Nonbacterial cystitis is a catchall term that encompasses various medical disorders, including infectious and noninfectious cystitis, as well as painful bladder syndrome/interstitial cystitis (PBS/IC). PBS/IC describes a syndrome of pain and genitourinary symptoms (eg, frequency, urgency, pain, dysuria, nocturia) for which no etiology can be found. There are many controversies regarding nonbacterial cystitis, including possible etiologic agents, methods of diagnosis, and treatment, especially for noninfectious causes.
Infectious nonbacterial cystitis includes the following forms of the disease:
Candidal infection of the bladder is shown in the image below.
Gross pathology of the bladder with candidal infection and hemorrhage.
Noninfectious nonbacterial cystitis includes the following forms of the disease:
General symptoms of cystitis include urgency, frequency, dysuria, and, occasionally, hematuria, dyspareunia, abdominal cramps, and/or bladder pain and spasms. Establishing or excluding a specific diagnosis often requires repeated cultures and various urologic procedures, including cystoscopy with bladder biopsies, various bladder tests, and immune system function examinations. Some conditions, such as carcinoma in situ, bladder calculi, and urethral foreign bodies, may result in symptoms that mimic those of nonbacterial cystitis.
While originally non-infectious or nonbacterial cystitis was reported more frequently in women, in the last decade there is increased reporting of similar syndromes in men.
In a twin registry where one member of the pair experienced symptoms of chronic fatigue for at least 6 months, the chronically fatigued twin had a significantly higher incidence of chronic pelvic pain (women) and chronic nonbacterial prostatitis (men).