Bladder Disorder - Bladder Infection Cystitis - New York Urologic

Hemorrhagic Cystitis

Hemorrhagic cystitis is marked by a sudden onset of hematuria, which is the presence of blood in the urine.  It is also accompanied by intense bladder pain and/or irritation in the bladder.  It's caused by bladder inflammation, which leads to heavy bleeding mixed with urine.  This inflammation and irritation occur when the interior surface lining of the bladder and surrounding blood vessels are damaged.  Hemorrhagic cystitis is caused by radiation treatment, certain medications, toxins, or as a result of viruses such as papovaviruses or certain bacteria such as Escherichia coli.  Certain types of oncology treatment, such as cyclophosphamide (Cytoxan, Neosar) and ifosfamide, can also lead to Hemorrhagic Cystitis, though it can often be prevented by drinking plenty of fluids along with using the medication Mesna.

Symptoms of hemmorrhagic cystitis include hematuria, painful or burning urination, a frequent or urgent need to urinate, and occasionally, urinary incontinence.  Some patients may also feel abdominal pain, fatigue and fever and chills.

Radiation Cystitis

Radiation cystitis is considered a noninfectious type of Hemorrhagic Cystitis since it is not caused by an infectious source such as a bacteria or virus.  Instead, it's caused by radiation to the pelvic area during oncological treatment.  Radiation treatment for tumors of pelvic organs including the bladder, prostate, colon, cervix, uterus or rectum, can irritate the bladder which may also have been irradiated during the process.  In less severe cases of Radiation cystitis, patients may only experience painless hematuria along with mild sensation of urinary frequency.  In the more severe cases of Radiation Cystitis however, bladder hemorrhaging can be extensive and even life-threatening. In such rare though extreme cases, patients may have severe bladder contractions as well as significant urinary urgency and frequency as well as sharp pelvic pain.

Emphysematous Cystitis

Emphysematous Cystitis is a rare but potentially life-threatening condition.  It's marked by the presence of gas within the bladder wall, and occurs most frequently in middle-aged women (roughly 65% of all cases) and diabetics (approximately in 65% of all cases).  Incidence of this condition is heightened in patients with chronic urinary tract infections or urinary tract outlet obstruction.  The direct cause of the condition is usually the presence of bacterial or fungal organisms in the bladder wall. The most common bacteria are Escherichia coli, Klebsiella pneumoniae, Clostridiums, and Enterobacters.  The severity of symptoms associated with Emphysematous Cystitis vary. Frequently, it presents itself without any specific symtoms and is only diagnosed via abdominal imaging during medical evaluation. Patients with Emphysematous Cystitis often come into the ER or doctor’s office in Septic shock.

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