Question

Case Study

Renal and Urologic Systems

Case Study: Cystitis

approx 30 min

Ms. Vance, age 28 years, has noticed urgency, frequency, and dysuria recently, as well as an unusual odor to the urine. Urinalysis indicated a heavy concentration of Escherichia coli in the urine, some pus, and WBCs.

Ms. T was prescribed antibiotics, which she took for the first few days. This seemed to give her relief, but she then stopped taking the medication. Within a few days, the symptoms returned, but she decided to “just live with it.”

Question 1

Explain why women are predisposed to cystitis.

Answers may vary.

Question 2

What preventive measures are important in reducing recurrence?

Answers may vary.

Question 3

Discuss other signs and symptoms that may indicate cystitis.

Answers may vary.

Question 4

What potential problems may she experience if she does not adhere to the treatment prescribed?

Answers may vary.

Answer 1

Cystitis is for inflammation of the bladder. Most of the time, the inflammation is caused by a bacterial infection, and it's called a urinary tract infection (UTI).

Women are more likely than others to develop bladder infections or recurrent urinary tract infections.

A key reason is physical anatomy. Women have a shorter urethra, which cuts down on the distance bacteria must travel to reach the bladder.

Women at greatest risk of UTIs include those who:

• Are sexually active. Sexual intercourse can result in bacteria being pushed into the urethra.
• Use certain types of birth control.Women who use diaphragms are at increased risk of a UTI. Diaphragms that contain spermicidal agents further increase your risk.
• Are pregnant. Hormonal changes during pregnancy may increase the risk of a bladder infection.
• Have experienced menopause.Altered hormone levels in postmenopausal women are often associated with UTIs.

2.

Prevention

Cranberry juice or tablets containing proanthocyanidin are often recommended to help reduce the risk of recurrent bladder infections for some women. However, recent studies suggest that it's less effective than previously thought. Some smaller studies demonstrated a small benefit, but larger studies found no significant benefit.

As a home remedy, avoid cranberry juice if you're taking the blood-thinning medication warfarin (Coumadin). Possible interactions between cranberry juice and warfarin can lead to bleeding.

Although these preventive self-care measures aren't well-studied, doctors sometimes recommend the following for repeated bladder infections:

• Drink plenty of liquids, especially water. Drinking lots of fluids is especially important if you're getting chemotherapy or radiation therapy, particularly on treatment days.
• Urinate frequently. If you feel the urge to urinate, don't delay using the toilet.
• Wipe from front to back after a bowel movement. This prevents bacteria in the anal region from spreading to the vulvq and  urethra.
• Take showers rather than tub baths. If you're susceptible to infections, showering rather than bathing may help prevent them.
• Gently wash the skin around the vulva and anus. Do this daily, but don't use harsh soaps or wash too vigorously. The delicate skin around these areas can become irritated.
• Empty your bladder as soon as possible after intercourse. Drink a full glass of water to help flush bacteria.
• Avoid using deodorant sprays or feminine products in the genital area. These products can irritate the urethra and bladder.

3. Sign and symptoms

Cystitis signs and symptoms often include:

• A strong, persistent urge to urinate
• A burning sensation when urinating
• Passing frequent, small amounts of urine
• Blood in the urine (hematuria)
• Passing cloudy or strong-smelling urine
• Pelvic discomfort
• A feeling of pressure in the lower abdomen
• Low-grade fever

4.COMPLICATION.

If

left untreated, they can become something more serious. Complications may include:

• Kidney infection. An untreated bladder infection can lead to kidney infection, also called pyelonephritis. Kidney infections may permanently damage your kidneys.

  Young children and older adults are at the greatest risk of kidney damage from bladder infections because their symptoms are often overlooked or mistaken for other conditions.

• Blood in the urine. With cystitis, you may have blood cells in your urine that can be seen only with a microscope (microscopic hematuria) and that usually resolves with treatment. If blood cells remain after treatment, your doctor may recommend a specialist to determine the cause.

  Blood in the urine that you can see (gross hematuria) is rare with typical, bacterial cystitis, but this sign is more common with chemotherapy- or radiation-induced cystitis.