Cystitis, which can manifest as urinary frequency, urgency, painful urination, difficulty urinating, increased nocturia and suprapubic pain, and in severe cases urinary retention, or even hematuria, purulent urine or proteinuria, is mostly cured with antibiotics, however there are several types of specific cystitis that often require surgical treatment. After surgical treatment previously long recurrent episodes of urinary frequency, hematuria and other uncomfortable symptoms are significantly relieved, postoperative general condition is good, and postoperative pathology confirms the diagnosis of adenoidal cystitis or/and cystitis with squamous. The following is a brief description of several types of cystitis that require surgery.
1, Interstitial cystitis: also known as Hunner ulcer, is a rare autoimmune specific type of chronic cystitis. It often occurs in middle-aged women, and cystoscopy + biopsy is the basis for a definitive diagnosis. Conservative treatment is poor, and in severe cases local lesions of the bladder mucosa are treated by electrocautery or electrodesiccation; bladder enlargement is required if there is reduced bladder volume and severe fibrosis; urinary diversion is feasible for those with ureteral reflux, hydronephrosis, lesions involving the triangle and posterior urethra.
2, adenoid cystitis: is a proliferative non-neoplastic lesion, but it is mostly considered precancerous and requires cystoscopy and biopsy to confirm the diagnosis. Once diagnosed with adenoid cystitis, surgical treatment is often required, which can be done by transurethral electrocautery or electrodesiccation of the lesion, followed by intravesical infusion of chemotherapy drugs to prevent recurrence and cancer. Because adenoid cystitis is prone to recurrence and can be transformed into adenocarcinoma, it must be followed up closely and regularly.
3.Eosinophilic cystitis: It is a disease caused by the metaplasia of local eosinophils in the bladder. The diagnosis is confirmed by cystoscopy and pathological examination, treatment with antihistamine or avoidance of antigenic stimulation can be relieved, and in severe cases, local lesions can be electrocautery, electrodesiccation or partial cystectomy.
4, cystitis with squamous: also a chemogenic non-neoplastic lesion, mostly considered precancerous, requires cystoscopy and biopsy to confirm the diagnosis, also requires surgery, can be transurethral electrocautery or electrodesiccation lesions, postoperative need to intravesical infusion of chemotherapy drugs to prevent recurrence and cancer.
5, hemorrhagic cystitis: is due to acute or chronic injury to the bladder produced by certain drugs or chemicals in the urine, resulting in extensive inflammatory bleeding of the bladder. It is a multi-causal complication. When bleeding is obvious, bladder medication is instilled to reduce bleeding, and in severe cases, bilateral internal iliac artery embolization or ligation and, if necessary, cystectomy can be considered.
6, radiation cystitis: mostly seen 2-3 years after radiation treatment of pelvic tumor, or a few months after. For the treatment of radiation cystitis, in addition to symptomatic supportive treatment, surgical electrocoagulation is required to stop bleeding in severe cases.
Therefore, for patients with frequent urination, urgent urination, painful urination and hematuria, they should not be satisfied with the diagnosis of “urinary tract infection”, but need specialist examination to avoid delaying the disease and bringing unnecessary pain to patients.