What is cystitis?

The word cystitis means inflammation of the bladder. Cystitis is also known as a urinary tract infection (UTI). The bladder is most commonly affected in UTIs, but in rare cases infection can spread to the kidneys (known as pyelonephritis).

What causes cystitis?

Cystitis is usually caused by a bacterial infection. However, similar symptoms can also be caused by physical irritation of the water passage (urethra) by sexual intercourse, chemicals (eg, soaps, perfumes, vaginal hygiene sprays), ulcers or inflammation near the urethra, or a sexually transmitted infection (STI) like chlamydia.

What are the symptoms of cystitis?

Cystitis may cause any or all of the following:

• a burning or painful feeling during or immediately after passing urine
• the need to pass urine urgently
• passing small amounts of urine more frequently
• smelly urine
• lower abdominal pain, pain in pubic area - pain or ache in the central back may indicate that the infection has gone up to the kidneys (pyelonephritis)
• repeatedly getting out of bed to pass urine at night.

How do you get cystitis?

A variety of factors may cause a bladder infection. They include:

• Bacteria making their way into the bladder via the urethra. Bacteria that cause cystitis often come from the anal area, so it is important for women to wipe from the front to the back after urinating or having a bowel motion.
• Women have a shorter urethra than men and are more likely to get cystitis.
• Sex can often cause cystitis in women because bacteria can be introduced when the urethra is pushed on during vaginal sex.
• Some anatomical problems in the kidneys, bladder or tubes can also be responsible for cystitis.
• UTIs in men are unusual and need additional investigation. 

How is cystitis diagnosed?

Cystitis or a UTI is diagnosed by having a doctor assess your symptoms and by doing a urine test. The urine is tested for bacteria and other indicators of infection. It is sometimes necessary to repeat the urine test a few weeks after treatment to ensure the infection has gone.

How is cystitis treated?

A course of antibiotics is needed to treat the cystitis. The discomfort caused by cystitis can be helped by drinking an alkaliniser (eg, one teaspoon of bicarbonate of soda in a glass of water or alkaliniser sachets (eg, Ural) that can be obtained from a chemist. The alkaliniser makes the urine more comfortable to pass. You also need to have a good fluid intake of 1.5 to 2 litres of water per day. Recurrent cystitis, or pain that develops in the back may require further investigations.

What can I do to help prevent cystitis?

• Don't delay urinating - don't 'hold on'.
• Make sure your bladder is as empty as possible every time you go.
• Women should always wipe from the front (vagina) to the back (anus) after urinating.
• Some women find urinating before and soon after sexual intercourse helps prevent cystitis.
• Drink plenty of water (1.5 to 2 litres a day) to flush bacteria out of the urethra and bladder.

Related topics

Also see: Kidney health

Original material provided by Auckland Sexual Health Service, June 2007. Reviewed by everybody in May 2008.