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II nd YEAR
• Infection of urinary bladder is known as Cystitis.
• It's usually caused by an infection in the bladder,
but can also be caused by irritation or damage
(from friction during sex).
• It is more common in women.
• A urinary tract infection (UTI) (also known
as cystitis or bladder infection) is an infection that
affects part of the urinary tract.
• The most common cause of cystitis is a bacterial
infection. If bacteria reach the bladder, they can
multiply and irritate the bladder lining, causing the
symptoms of cystitis.
• Cystitis can also result from damage or irritation
around the urethra. The urethra is the tube that
carries urine from the bladder out of the body. In
men, the urethral opening (where urine leaves the
body) is at the tip of the penis. In women it's just
below the clitoris.
• This happens when bacteria get into the bladder
and multiply. It can happen if you don't empty your
• Bacterial infection can also happen when bacteria
from the anus are transferred to the urethra. This is
more common in women than in men, as the
urethra is closer to the anus in women than it is in
In women, transferring bacteria in this way can
happen when you are:
• Having sex
• Wiping after going to the toilet (you're less likely to
transfer bacteria in this way if you wipe from front to
• Inserting a tampon
• Using a diaphragm (a soft dome made of latex or
silicone) for contraception
• In women who have had, or are going through,
the menopause, the lining of the urethra and the
bladder become thinner. This is due to a lack of the
hormone oestrogen. The thin lining is more likely to
become infected or damaged. Women also
produce fewer vaginal secretions after the
menopause, which means that bacteria are more
likely to multiply.
DAMAGE OR IRRITATION
Cystitis can also be caused by damage or irritation in
the area around the urethra in both men and
women. This could be the result of:
• Wearing tight clothing
• Chemical irritants – for example, in perfumed soap
or talcum powder
• Other bladder or kidney problems, such as a kidney
infection or prostatitis
DAMAGE OR IRRITATION
• Diabetes (a long-term condition caused by too
much glucose in the blood)
• Damage caused by a catheter (a tube inserted into
the urethra to allow urine to flow into a drainage
bag, which is often used after surgery)
Children and adults can get cystitis, and the
symptoms can be different.
Symptoms in men and women:
• Cystitis in men and women can cause:
• pain, burning or stinging when you urinate
• needing to urinate often and urgently but passing
only small amounts of urine
• urine that's dark, cloudy or strong smelling.
• urine that contains traces of blood (haematuria)
• pain low in your belly (directly above the pubic
bone), or in the lower back or abdomen
• feeling unwell, weak or feverish
Symptoms in children
• Symptoms of cystitis in children may include:
• reduced appetite
• pain when urinating
• Cystitis is usually treated easily. Find out more
about treating cystitis.
The symptoms caused by cystitis could also be
• sexually transmitted infections (STIs), such as
gonorrhoea or chlamydia
• being infected with bacterium such as E-coli
• vaginal thrush, also known as candida (a yeast
• inflammation of the urethra (urethritis)
• urethral syndrome (women only)
• inflammation of the prostate gland, also known
as prostatitis (men only)
• The bacteria that cause urinary tract infections
typically enter the bladder via the urethra. However,
infection may also occur via the blood or lymph. It is
believed that the bacteria are usually transmitted to
the urethra from the bowel, with females at greater
risk due to their anatomy. After gaining entry to the
bladder, E. Coli are able to attach to the bladder
wall and form a biofilm that resists the body's
• It is the most frequent bacterial infection in women.
• They occur most frequently between the ages of
16 and 35 years, with 10% of women getting an
infection yearly and 60% having an infection at
some point in their lives.
• Recurrences are common, with nearly half of
people getting a second infection within a year.
Urinary tract infections occur four times more
frequently in females than males.
• Pyelonephritis occurs between 20–30 times less
frequently . They are the most common cause
of hospital acquired infections accounting for
approximately 40%. Rates of asymptomatic
bacteria in the urine increase with age from two to
seven percent in women of child bearing age to as
high as 50% in elderly women in care
homes. Rates of asymptomatic bacteria in the urine
among men over 75 are between 7-10%.
• Urinary tract infections may affect 10% of people
during childhood. Among children urinary tract
infections are the most common in uncircumcised
males less than three months of age, followed by
females less than one year. Estimates of frequency
among children however vary widely. In a group of
children with a fever, ranging in age between birth
and two years, two to 20% were diagnosed with a
• The symptoms of cystitis usually clear up without
treatment within 4-9 days. There are some self-help
treatments that can ease the discomfort of any
Over-the-counter (OTC) painkillers, such as
paracetamol or ibuprofen. These can reduce pain
and discomfort. Always read the label and check
with your pharmacist first, particularly if you have
any other medical condition, you are taking other
medicines, or you're pregnant or breastfeeding.
Drinking plenty of water is often recommended as a
treatment for cystitis. There's no evidence that this
is helpful, although drinking around 1.2 liters (6-8
glasses) of water a day is generally good for your
health. Also avoid alcohol.
Don't have sex until your cystitis has cleared up
because having sex can make it worse.
• Some people find that using urine alkanising
agents, such as sodium bicarbonate or potassium
citrate, for a short period of time may help to relieve
pain when urinating. However, there is currently a
lack of clinical evidence for their effectiveness.
• This will usually involve taking a tablet 2-4 times a
day, for three days.
It's not always possible to prevent cystitis, but
you can take some steps to help avoid the
• don't use perfumed bubble bath, soap, or
talcum powder around your genitals - use plain,
• have a shower, rather than a bath, to avoid
exposing your genitals to the chemicals in your
cleaning products for too long
• always empty your bladder fully when you go to
• don't wait to go if you need to urinate: delaying it
can place extra stress on your bladder and could
make it more vulnerable to infection
• wear underwear made from cotton rather than
synthetic material such as nylon
• avoid wearing tight jeans and trousers
• always wipe from the front of your genital area
to the back, not back to front, when you go to the
• some people find certain types of food
and drink make their cystitis worse: for example,
coffee, fruit juice or spicy foods. If there is anything
that triggers your cystitis, you may wish to avoid it
TO REDUCE PAIN:
• Monitor urine color changes, monitor the voiding
pattern, input and output every 8 hours and monitor
the results of urinalysis repeated.
• Perineal care.
• Catheter treatment 2 times per day.
Impaired Urinary Elimination
• Assess the patient's pattern of elimination.
• Encourage the patient to drink as much as possible
and reduce drinking in the afternoon.
• Encourage the patient to urinate every 2-3 hours
and when it suddenly felt.
Disturbed Sleep Pattern
• Provide a comfortable bed.
• Increase comfort bedtime regimen, for example, a
warm bath and a massage, a glass of warm milk.
• Reduce noise and light.