Bladder ultrasound in the differential diagnosis of variably-aetiologic chronic recurrent cystitis

Abstract

Introduction. In recent years, there has been a shift in the perspective on the pathogenic basis of infectious and inflammatory diseases of the lower urinary tract. This change is due to the paradigm of non-sterility of urine and the urinary tract. As a result, the long-held view of the etiological structure, pathogenesis, and methods of diagnosis and treatment is being revised. Objective. To study ultrasound changes in the bladder wall of patients with chronic recurrent cystitis (CRC) depending on the etiologic factor. Materials & Methods. The prospective study involved 177 sexually active women aged 20 – 45 years who had previously been diagnosed with CRC during an exacerbation. Depending on the etiologic factor, they were divided into three groups: Group 1 (n = 96) — papillomavirus CRC (PV-CRC), Group 2 (n = 70) — bacterial CRC (B-CRC), and Group 3 (n = 11) — candidal CRC (C-CRC). To perform a bladder ultrasound, scanner «Philips En Visor» CHD was used using in the B-mode. Results. The study data analysis on the bladder volume in patients of groups 1 and 2 showed significant differences from the results of group 3. When assessing the ultrasound data for residual urine, no clinically significant deviations were found in any of the groups. Regarding the bladder wall thickening, there are reliable differences between the studied groups: in most patients from group 1 and almost all patients in group 3, the bladder wall thickness exceeded standard values. Conclusion. CRC is a multi-causal disease, and the etiological factor determines its pathogenetic basis. Ultrasound examination of the bladder can serve as a screening method for CRC, providing clues about the nature of infectious and inflammatory processes in the bladder.

Keywords

• chronic cystitis
• bladder
• ultrasound
• bacteria
• viruses
• fungi