This condition can be due to infectious agents, such as bacteria, viruses or fungi, or to non-infectious causes, such as radiotherapy performed in the pelvic area or chemotherapy.
In addition to causing hematuria, hemorrhagic cystitis is often also responsible for: dysuria, pollakiuria, stranguria, bladder tenesmus, suprapubic pain and fatigue.
For a correct diagnosis, physical examination, anamnesis, blood and urine tests, imaging diagnostics and cystoscopy are essential.
Treatment of hemorrhagic cystitis varies in relation to the severity of the condition itself and its causes.
Hemorrhagic cystitis, therefore, is characterized by two elements:
- Inflammation of the urinary bladder mucosa, hence the term "cystitis", e
- Presence of hematuria (ie blood in the urine), on which the use of the term "hemorrhagic" depends.
The blood loss (haemorrhage) that distinguishes haemorrhagic cystitis is the expression of damage to the transitional epithelium of the bladder and to the underlying blood vessels; as will be seen, such damage may be due to toxins, pathogens, radiation and drugs.
it is at the origin of 80-85% of the episodes of urinary infection);Among the viral agents, we note:
- Adenovirus (especially strains 7, 11, 21 and 35);
- Polyomavirus (or BK virus);
- Cytomegalovirus;
- Influenza A virus;
- JC virus;
- Herpes simplex virus.
Finally, among the mushrooms, they deserve a mention:
- Candida albicans;
- Cryptococcus neoformans;
- Aspergillus fumigatus;
- Torulopsis glabrata.
Most cases of infectious hemorrhagic cystitis are viral in origin; bacterial and fungal forms follow in order.
Infectious Hemorrhagic Cystitis: Risk Factors
Hemorrhagic cystitis of an infectious nature is associated with various risk factors.
Among these favorable conditions, the most important is undoubtedly the weakening of the immune system (immunosuppression), which can arise for example from a chemotherapy therapy, from the presence of an extensive tumor, from the use of immunosuppressants or from diseases such as AIDS.
Immunosuppression, therefore, is followed by conditions or behaviors such as:
- The very young age;
- Poor or excessive intimate hygiene;
- The use of tampons;
- The use of the diaphragm or spermicidal creams that reduce vaginal acidity favoring bacterial contamination;
- Sexually transmitted diseases such as gonorrhea;
- Promiscuous sexual intercourse or unprotected anal;
- The use of the bladder catheter;
- Diabetes. The presence of glucose in the urine (glycosuria) promotes bacterial growth and, consequently, the possibility of developing an "infection.
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