. In: Rakel RE, Rakel D, eds. Textbook of Family Medicine. 9th ed. Philadelphia, PA: Elsevier; 2016:chap 40.
P Hanno PM. Painful bladder syndrome (interstitial cystitis) and related disorders. In: Wein AJ, Kavoussi LR, Partin AW, Peters CA, eds. Campbell-Walsh Urology. 11th ed. Philadelphia, PA: Elsevier; 2016:chap 14.

T Review Date 3/28/2016
P Updated by: Scott Miller, MD, urologist in private practice in Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

