Cystitis is inflammation of the lining of the bladder. It is not normally passed from person to person but is often due to an infection caused by micro-organisms reaching the urethra or as a result of mechanical trauma to the body, such as vigorous sexual activity (vaginal or anal) or wearing very tight jeans. Other causes of cystitis include chemical irritants such as perfumed soap or bath oils, hormone deficiency, ‘holding on’ too long before going to the toilet or urinary catheters. A common cause among young men is a congenital deformity in the urinary system that prevents complete emptying of the bladder.

Incubation time varies between individuals and the causative agent involved.

The type and severity of symptoms experienced by sufferers can vary. The types of symptoms include a frequent urge to go to the toilet, a pain or burning sensation on passing urine, the need to go to the toilet several times in the night, a dark, strong smelling, cloudy coloured urine that may contain blood, a pain in the lower back or abdomen and a general feeling of unwell with fever and sickness.

There are many self-help treatments that are recommended for cystitis. However, recurrent attacks may benefit from a course of antibiotics. Doctor’s advice should be sought if blood is present in the urine, the symptoms are no better after 24 hours of self-help treatments, if the sufferer is pregnant, has a high temperature or a severe pain in the lower back or abdomen or if the symptoms keep recurring. Men suffering from cystitis should always consult a doctor.

Self-help treatments include:

• drinking plenty of fluids
• going to the toilet as often as is necessary. Avoiding holding on
• placing a hot water bottle over the abdomen and at the lower back
• resting as much as possible.

Further guidance on the management of cystitis includes:

Sexual intercourse or alcohol should be avoided during an attack.

Not a notifiable disease. Refer to your local policy/infection control team for further information.

If untreated, cystitis can lead to kidney problems, pyelonephritis and sepsis.

Plenty of fluid should be drunk as this will help flush any bacteria from the bladder. The individual should go to the toilet when needed and try not to ‘hold on’. This will avoid placing any unnecessary stress on the bladder. After going to the toilet, women should wipe themselves from front to back to avoid spreading any bacteria from the anus. Products that are strongly perfumed and any tight fitting trousers or underwear should be avoided. Foods or drinks that may make the cystitis worse, such as alcohol, caffeine or strongly spiced foods, should also be avoided.

To avoid an attack of cystitis after sexual intercourse, hands and the genital area should be washed before any sexual contact. Passing urine immediately after intercourse will help flush out any bacteria. Using a lubricant during sexual intercourse will help ease any problems of friction and help prevent bruising. In a relationship involving a woman, it is recommended to avoid touching the anal area and then the vaginal area.

No vaccine available.

HEALTH EDUCATION BOARD FOR SCOTLAND (2003) Cystitis: a self help guide [on-line].
Available at: www.hebs.com/services/pubs [Accessed 13 April 2005].

MACFARLANE J and KLENERMAN P (2005) Cystitis [on-line].
Available at: www.netdoctor.co.uk/diseases/facts/cystitis.htm [Accessed 7 April 2005].

PRODIGY (2002) PRODIGY guidance – Urinary tract infection (lower) – in men. [on-line]. London: Department of Health.
Available at: www.prodigy.nhs.uk/guidance.asp? [Accessed 13 April 2005].

PRODIGY (2003) Cystitis in women [on-line]. London: Department of Health.
Available at: www.prodigy.nhs.uk/clinicalguidance/releasedguidance/ [Accessed 13 April 2005].

PRODIGY (2004) PRODIGY guidance – Urinary tract infection (lower) – in women [on-line]. London: Department of Health.
Available at: www.prodigy.nhs.uk/guidance.asp? [Accessed 13 April 2005].