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Classification of cystitis: interstitial cystitis,glandular cyslitis

Date:2012-03-28 click:

Cystitis is divided to specific and nonspecific bacterial infection. The former refers to bladder tuberculosis. While non-specific cystitis is usually caused by E. coli, vice E. coli, proteus mirabilis, pseudomonas aeruginosa, streptococcus faecalisand and staphylococcus aureus. Its clinical manifestations include acute ones and chronic ones. For acute manifestations, patients always feel buring when urinating and pain in urethra.

 
Classification of cystitis
 
1. Interstitial cystitis is a special chronic cystitis. Its primary symptoms: frequent urination, urgency of micturition, lower abdominal pain, urodynia, hematuria. Generally speaking, these symptoms usually occur in women. When bladder is tested, reduced bladder capacity and submucosal hemorrhage which is at bottom of the bladder or in the trianglar area of the bladder can be seen on cystoscopy. It is difficult to be found in the first check, but can be seen when bladder is full of urine. Besides, villous congestion appears on the top of the bladder. Its diameter ranges from 1 cm to 1.5 cm, and the central part of it is yellow. Histologically, except significant mast cell infiltration in chronic nonspecific ulcerative cystitis patients can be observed, chronic inflammatory infiltration of the perineural is also found. In fact, causes of this disease is unclear. Neither bacterial infection or viruses can be seen. Some researchers find antibodies of interstitial cystitis in the blood of patients, so interstitial cystitis is considered as an auto-immune disease by some people. While some researchers think this disease relates to chronic granulomatosis or it is a neuropathy.
 
Interstitial cystitis is usually treated by antibiotic, expansion of the bladder under general anesthesia is effective to relieve symptoms. Other treatments, such as stabilizer, antihistamines, heparin, adrenal cortex hormones or direct cauterantia do not work well. 
 
2. Follicular cystitis: follicular cystitis always have something to do with chronic urinary tract infection. Small lark boss which is usually surrounded by inflammatory mucosal is the typical symptom. However, normal mucosal can also be found in nodules. Commonly, pathological changes are also seen in triangular area or at the bottom of the bladder. Furthermore, Lymphocyte follicles nodules can be observed in lamina propria and need to be compared with tumors.     Control infection and symptomatic treatment is applied to treat follicular cystitis.
 
3. Glandular cyslitis: Bladder mucosa edema and proliferation of adenoid structure occur,   besides, inflammatory cell infiltration can also be noticed. By the way, this disease is usually found in women.
 
4. Eemphysematous cystitis: This type of cystitis is not common, but often occurs in diabetics.   Glucose is invaded by bacteria (proteus) and ferments, which leads to gaseous form. Gas will disappear after antibiotic therapy.
 
5. Gangrenous cystitis: Gangrenous cystitis is a rare result of bladder injury. In serious condition, abscess and necrosis of the bladder wall are possible. Gangrenous changes can be found in the whole bladder wall of some patients. In this situation, suprapubic cystostomy and antimicrobial agent irrigation can take effect. 
 
6. Incrusted cystitis: Incrusted cystitis is also a disease that often occurs in women. That is because urea can decompose bacterial infection and make the urine become alkaline. Consequently, inorganic salts which are in the urine sink to the bottom of the bladder. When the precipitated material is unshrouded, mucosal at the bottom easily bleed. However, acidify the urine and control the infection are ways to remove sediment.
 
7. Chemical cystitis: Injection of cyclophosphamide helps metabolize medicines in liver and finally these metabolites can be discharged form bladder. As a result, these metabolites stimulate the bladder mucosa and brings about severe cystitis. Bladder epithelial ulceration is also a manifestation. Telangiectasia in lamina propria can also cause bleeding as well. If it is serious, lamina propria and muscle fibrosis can lead to bladder contracture and vesicoureteral reflux.
 
8.Radio cystitis: If the bladder has been treated with radiation for several months or years, and doses are much more than 40 to 65 Gy (4000~6500rad, radio cystitis is easily to happen. Its major symptom is hematuria. 

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