Cystitis (inflammation of the bladder)

Acute cystitis is characterised by burning or painful urination, frequent urination, and occasionally by blood in the urine. It is a urinary tract infection caused by bacteria which often has to be treated with antibiotics in addition to pain therapy. In principle, it is recommended to increase the amount the patient drinks in order to flush out the bacteria. In the case of frequently recurring cystitis, contributing factors should be ruled out through a urological examination.

Questions about the diagnosis and treatment of cystitis

Typical symptoms are frequent and painful urination. In addition, urine may be bloody, and the patient may experience pain in the lower abdomen. Fever does not usually occur. In case of doubt, a doctor should always be consulted as these symptoms can also be signs of other serious diseases such as ureteral stones. A urological consultation is necessary at the latest when fever occurs, as this is a sign that other organs in the urinary tract are also affected.

Acute cystitis is a bacterial inflammation. Contrary to common belief, toilets are not a cause of infection; rather, bacteria usually stem from the patient’s own skin or intestinal flora. These are not particularly dangerous or malignant but have no place in the bladder. Exceptions are sexually transmitted infections, which can be transmitted during unprotected sexual intercourse.

Due to their anatomy, women often suffer from bladder infections even at a young age, as germs can easily enter the bladder through the short urethra. The disease usually heals without treatment, but there is a risk of ascending infection involving the kidneys. Men are more frequently affected with increasing age, as the growing prostate gland causes residual urine formation in which bacteria can multiply. In this case, antibiotic treatment should always be given, as complications such as prostatitis or epididymitis often occur.

Women can wait for a mild bladder infection to heal. In any case, it is recommended to drink plenty of fluids and painkilling medications are helpful. However, there are exceptions. During pregnancy, any bladder infection should be treated with antibiotics. In addition, antibiotics should be given if the symptoms are more severe.

In addition to a detailed interview and a physical examination, a urine test is carried out. If there are typical indications of cystitis, a urine culture is also prepared in which bacteria are cultivated. It takes a few days for the results, but this allows the exact antibiotic for the inflammation to be selected. An ultrasound examination serves to rule out other causes of the symptoms.

Almost one third of all adult women experience cystitis at least once a year. General recommendations for preventing recurring inflammation include drinking enough and urinating after sex. Whether drinking cranberry juice or concentrate is helpful is still unclear.

If inflammations occur several times a year, an extended urological diagnosis should be carried out, including a cystoscopy and, if necessary, X-ray diagnostics.

If no specific causes requiring treatment are found, there are various options for prophylaxis. Vaccinations are available, both in capsule form and as injections. D-mannose is a type of sugar available in powder form that is excreted largely unchanged in the urine and thus reaches the bladder. Once there, it binds to the bacteria and inhibits their “docking” to the mucous membrane of the bladder. In the case of severe problems, a low-dose permanent therapy with antibiotics is also possible.

The prognosis is good. Most of the time, symptoms occur episodically; very few women have lifelong severe problems with bladder inflammation.

About this page:


Prof. Dr. med. Sven Lahme
Urology specialist

Medical director of the Goldstadt-Privatklinik.
Specialist for Urology, Mini-PCNL and robot-assisted da Vinci procedures.

Member in Scientific Societies and Reviewer of scientific journals.

Creation Date: 08.03.2020Modification date: 08.03.2020