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Cystitis is the medical term for inflammation of the bladder. Most of the time, the
inflammation is caused by a bacterial infection, in which case it may be referred to as a urinary
tract infection (UTI). A bladder infection can be painful and annoying, and can become a serious
health problem if the infection spreads to your kidneys. UTIs are generally claasified as infection
involving the upper or the lower urinary tract.

Lower UTIs

• Cystitis - an inflammation of the urinary bladder related to a superficial infection that

doesn’t extend to the bladder mucosa, most often caused by ascending infection from
the urethra; it can also be caused by sexual intercourse

• Prostatitis – inflammation of the prostate gland

• Urethritis – inflammation of the urethra.

Upper UTIs

• Acute/Chronic pyelonephritis – inflammation of the renal pelvis

• Interstitial nephritis – inflammation of the kidney

• Renal Abscess

Uncomplicated Lower or Upper UTI

• Community-acquired infection; common in young women

Complicated Lower or Upper UTI

• Often nosocomial and r/t catheterization; occurs in patients with urologic

abnormalities; pregnancy, immunosuppression, DM, obstructions
Incidence

• One of the most common reasons patient seek health care, accounting for about 7 million
patient visits a year (Bacheller&Bernstein, 1997)

• Most cases occur in women, with one of every five women

• The urinary tract is the most common site of nosocomial infection, accounting for greater
than 40% of the total number reported by hospitals and affecting about 600,000 patients
each year (Winn, 1996)

• In most of these hospital-acquired UTIs, instrumentation of the urinary tract or

catheterization is the precipitating cause

• The National Kidney Foundation estimates that 10 to 20 percent of women have had at
least one episode of UTI, and 80 percent of this group has had it recurrently
(healthcentral.com)

• Cystitis accounts for about 6 million medical visits per year or more (healthcentral.com)

Causes

• Escherichia Coli – most common causative agent

• Staphylococcus saprophyticus – second most frequent causative agent

• Chlamydia

• Mycoplasma

• Trichomonad
Risk Factors

• Inability or failure to empty bladder completely – This can serve as a breeding ground for
bacteria

• Obstructed urinary flow - This can occur in conditions such as a stone in the bladder or,
in men, an enlarged prostate

• Decreased natural host defenses or immunosuppression - A lowered immune system

increases the risk of bacterial and, in some cases, viral bladder infections

• Instrumentation of the urinary tract (e.g. catheterization) - Prolonged use can result in
increased vulnerability to bacterial infections as well as bladder tissue damage

• Pregnancy - Hormonal changes during pregnancy may increase the risk of a bladder
infection

• Genetics - Some experts say genetics may be the key, since research has shown that
women with certain blood antigens (called the Lewis groups) are more susceptible to
cystitis. The cells that line their urinary tracts seem to have far more receptors to which
bacteria can adhere. Others may lack glycosaminoglycan, a substance found on the
surface of the bladder that is inhospitable to bacteria

• Sexual intercourse - Sexual intercourse can result in bacteria being pushed into the
urethra

• Poor perineal hygiene

• Use of feminine wash - Some people may be hypersensitive to chemicals contained in

certain products, such as feminine wash and may develop an allergic-type reaction within
the bladder, causing inflammation.

• Diet - Although there is no scientific evidence linking diet to UTIs, some people have
found that alcohol, tomatoes, spices, chocolate, caffeinated and citrus beverages, and
high-acid foods might contribute to bladder irritation and inflammation
 • Gender - The infection is more common in women because a woman's anatomy is
designed in such a way that it makes it easier for bacteria to enter the bladder.

• History of UTI

Manifestations

Lower UTIs

• Frequent pain and burning on urination

• Urinary frequency

• Urinary urgency

• Nocturia

• Urinary incontinence

• Suprapubic or pelvic pain

• Hematuria

• Back pain

Upper UTIs

• Fever

• Chills

• Flank or low back pain

• Nausea & vomiting

• Headache

• Malaise

• Painful urination
 • Pain and tenderness in the area of the costovertebral angles

Complicated UTIs

• Asymptomatic to development of s/s of septic shock

References

scribd.com

healthcentral.com

mayoclinic.com

Medical Surgical Nursing