Genitourinary Radiology > Bladder > Diffuse Thickening of Bladder Wall > Cystitis


Cystitis

 

Cystitis is inflammation of part or the entire urinary bladder wall. The common causes include infection (E. coli, Klebsiella, Pseudomonas, Schistosomiasis, also viral and fungal cause), irritative or mechanical (such as an indwelling catheter or a stone), toxic (cyclophosphamide), radiation, and allergic.

It may be described as acute, chronic, hemorrhagic, bullous, emphysematous, polypoid, cystitis cystica, cystitis glandularis, squamous metaplasia, or alkaline encrustation. Acute cystitis may have a a normal appearance; chronic usually appears as thickened walls and diminished filling capacity. Focal inflammation, such as bullous edema, may be radiographically indistinguishable from bladder carcinoma.

Contrast enhaced CT scan of the pelvis. An indwelling nephroureteral stent sits in the bladder. This patient received pelvic radiation for a non-bladder malignancy. This resulted in bladder wall thickening and obstruction of the left ureter at the ureteral orifice into the bladder causing left sided hydronephrosis and thus requiring stenting. Note bladder wall thickening in the left lateral bladder wall from radiation induced cystitis (arrows).

Contrast enhaced CT scan of the pelvis. A mass like lesion in the dependent portion of the bladder may represent a mass (arrows). However, this patient presented with gross hematuria. Cystoscopy was performed for diagnosis and treatment (irrigation). This clot resolved following irrigation. This clot is indistinguishable from a bladder or prostate mass. The clinical data is helpful to be able to suggest the possibility that this mass is blood clot requiring irrigation.



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