OTHER / RESEARCH PAPER
CYSTITIS CYSTICA – CHRONIC URINARY BLADDER INFLAMMATION IN CHILDREN
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Department of Pediatric Surgery and Pediatric Urology, Medical Centre of Postgraduate Education, Warsaw, Poland
Submission date: 2020-10-23
Final revision date: 2021-01-26
Acceptance date: 2021-01-26
Publication date: 2021-02-20
Health Prob Civil. 2021;15(1):61-67
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ABSTRACT
Introduction:
Infections of the urinary tract are the second most common bacterial
infections occurring among the pediatric population. Cystitis cystica is the prevalent form
of chronic inflammation which occurs in children. The pathogenesis of the disease is unclear,
however recurrent urinary tract infections are considered to be the most common cause.
Inflammation may be asymptomatic or present with symptoms of active infection. Chronic
inflammation can lead to micturition disorders. 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.
Material and methods:
In the period 2016-2019, 871 cystoscopies were performed at
the Department of Pediatric Surgery and Pediatric Urology of the Centre of Postgraduate
Medical Education, Warsaw, Poland. Depending on the severity of macroscopic changes, the
severity of symptoms, and the occurrence of recurrent urinary tract infections, different
treatment protocols were used: oral administration of furazidine and trimethoprim with
sulfamethoxazole, intravesical instillation of gentamicin and immunomodulating treatment
in chosen cases.
Results:
Improvement in the clinical condition of sick children was achieved in 79% of patients
(84/106). Changes in endoscopic findings did not always correlate with clinical symptoms.
Conclusions:
The authors recommend extended diagnostics to include endoscopic
examination in children with recurrent bladder infections and/or voiding disorders that
are difficult to treat. This will allow exclusion or diagnosis of cystitis cystica and enable
appropriate treatment at the initial stage of the disease, making regression of the changes in
the bladder mucosa possible with oral pharmacotherapy only.