Cystitis cystica is a condition of the bladder where a series of mucosal cysts form in the bladder wall. A condition called cystitis glandularis causes similar lesions, although they may not necessarily involve glandular tissue. If it is not treated, this condition can lead to adenocarcinoma of the bladder as a result of cellular changes. A urologist is usually involved in diagnosis and treatment.
People develop cystitis cystica as a result of chronic irritation and inflammation in the bladder. They may have a history of bladder infections, paired with an issue like stones in the urine, tumors, or other irritants in the bladder. Over time, the bladder reacts to the irritation by producing more mucus and eventually developing more mucus-producing cells. These cells proliferate, forming masses, and they start to grow into the bladder wall before rupturing and creating cysts. The cysts fill with mucus, as they are lined by mucus cells.
Patients can notice symptoms like pelvic pain, difficulty urinating, or changes in the urine color. In some cases, cystitis cystica causes a urinary obstruction and the patient can only urinate with difficulty, if at all. The growing irritation in the bladder will increase, causing the lesions to grow. Eventually, this condition can convert from being benign to being malignant, causing cancerous tumors to develop. These growths can spread beyond the bladder in metastatic bladder cancer.
To diagnose this condition, a doctor may take images of the bladder and can request an endoscopy to see what is happening inside this organ, in addition to collecting a sample for biopsy. A pathologist can determine what kinds of cells are involved and provide information about how rapidly they are growing. After diagnosis, treatment can include medications to resolve inflammation and surgery to remove irritants like stones. If the condition has progressed to an extreme stage, the urologist may recommend removing the bladder altogether.
People who experience recurrent bladder infections may want to get a medical evaluation to find out why and see if the problem can be addressed, before they have a chance to progress to cystitis cystica. Pelvic pain and difficulty urinating should be treated quickly to avoid complications. If a patient is diagnosed with cystitis cystica, the doctor can provide information about the available treatment options and the prognosis with different choices. Patients can also request a second option from another provider if they want a comprehensive view of the kinds of treatments they have access to.