Special Forms of Cystitis 1. Interstitial Cystitis (IC)/Bladder Pain Syndrome (BPS): o Definition: Interstitial cystitis is a chronic condition characterized by bladder pain, frequent urination, and urgency without a clear infection or other obvious causes. o Symptoms: Includes pelvic pain, a frequent need to urinate (more than 8 times a day), pain during intercourse, and a feeling of bladder fullness. o Diagnosis: Diagnosis is often one of exclusion, involving ruling out other conditions such as urinary tract infections (UTIs) or bladder cancer. Cystoscopy and bladder biopsy may be used to examine the bladder's interior. o Treatment: Management includes lifestyle modifications (diet changes, stress management), medications (such as pentosan polysulfate, antihistamines), bladder instillations (medications put directly into the bladder), and physical therapy. Severe cases might require surgical interventions. 2. Hemorrhagic Cystitis: o Definition: Hemorrhagic cystitis is characterized by bleeding from the bladder, typically seen as blood in the urine. o Causes: Often associated with certain medications (e.g., cyclophosphamide used in chemotherapy), radiation therapy, or infections. Can also result from viral infections, particularly adenoviruses. o Symptoms: Includes hematuria (blood in urine), dysuria (painful urination), and lower abdominal pain. o Diagnosis: Diagnosis involves urine analysis, cystoscopy, and sometimes imaging studies to assess the extent of bleeding. o Treatment: Focuses on addressing the underlying cause. For druginduced cases, modifying or discontinuing the offending medication can help. Bladder irrigation and medications to control bleeding may also be used. 3. Radiation Cystitis: o Definition: Radiation cystitis occurs as a complication of radiation therapy for pelvic cancers, such as prostate or cervical cancer. o Symptoms: Includes frequent urination, urgency, hematuria, and pain in the bladder region. o Diagnosis: Based on patient history of radiation therapy and symptoms. Cystoscopy and imaging may be used to evaluate bladder damage. o Treatment: Includes medications to manage symptoms (e.g., analgesics, anti-inflammatory drugs), bladder irrigation, and hyperbaric oxygen therapy in severe cases. Preventive strategies may include adjusting radiation therapy techniques. 4. Chemotherapy-Induced Cystitis: o Definition: A type of cystitis that occurs as a side effect of chemotherapy drugs, particularly those that are toxic to the bladder. o Symptoms: Similar to other forms of cystitis with possible additional symptoms like urgency and pain. o Diagnosis: Involves reviewing the patient’s chemotherapy regimen and assessing symptoms. Urinalysis and cystoscopy might be used to confirm. o Treatment: Includes hydration to flush out toxins, bladder irrigation, and medications to alleviate symptoms. Adjustments to the chemotherapy regimen may also be considered. 5. Eosinophilic Cystitis: o Definition: A rare form of cystitis where eosinophils (a type of white blood cell) infiltrate the bladder wall. o Symptoms: Similar to other cystitis forms with additional symptoms like bladder wall thickening. o Diagnosis: Requires biopsy to identify eosinophil infiltration. o Treatment: Corticosteroids and other immunomodulatory drugs are often used to manage symptoms and reduce inflammation. Each special form of cystitis presents unique challenges in diagnosis and management, often requiring a multidisciplinary approach for optimal care.