Cystitis cystica usually develops in the elderly and occasionally in children, a prevalence of 2.4% has been reported in children with urinary tract infections [1]. It has the same clinical presentation as cystitis, but on cystoscopy it can be mistaken for a malignant lesion. Cystitis cystica is considered a premalignant condition and may progress to adenocarcinoma of the bladder [2].

Frequently no specific symptoms can be attributed to the disease and it is mostly detected incidentally by ureteroscopy or radiography for other complaints. However, in symptomatic cases, painless hematuria and various other symptoms such as dysuria, urinary frequency and urgency occur. Mucus may rarely be secreted in the urine. Cystitis cystica affecting the orifices of ureters in the bladder can contribute to reflux. The bladder neck involvement may result in vesical outlet obstruction [3] [4] [5] [6] [7].

• Mucosal Edema

   Leads to mucosal edema and proliferation of blood vessels within the stroma.  The damaged epithelium sloughs off and regenerates with hyperplasia and subsequent glandular metaplasia. [slideshare.net]

• Lymphadenopathy

  No retro peritoneal or pelvic lymphadenopathy (Figure 1). Calculation of the left kidney of 2 mm non obstructive. Kidney function and morphology are normal. [openaccesspub.org]

  ウィルス性リンパ節炎：viral lymphadenitis 風疹，EBV（伝染性単核球症：infectious mononucleosis） 薬剤性リンパ節症：drug-induced lymphadenopathy ◎亜急性壊死性リンパ節炎：subacute necrotizing lymphadenitis, Kikuchi's lymphadenitis ◎Piringerリンパ節炎：toxoplasmic lymphadenitis ◎木村氏病：angiolymphoid hyperplasia [medical-e.net]

• Back Pain

  Saad Medicine Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie 2005 The patient presented with terminal haematuria and right low back pain with a history of endoscopic resection of a bladder tumour [semanticscholar.org]

  Usual symptoms are frequent urination with burning pain, blood in the urine, and pain in the pubic area; chills and fever, back pain, and nausea may indicate kidney involvement. [encyclopedia2.thefreedictionary.com]

  Posted 4 years ago, 2 users are following. has anyone been in my situation i have had horrific lower back pain and bladder pain for 6months now with blood and pus in urine on dipstick but never any positive uti - i has a cystocopy under gen anesthetic [patient.info]

• Low Back Pain

  Saad Medicine Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie 2005 The patient presented with terminal haematuria and right low back pain with a history of endoscopic resection of a bladder tumour [semanticscholar.org]

• Burning Sensation

  Ammonium salts are responsible for the burning sensation and the strong smell of urine. The bladder will increase frequency in order to flush the bacteria out. [bladder-help.com]

  Symptoms The following are common signs and symptoms of cystitis: traces of blood in the urine dark, cloudy, or strong-smelling urine pain just above the pubic bone, in the lower back, or in the abdomen burning sensation when urinating urinating frequently [medicalnewstoday.com]

  Symptoms Cystitis signs and symptoms often include: A strong, persistent urge to urinate A burning sensation when urinating Passing frequent, small amounts of urine Blood in the urine (hematuria) Passing cloudy or strong-smelling urine Pelvic discomfort [mayoclinic.org]

• Dysuria

  However, in symptomatic cases, painless hematuria and various other symptoms such as dysuria, urinary frequency and urgency occur. Mucus may rarely be secreted in the urine. [symptoma.com]

   Irritative voiding symptoms:  Frequency  Dysuria  Urgency  Bacteruria  Gross hematuria  Chronic UTI  They may complain of voiding mucus  Less frequently: ureteral obstruction and subsequently hydronephrosis. 12. [slideshare.net]

  Nine months following transurethral fulguration, 8/11 (72.7%) patients were in complete remission and 1/11 (9.1%) complained of urgency and dysuria; two patients were lost to follow‑up. [spandidos-publications.com]

  Gross hematuria was the most common presenting symptoms followed by increased frequency of micturition and dysuria. Eight patients (5.12%) had hydroureteronephrosis at presentation. [indianjurol.com]

• Macroscopic Hematuria

  CASE REPORT A 47-year-old man presented at our institution with a 10-year history of irritative and obstructive voiding symptoms and intermittent macroscopic hematuria. [scielo.br]

  The second one where a macroscopic hematuria predominates(2/3 of cases). The conventional radiology usually shows a trigonal mass in the bladder. [webmedcentral.com]

  hematuria肉眼的血尿 maintenance dialysis維持透析 malformation 奇形、先天異常 medulla髄質 mesangial cellメサンギウム細胞 metastatic carcinoma転移性癌 microscopic hematuria顕微鏡的血尿 micturition hyperreflexia 排尿反射亢進 micturition reflex 排尿反射 minimally invasive therapy低侵襲治療 mycobacteriaミコバクテリア [tokyo-med.ac.jp]

  He had presented with macroscopic hematuria, and his lesion was extensive but mainly located on the trigone. Although the immediate repeat cystoscopy after TUR was normal, tumor had developed on the trigone 6 months later. [bmcurol.biomedcentral.com]

• Burning Micturition

  A 60-year-old male presented with complaints of hematuria, burning micturition, irritative, and obstructive urinary symptoms for 15 days. [ijmsweb.com]

  There was no history of fever and burning micturition. [afju.springeropen.com]

• Frequency of Micturition

  Gross hematuria was the most common presenting symptoms followed by increased frequency of micturition and dysuria. Eight patients (5.12%) had hydroureteronephrosis at presentation. [indianjurol.com]

The differential diagnoses of cystitis cystica include intestinal metaplasia, the nested variant of urothelial carcinoma and adenocarcinoma [8] [9].

On cystoscopy, nodules are often found in the bladder neck and trigone region and the mucosa has a cobblestone pattern. The muscular layer should be unaffected, which is considered a feature that can distinguish cystitis cystica from urothelial carcinoma. A young age of a patient should raise the suspicion that the lesion is benign, but a cystoscopic biopsy is required to make a definitive diagnosis. Histological evaluation reveals nests of columnar epithelial cells in the submucosa that surround a central region of liquefied columnar degeneration [3] [10] [11] [12].

Earlier the preferred diagnostic tools for cystitis cystica were intravenous pyelography (IVP) and retrograde urography. However, magnetic resonance tomography and computed tomography have become more accurate and available. Despite these technical advances, imaging studies can be inadequate to diagnose some patients in which case a cystoscopy is the definite approach used for diagnosis [4] [13]. Using imaging modalities, cystitis cystica generally appears as discrete and multiple masses that elevate the urothelium. However, the radiological appearances are non-specific and may be mistaken for a malignancy [7] [14].

• Pyuria

  […] postulate仮定、仮説 pregnancy妊娠 prerenal failure腎前性腎不全 prostate前立腺 prostate cancer前立腺癌 prostate-specific antigen (PSA)前立腺特異抗原 proteinuria蛋白尿 proximal tubule近位尿細管 psychological精神的な puberty思春期 pudendal外陰部の pudendal nerve 陰部神経 pyelonephritis腎盂腎炎 pyeloplasty腎盂形成術 pyuria [tokyo-med.ac.jp]

• Gram-Positive Bacteria

  Keywords Actinomycosis Bladder mass Cystitis cystica Infectious disease INTRODUCTION Actinomycosis is a rare bacterial infection caused by Actinomyces which are a group of Gram-positive anaerobic bacteria. [ijmsweb.com]

Conservative treatment and TUR of the lesions had no effect on the symptoms. [ncbi.nlm.nih.gov]

Treatment of cystitis cystica is difficult and long-lasting. Here, the authors present their experience on the diagnosis and treatment of patients with cystitis cystica. [termedia.pl]

Contains a new section on painful and irritative voiding disorders, including a discussion of overactive bladder and the latest treatment options available. [books.google.com]

A plethora of treatments ranging from simple observation, treatment of infection, removal of irritant, excision of the lesion, TUR[6] to more extensive procedures such as resection of bladder, ureter, and PUJ have been reported. [bioline.org.br]

A urologist is usually involved in diagnosis and treatment. People develop cystitis cystica as a result of chronic irritation and inflammation in the bladder. [wisegeekhealth.com]

Cystitis cystica is a derivative of the focal epithelial proliferation, the associated tumors tend to be non-infiltrating papillary and the prognosis is good. [ncbi.nlm.nih.gov]

Factors 7-49 82 Genetic Predisposition and Syndromic Associations 8-1 83 Clinical Features and Natural History of Bladder Cancer 8-2 84 Morphologic Characteristics of Invasive Urothelial Carcinoma 8-10 85 Urothelial Carcinoma in Young Adults 8-14 86 Prognosis [books.google.com]

Treatment and prognosis Treatment consists of removing the source of irritation and surgical excision of the area of inflammation or, in rare severe cases, cystectomy. [radiopaedia.org]

[…] urothelium within the lamina propria with cyst formation, i.e. lumens are present; no nuclear atypia LM DDx nested urothelial carcinoma, cystitis cystica et glandularis, inverted urothelial papilloma Site urinary bladder - see urothelium Prevalence common Prognosis [librepathology.org]

Etiology and Pathology of Cystitis Cystica Cystitis cystica is an inflammatory reaction of the urothelium to infection or mechanical irritation. Subepithelial vesicles develop with a few mm in size. [urology-textbook.com]

[…] columnar luminal cells are present Cystitis glandularis Cystitis cystica with luminal cuboidal or columnar lining cells Cystitis glandularis with intestinal metaplasia (intestinal type) Cystitis glandularis with at least focal intestinal-type goblet cells ETIOLOGY [basicmedicalkey.com]

"The etiology of urinary tract infection: traditional and emerging pathogens". Am J Med. 113 Suppl 1A: 14S–19S. PMID 12113867. ↑ Hemorrhagic cystitis. [wikidoc.org]

and renal pelvis (pyelitis) Pathophysiology Reactive process in response to chronic irritation, infection, calculi, outlet obstruction, catheterization (Pathol Annu 1995;30:95) Urothelium proliferates and invaginates into underlying lamina propria Etiology [pathologyoutlines.com]

[…] conventional type Cystitis glandularis, intestinal type (preferred term: intestinal metaplasia) Proliferative cystitis (discouraged terminology) ICD coding ICD-10: N30.80 - Other cystitis without hematuria ICD-10: N30.81 - Other cystitis with hematuria Epidemiology [pathologyoutlines.com]

Considerations 7-3 74 Histopathology and Diagnostic Criteria 7-4 75 Variants of Urothelial Carcinoma in Situ 7-9 76 Differential Diagnosis 7-31 77 Diagnostic and Predictive Biomarkers 7-34 78 Prognosis 7-37 79 Molecular Characteristics 7-40 References 7-42 81 Epidemiology [books.google.com]

We report 4 cases of cystitis glandularis, we analyze the epidemiological, clinical, biological, pathological and therapeutic of this affection. In the last 5 years we treated four patients with cystitis glandularis. [webmedcentral.com]

"Population-based epidemiologic analysis of acute pyelonephritis". Clin Infect Dis. 45 (3): 273–80. doi:10.1086/519268. PMID 17599303. ↑ Echols RM, Tosiello RL, Haverstock DC, Tice AD (1999). [wikidoc.org]

This review article aims to describes CG including its epidemiology, pathogenesis and etiology, pathology, classification, diagnosis, identification, therapy. [jxym.amegroups.com]

[…] common: 60% of normal bladders at autopsy (J Urol 1979;122:317) Can occur in males and females at any age (Arch Pathol Lab Med 2012;136:721) Sites Bladder; neck and trigone are most common sites Also ureters (ureteritis) and renal pelvis (pyelitis) Pathophysiology [pathologyoutlines.com]

Pathogenesis and etiology At the moment, the etiology and pathophysiology of CG remain unknown. [jxym.amegroups.com]

Urinary Tract Infections Main Page Cystitis Microchapters Home Patient Information Overview Historical Perspective Classification Pathophysiology Causes Differentiating Cystitis from other Diseases Epidemiology and Demographics Risk Factors Screening [wikidoc.org]

In the light of this observation, we will discuss the diagnostic difficulties, the pathophysiological mechanisms, the radiological aspects, the anatomopathological, therapeutic features and the prognosis of this rare condition. [openaccesspub.org]

Study results suggested that early control of urinary tract infections by chemoprophylaxis could prevent higher grades of bladder wall mucosal changes and consequently shorten the length of chemoprophylaxis. [ncbi.nlm.nih.gov]

Prevention Cystitis is often not preventable, but the following measures may help: practicing good hygiene after sex using neutral, unperfumed soaps around the genitals. [medicalnewstoday.com]

Prevention Self-care measures to prevent repeated bladder infections aren't well studied. But some providers recommend these tips for prevention: Drink plenty of liquids, especially water. [mayoclinic.org]

[…] cystitis If you get cystitis frequently, there are some things you can try to help prevent it returning. [nhs.uk]

1. Capozza N, Collura G, Nappo S, de Dominicis M, Francalanci P, Caione P. Cystitis glandularis in children. BJU Int. 2005;95:411–413.
2. Nariculam J, Patel A, Murphy D, Rane A. Cystitis Cystica Causing Bilateral Ureteric Obstruction. Internet J Urol. 2006;4(3).
3. Wong-You–Cheong JJ, Woodward PJ, Manning MA, Davis CJ. Inflammatory and Nonneoplastic Bladder Masses: Radiologic-Pathologic Correlation. RadioGraphics 2006;26(6);1847-1868. doi:10.1148/rg.266065126.
4. Menéndez V, Sala X, Alvarez-Vijande R, Solé M, Rodriguez A, Carretero P. Cystic pyeloureteritis: Review of 34 cases. Radiologic aspects and differential diagnosis. Urology. 1997;50(1):31–37. doi:10.1016/s0090-4295(97)00205-7.
5. Rothschild JG, Wu G. Ureteritis Cystica: A Radiologic Pathologic Correlation. J Clin Imaging Sci. 2011;1:23.
6. Vlatković G, Bradić I, Gabrić V, Batinić D. Cystitis cystica: characteristics of the disease in children. Br J Urol. 1977;49(1):57-9.
7. Raja J, Anson K, Patel U. Cystitis cystica and cystitis glandularisPresentation with acute ureteric obstruction. Clinical Radiology Extra. 2003;58(6):43-4.
8. Smith AK, Hansel DE, Jones JS. Role of Cystitis Cystica et Glandularis and Intestinal Metaplasia in Development of Bladder Carcinoma. Urology. 2008;71:915–8.
9. Volmar KE, Chan TY, De Marzo AM, et al. Florid von Brunn nests mimicking urothelial carcinoma: a morphologic and immunohistochemical comparison to the nested variant of urothelial carcinoma. Am J Surg Pathol. 2003;27:1243–52.
10. J Nariculam, A Patel, D Murphy, A Rane. Cystitis Cystica Causing Bilateral Ureteric Obstruction. Internet J Urol. 2006;4(3).
11. Hochberg DA, Motta J, Brodherson MS. Cystitis glandularis. Urology. 1998;51:112–113.
12. Lee G, Tsiriopoulos I, Yajnik K, Smith R, Pancharatnam M. Cystitis glandularis mimics bladder tumour: a case report and diagnostic characteristics. Int Urol Nephrol. 2005;37:713–715.
13. Argüelles Salido E, Rodríguez Corchero J, López García MA, Pérez Espejo MP, Campoy Martínez P, Pena Outeiriño JM. Cystic ureteritis in a kidney transplantation candidate. Actas Urol Esp. 2005;29:226–9.
14. Ito N, Hirose M, Shirai T, Tsuda H, Nakanishi K, Fukushima S. Lesions of the urinary bladder epithelium in 125 autopsy cases. Acta Pathol Jpn. 1981;31(4):545-57.