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Non-bacterial cystitis

As well as bacterial infections (which are the most common cause of cystitis) there are a number of non-bacterial causes that need to be considered when the bladder becomes inflamed, such as:16,18

  • Drug-induced cystitis – certain medications, particularly chemotherapy drugs, certain immuno-suppressants and anti-inflammatory treatments can cause inflammation of the bladder as broken-down components of the drugs exit the body16,18
  • Radiation cystitis – radiation treatment of the pelvic area can cause inflammatory changes in bladder tissue16,18

  • Radiation cystitis

    Radiation cystitis is a potential complication of radiation therapy (when used to treat tumours in the lower abdomen/pelvic area). Radiation cystitis can cause symptoms that range from minor and temporary, to severe and chronic.41,42

    There are three types of radiation cystitis:43

    1. Acute radiation cystitis is an inflammatory reaction to radiation treatment that can occur during, immediately after or within the first three months of radiotherapy.
    2. Chronic radiation cystitis is a progressive condition and major source of morbidity for cancer survivors, symptoms begin to develop after a period of six months to three years but can occur up to three decades following treatment.
    3. Latent radiation cystitis can first appear years or decades after the initial radiotherapy treatment, and symptoms are those of secondary malignancies within or outside of the irradiation field.
  • Chemical cystitis – some people may be hypersensitive to chemicals contained in certain products, such as bubble bath, feminine hygiene sprays or spermicidal jellies, and may develop an allergic-type reaction within the bladder, causing inflammation16,18
  • Bladder pain syndrome, also known as interstitial cystitis (BPS/IC) – an unpleasant sensation (pain, pressure or discomfort) thought to be related to the urinary bladder, associated with lower urinary tract symptom(s) of more than six weeks duration, in the absence of infection or other identifiable causes.1,16

BPS/IC is one of the most frustrating types of non-bacterial cystitis as its causes are, as yet, unknown. There's no obvious infection and antibiotics don't help. This means the pathway to diagnosis and treatment isn’t straightforward.1,44

References

  • 1.Meijlink JM. Interstitial Cystitis/Bladder Pain Syndrome. Int Painful Bl Found. 2014.
  • 16.Mayo Clinic. Cystitis. http://www.mayoclinic.org/diseases-conditions/cystitis/basics/causes/con-20024076. Published 2015. Accessed September 1, 2017.
  • 18.Medline Plus. Cystitis - noninfectious. medlineplus.gov/ency/article/000514.htm. Published 2016. Accessed September 1, 2017.
  • 41.Thompson A, Adamson A, Bahl A, et al. Guidelines for the diagnosis, prevention and management of chemical- and radiation-induced cystitis. J Clin Urol. 2014;7(1):25-35. doi:10.1177/2051415813512647.
  • 42.Nascimento JCR, Campelo MWS, Aragão IA, Moura JFB de, Silva LFG, Oriá RB. Treatment of Severe Refractory Hematuria due to Radiation-Induced Hemorrhagic Cystitis with Dexamethasone. Case Rep Med. 2017;2017(Article ID 1560363):1-3. doi:10.1155/2017/1560363.
  • 43.Morris K Al, Haboubi NY. Pelvic radiation therapy: Between delight and disaster. World J Gastrointest Surg. 2015;7(11):279-288. doi:10.4240/wjgs.v7.i11.279.
  • 44.Fiander N. Painful bladder syndrome and interstitial cystitis: treatment options. Br J Nurs. 2013;22(9):27-33.

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