Diagnosis

If you have symptoms of cystitis, talk to your doctor as soon as possible. In addition to discussing your signs and symptoms and your medical history, your doctor may recommend certain tests, such as:

  • Urine analysis. For a suspected bladder infection, your doctor may ask for a urine sample to determine whether bacteria, blood or pus is in your urine. If so, he or she may request a urine bacterial culture.
  • Cystoscopy. During this test, your doctor inserts a cystoscope — a thin tube with a light and camera attached — through the urethra into your bladder to view your urinary tract for signs of disease.

    Using the cystoscope, your doctor can also remove a small sample of tissue (biopsy) for lab analysis. But this test most likely won't be needed if this is the first time you've had signs or symptoms of cystitis.

  • Imaging. An imaging test usually isn't needed, but in some instances — especially when no evidence of infection is found — imaging may be helpful. For example, an X-ray or ultrasound may help your doctor discover other potential causes of bladder inflammation, such as a tumor or structural abnormality.

Treatment

Cystitis caused by bacterial infection is generally treated with antibiotics. Treatment for noninfectious cystitis depends on the underlying cause.

Treating bacterial cystitis

Antibiotics are the first line of treatment for cystitis caused by bacteria. Which drugs are used and for how long depend on your overall health and the bacteria found in your urine.

  • First-time infection. Symptoms often improve significantly within a day or so of antibiotic treatment. However, you'll likely need to take antibiotics for three days to a week, depending on the severity of your infection.

    No matter what the length of treatment is, take the entire course of antibiotics prescribed by your doctor to ensure that the infection is completely gone.

  • Repeat infection. If you have recurrent UTIs, your doctor may recommend longer antibiotic treatment or refer you to a doctor who specializes in urinary tract disorders (urologist or nephrologist) for an evaluation, to see if urologic abnormalities may be causing the infections. For some women, taking a single dose of an antibiotic after sexual intercourse may be helpful.
  • Hospital-acquired infection. Hospital-acquired bladder infections can be a challenge to treat because bacteria found in hospitals are often resistant to the common types of antibiotics used to treat community-acquired bladder infections. For that reason, different types of antibiotics and different treatment approaches may be needed.

Postmenopausal women may be particularly susceptible to cystitis. As a part of your treatment, your doctor may recommend a vaginal estrogen cream — if you're able to use this medication without increasing your risk of other health problems.

Treating interstitial cystitis

With interstitial cystitis, the cause of inflammation is uncertain, so there's no single treatment that works best for every case. Therapies used to ease the signs and symptoms of interstitial cystitis include:

  • Medications that are taken orally or inserted directly into your bladder
  • Procedures that manipulate your bladder to improve symptoms, such as stretching the bladder with water or gas (bladder distention) or surgery
  • Nerve stimulation, which uses mild electrical pulses to relieve pelvic pain and, in some cases, reduce urinary frequency

Treating other forms of noninfectious cystitis

If you're hypersensitive to certain chemicals in products such as bubble bath or spermicides, avoiding these products may help ease symptoms and prevent further episodes of cystitis.

Treatment of cystitis that develops as a complication of chemotherapy or radiation therapy focuses on pain management, usually with medications, and hydration to flush out bladder irritants.

Lifestyle and home remedies

Cystitis can be painful, but you can take steps to ease your discomfort:

  • Use a heating pad. A heating pad placed on your lower abdomen can soothe and possibly minimize feelings of bladder pressure or pain.
  • Stay hydrated. Drink plenty of fluids to keep yourself hydrated. Avoid coffee, alcohol, soft drinks with caffeine and citrus juices — as well as spicy foods — until your infection clears. These items can irritate the bladder and aggravate a frequent or urgent need to urinate.
  • Take a sitz bath. Soak in a bathtub of warm water (sitz bath) for 15 to 20 minutes to help relieve pain or discomfort.

For recurrent bladder infections, work with your doctor to develop a strategy to reduce recurrences and the discomfort that cystitis can cause.

Preparing for your appointment

If you have signs or symptoms common to cystitis, make an appointment with your primary care provider. After an initial evaluation, you may be referred to a doctor who specializes in urinary tract disorders (urologist or nephrologist).

What you can do

To prepare for your appointment:

  • Ask if there's anything you need to do in advance, such as collect a urine specimen.
  • Write down your symptoms, including any that seem unrelated to cystitis.
  • Make a list of all the medications, vitamins or other supplements that you take.
  • Take a family member or friend along, if possible. Sometimes it can be hard to remember everything your doctor tells you, and a relative or friend may hear something that you missed or forgot.
  • Write down questions to ask your doctor.

For cystitis, basic questions to ask your doctor include:

  • What is the most likely cause of my signs and symptoms?
  • Are there any other possible causes?
  • Do I need any tests to confirm the diagnosis?
  • What factors do you think may have contributed to my cystitis?
  • What treatment approach do you recommend?
  • If the first treatment doesn't work, what will you recommend next?
  • Am I at risk of complications from this condition?
  • What is the risk that this problem will recur?
  • What steps can I take to reduce my risk of a recurrence?
  • Should I see a specialist?

In addition to the questions that you've prepared, don't hesitate to ask other questions during your appointment.

What to expect from your doctor

Your doctor is likely to ask you a number of questions, including:

  • When did you first notice your symptoms?
  • Have you been treated for a bladder or kidney infection in the past?
  • How severe is your discomfort?
  • How frequently do you urinate?
  • Are your symptoms relieved by urinating?
  • Do you have low back pain?
  • Have you had a fever?
  • Have you noticed vaginal discharge or blood in your urine?
  • Are you sexually active?
  • Do you use contraception? What kind?
  • Could you be pregnant?
  • Are you being treated for any other medical conditions?
  • Have you ever used a catheter?
  • What medications are you currently taking, including over-the-counter and prescription drugs as well as vitamins and supplements?

Cystitis care at Mayo Clinic

March 18, 2015
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