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Generally, the transitional epithelium of the bladder is resistant to infection and may remain healthy for a long time, inspite of a heavy infection of the urine. Some additional predisposing factor must usually be present before the bladder becomes infected and leading to Cystitis.

Causes of cystitis

1) By for the most important is incomplete emptying of the bladder, such as accruing in pregnancy, diseases and injuries of the spinal cord, cystocele, urethral stricture, etc.

2) The presence in the bladder of a calculus, foreign body or neoplasm.

3) Lower general resistance from avitaminosis.

Symptoms of cystitis

The severity of symptoms varies greatly. Symptoms of acute cystitis are usually more distressing.

1) Frequency is most common symptom. It is in evidence both during the day and at night. The desire to empty the bladder occurs from every hour to every few minutes and often it is so urgent that if the bladder cannot be emptied forthwith then incontinence occurs.

2) Pain varies from milk to agonizing. When the inflammation is mainly confined to the done of the bladder, the pain is referred to the suprapubicrgion. But when the inflammation is confined to the trigone region, then it is referred to the tip of the penis, the labia majora and the perineium.

3) Haematuria: The passage of a few drops of blood stained urine or blood stained debris at the end of nicturition is a common feature in patients suffering from cystitis.

4) Pyuria is always present except in some cases of interstitial cystitis.

5) Pyrexia: In chronic cases the temperature is usually normal. But in acute cases, uless the cystitis is secondary to pyelonephritis, it seldomrises above 100 degree F or 37.7 degree C.

On examination of cystitis

On examination there is tenderness over the bladder suprapublically, per rectum or per vaginam. Absence of tenderness over the renal angles and a normal or slightly elevated temperature shows the non-renal origin. The absence of a urethral discharge or a tender swelling of the prostate eliminates a primary focus in the urethra or the prostate.

Types of cystitis

1) Chronic trigonal cystitis: It is a common form of chronic cystitis in common and is usually associated with chronic urethritis.

2) Interstitial Cystitis: In this case, the lesion appears in the roof of the bladder as a star shaped are of intense congestion, which rapidly fissures as the bladder is distended and leads to bleeding.

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