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Cystitis

How Do I Know If I have Cystitis?

Last modified: 
21/03/2012 - 15:10

Contributing Author: Guy Slowik FRCS

Common symptoms of cystitis

How Will the Doctor Diagnose Cystitis?

How Is a Urine Sample Studied?

Other Procedures That May Be Needed

Common Symptoms Of Cystitis

These include:

  • Painful or burning urination
  • A sense of urgency to urinate
  • Continually feeling the urge to urinate, but almost nothing comes out when you try
  • Trying to urinate hurts
  • A feeling of heaviness in your lower pelvic area
  • Urine may look cloudy, smell bad, or be pink or red with blood

Other symptoms may include:

  • Painful sex
  • Penis pain
  • Extreme fatigue
  • Your sides, lower back, and belly may hurt
  • Fever with chills
  • Vomiting
  • Slower thinking, or feeling confused. In older people, this may be their only symptom.

Many times, cystitis will clear up on its own within a day or two with self-care. If symptoms persist, contact a doctor or health clinic.

How Will the Doctor Diagnose Cystitis?

Your doctor will conduct a physical examination and will ask about your medical history.

  • In women, the doctor will perform a pelvic examination.
  • In men, the doctor will insert a gloved finger into the rectum to check for prostate enlargement. The doctor also will examine a man's penis and testicles for infection.

For both women and men, the doctor will check the abdomen and kidney areas for any swelling and tenderness. You will be asked to give a urine sample.

In diagnosing cystitis, the doctor must make sure that other conditions are not causing the bladder infection. Some of these other conditions include:

  • Sexually transmitted diseases, such as chlamydiagonorrhea, and urethritis
  • Infection of the upper urinary tract, called pyelonephritis
  • Vaginal infection

In people with severe, recurring bladder infections, the doctor will rule out such things as:

  • Diabetes, which increases risk for cystitis
  • Kidney stones, which may block urine flow anywhere along the urinary tract. This can cause urine to pool in the bladder.
  • Body abnormalities of the lower urinary tract.

Nice To Know:

Urine is Key

Normal urine is clear and has little odor. If infection is present, urine is often cloudy or thick-looking, and may have a foul odor.

Examining a sample of urine allows the doctor to see if some other condition is causing the bladder infection.

Large numbers of bacteria in a urine sample indicate infection. A urine sample also allows the doctor to determine the bacteria that is causing cystitis, which is essential for choosing the right treatment.

Knowing which type of bacteria helps the doctor pinpoint the most effective antibiotic to use for treatment.

How To Information:

Giving a urine sample

The urine sample needs to be free from any other bacteria on the skin or vaginal area. This kind of urine sample is called a "clean catch."

Here's how a woman can get a clean catch:

  • The staff will give you a kit with a sterile container and moistened, antiseptic wipes for cleaning the outer vaginal area.
  • Wash your hands before opening the kit.
  • Open the container, but do not touch the inside of the lid or container.
  • Sit down on the toilet. Some women find it helpful to sit backward on the toilet and use the toilet lid as a shelf.
  • Once you're seated, use one hand to spread vaginal lips apart.
  • Using the moistened wipes, wipe front to back once only with each wipe, dropping each wipe in the toilet when done.
  • Begin urinating and let a little urine go into the toilet-then put the container under the stream. You don't need to fill the container with urine completely.
  • Put the lid on the container, but don't touch the inside of the lid.
  • Wash your hands thoroughly.
  • Moisten a paper towel and wipe the outside of the container.
  • Give the container to the appropriate staff person.

Make sure that both inner and outer vaginal folds are open before cleaning the area front to back with antiseptic wipes.

How Is A Urine Sample Studied?

A few ounces of urine can reveal many things. The lab will run a series of tests:

  • Dipstick test. A laboratory technician dips a stick containing chemicals into the urine sample. The stick will change color if it finds large numbers of bacteria, abnormal proteins, blood, or pus cells. Normal urine contains none of these.
  • Spinning out sediments. A small laboratory machine called a centrifuge works like the spin cycle of a washing machine-only much faster. Spinning a bit of urine allows particles to collect, which are then examined under a microscope.
  • Microscopic examination. Looking at the urine under a microscope can reveal pus and blood cells, as well as skin cells from the lining of the bladder or urethra. It can also reveal large numbers of bacteria.

Additional tests may be needed, such as a urine culture. The doctor may request a urine culture if:

  • Basic tests are negative but severe symptoms continue.
  • Bladder infection happens repeatedly.
  • The doctor suspects that there may be other complications.

Culturing is a laboratory procedure that involves growing germs in a dish of special jelly-like material.

  • Different types of bacteria grow in different ways, so culturing urine can help identify which specific type of germ is present.
  • Sometimes, pus shows up in the urine but not bacteria. This may indicate the presence of certain other organisms, such aschlamydia.

Nice To Know:

Q. A friend says she tests her own urine at home whenever a bladder infection starts up. How can she do that?

A. In the U.S., home dipstick urine tests are now available without prescription and are easy to use. The dipstick turns color if the urine shows large amounts of bacteria. Some experts say that these tests detect almost all common bladder infections. The tests are especially useful for women who have recurring attacks.

Other Procedures That May Be Needed

Other procedures that may be necessary for diagnosis include:

  1. Obtaining a catheter specimen of urine
  2. Obtaining a direct urine sample from the bladder
  3. Ultrasound
  4. Intravenous pyelogram (IVP)
  5. Voiding cystourethrogram (VCUG)
  6. Cystoscopy
  1. catheter specimen of urine may be requested. This procedure is performed by passing a thin, flexible tube into the bladder through the urethral opening. Catheterization involves:
    • Positioning the knees up and spread apart
    • Cleaning the area around the urethral opening with an antiseptic solution
    • Passing the catheter into the bladder

    Deep breathing in and out through the mouth while the catheter is inserted helps the muscles relax and makes insertion easier and more comfortable.

  2. Sometimes it is useful to take a urine sample directly from the bladder, especially in babies, small children, and certain adults. A long, thin needle is passed directly through the skin of the lower abdomen into the bladder.
  3. Ultrasound is an easy test to take because nothing is inserted, injected, or placed inside the body. It uses sound waves that produce pictures of the urinary tract, which can show if anything inside is blocking urine flow. It also can reveal kidney stones or kidney abscesses.

    Ultrasound is useful for all people with urinary tract infections because:

    • In men, it can detect any enlargements or abscesses.
    • In children, it can observe defects that can occur in the tubes that go from the kidneys to the bladder.
  4. The intravenous pyelogram (IVP) test involves injecting a special dye into the bloodstream.
    • The dye circulates throughout the body and enters the kidneys, ureters, and bladder.
    • A series of x-rays are taken as the dye moves through the urinary tract.
    • The dye later leaves the body through urination.

    IVP tests help detect:

    • Kidney stones .
    • Small pockets of tissue containing urine that may be bulging out of the bladder or urethra. These pockets are called diverticula.
    • Narrowing of urinary tract tubes.
    • Whether the bladder has dropped down into the vagina. This common condition, called a cystocele, occurs when the body's support structures that normally hold the bladder in place weaken. Childbirth and aging are common causes.
  5. In a voiding cystourethrogram, a chemical is put into the bladder via catheter. X-rays are taken as the person urinates. VCUG detects any back up of urine that may be causing infection.
  6. Cystoscopy is a procedure that lets the doctor actually see inside the bladder. For this procedure, light anesthetic is given and the bladder is filled with water. The doctor inserts a flexible, tube-like instrument called a cystoscope into the bladder.

    The doctor can then directly examine the inside of the bladder and its related organs. Cystoscopy can help detect:

    • Structural abnormalities
    • Masses that do not show up on x-ray
    • Interstitial cystitis
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From Andrew Maynard - Chair of the University of Michigan Department of Environmental Health Sciences, with help from David Faulkner - 2013 Master of Public Health graduate.