Inflammation of the Bladder (Cystitis): Symptoms, Complaints, Signs

The following symptoms and complaints may indicate cystitis (bladder infection) or lower UTI* :

  • Pollakiuria – urge to urinate frequently without increased urination.
  • Dysuria – painful urge to urinate with difficulty urinating.
  • Nocturia – urination at night
  • Strangury – unsuppressible urge to urinate with pain, which leads only to emptying a few droplets of urine.
  • If applicable, urinary incontinence – inability to hold urine.
  • Pain in the lower abdomen (suprapubic pain).
  • Cloudy, flaky urine
  • Hematuria – blood in the urine
  • Imperative urge to urinate (urge to urinate that can not be suppressed or controlled), although the bladder has just been emptied

* HWI = urinary tract infection.

The following symptoms and complaints may indicate a UTI in children:

  • Nonspecific symptoms such as weakness in drinking, lower abdominal pain.
  • New onset enuresis nocturna (involuntary wetting at night).

Note: In children younger than 2 years, fever is often the only symptom of UTI (DD: cystitis/pyelonephritis (inflammation of the renal pelvis)).

In a meta-analysis, the following symptoms were found to be the most reliable signs of a UTI in children:

  • Dysuric symptoms (painful urination).
  • Abdominal pain (abdominal pain)
  • Flank or back pain
  • Pollakisuria (frequent urination)
  • New onset enuresis nocturna

Warning signs (red flags)

  • Anamnestic information:
    • Men → think of: different spectrum of germs; tumor-associated.
    • Pregnant women → think of: increased risk of urosepsis (blood poisoning originating from the urogenital tract).
    • Children < 12 years → think of: possible indication for malformations.
    • Pre-existing conditions:
      • Fluor vaginales (vaginal discharge); vaginal irritation.
      • Adnexitis (inflammation of the fallopian tube and ovary), colpitis (vaginitis), prostatitis (prostatitis) → think of: venereal disease.
      • Diabetes mellitus (habituated germ colonization).
      • Urolithiasis → think of: Risk of urosepsis due to congestion.
  • Micturition disorder (urinary bladder emptying disorder) or other abnormalities with residual urine formation.
  • In the presence of fever and back or flank pain is a pyelonephritis (renal pelvic inflammation), ie, an involvement of the upper urinary tract, such as ureters and / or kidneys including renal pelvis very (= upper UTI* ) likely.
  • Permanent catheter → clustered occurrence of problem germs.
  • Immunosuppression (measures to suppress the defense reactions).