Inflammation of the Bladder (Cystitis): Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps:

  • General physical examination – including blood pressure, pulse, body temperature, body weight, body height; furthermore:
    • Inspection (viewing).
      • Skin and mucous membranes
    • Auscultation (listening) of the heart
    • Auscultation of the lungs
    • Palpation (palpation) of the abdomen (abdomen) (tenderness?, knocking pain?, coughing pain?, defensive tension?, hernial orifices?, renal bearing knocking pain?) [pain in the lower abdomen (suprapubic pain)]
    • Palpation of the renal region [If fever and back or flank pain occur, pyelonephritis (renal pelvic inflammation), i.e., involvement of the upper urinary tract, such as ureters and/or kidneys including renal pelvis is very likely].
    • Digital rectal examination (DRU): examination of the rectum (rectum) and adjacent organs with a finger by palpation: assessment of the prostate in size, shape and consistency[due topossible cause: benign prostatic hyperplasia (BPH) (benign enlargement of the prostate)][due todifferential diagnosis: chronic prostatitis (prostatitis)]
  • Cancer screening [due topossible cause: tumors of the kidneys, for example, renal cell carcinoma]
  • Gynecological examination [due topossible cause: pregnancy; due todifferential diagnoses]inspection.
    • Vulva (external, primary female sex organs) [due todifferential diagnosis: vulvovaginitis (inflammation of the female external genitals, including the vagina]
    • Vagina (vagina) [due todifferential diagnosis: vaginitis (inflammation of the vagina)]

    Palpation (bimanual; palpation with both hands) of the internal genital organs [due todifferential diagnosis: endometriosis (painful, chronic disease of women in which the lining of the uterus (endometrium) occurs outside the uterine cavity, for example, in the ovary (ovary) or vesica urinaria (urinary bladder))]

    • Adnexa (appendages of the uterus, i.e., the ovary (ovary) and uterine tubule (fallopian tube)) [due todifferential diagnosis: salpingitis (inflammation of the fallopian tube (tube))]
  • Urological/nephrological examination[due topossible causes:
    • Descending infections from the kidneys and upper urinary tract – e.g., pyelonephritis (inflammation of the renal pelvis).
    • Renal insufficiency (kidney weakness).
    • Urolithiasis (urinary stones)
    • Previous urinary tract infections
    • Cystic kidneys]

    [due todifferential diagnoses:

    • Acute pyelonephritis (inflammation of the renal pelvis).
    • Chronic pyelonephritis (inflammation of the renal pelvis).
    • Urinary bladder stones
    • Interstitial cystitis (interstitial cystitis, IC; synonym: Hunner’s cystitis) – bladder inflammation of unclear etiology occurring predominantly in women with fibrosis of the bladder muscles, urge incontinence (irritable bladder or overactive (hyperactive) bladder) and development of a shrinking bladder; confirm diagnosis by: Urethrocystoscopy (urethral and bladder endoscopy) and biopsy (tissue sampling) for histology (fine tissue examination) and molecular diagnostics of specific cell proteins.
    • Neurogenic bladder disease – congenital or acquired reduction or cancellation of the state of tension of the muscles of the urinary bladder.
    • Perivesical inflammation – inflammation affecting the area surrounding the urinary bladder.
    • Radiogenic cystitis – occurrence of cystitis after radiation therapy (radiatio, in cancer).
    • Irritable bladder (synonyms: urethral syndrome, Frequenca urgency syndrome; overactive bladder) – functional disorder of bladder function without organ pathological findings; the irritable bladder occurs especially in women in the 3rd to 5th decade of life.
    • Urethritis (inflammation of the urethra).
    • Cystitis follicularis – cystitis associated with nodulation]

    [due topossible sequelae:

    • Acute renal insufficiency (acute renal failure/ANV).
    • Paranephritic abscess (collection of pus in fatty tissue located around the kidney).
    • Pyelonephritis (inflammation of the renal pelvis).
    • Pyonephrosis (septic urinary stasis kidney).
    • Shrinkage bladder
    • Urosepsis (blood poisoning originating from the urinary tract)]

Square brackets [ ] indicate possible pathological (pathological) physical findings.