Hemorrhagic cystitis: symptoms and treatment

Cystitis is characterized by an acute or chronic inflammatory lesion of the bladder walls, most of which does not extend to the mucosa. In 80% of cases of the diagnosed disease, the pathology is provoked by infectious pathogens of a viral, bacterial or fungal nature.

In urological practice, there are situations where the inflammatory process affects the deep layers of the bladder wall, affecting the blood vessels, disrupting their integrity. The bleeding form of the inflammatory process is characterized not only by the appearance of blood clots in the urine, but also by relatively severe complications that occur if the disease is not diagnosed in time.

Condition characteristics

With the development of hematuria, blood clots are released in the background of acute or chronic inflammatory lesions of the bladder wall after emptying the bladder. When a hemorrhagic form of the inflammatory process develops, pieces of blood are released in detail throughout the urination process and the urine stains dirty brown or red. With this disease, not only the color changes but also the smell of the urine. The urine takes on a faint odor reminiscent of rust. Depending on the severity of the course of the disease, patients may complain not only of the presence of blood in the urine, but also of the appearance of blood clots, the presence of which indicates a severe change in the urinary tract. The danger of this condition lies not only in the fact that the infection can spread from the local foci throughout the body, but also in the fact that prolonged blood loss leads to the development of iron deficiency anemia.

Against the background of a decrease in hemoglobin indices, the process of oxygen supply to all organs and tissues is disrupted, with serious consequences. An equally serious complication of this disease is a blockage (blockage) of the lumen of the urethra or bladder with blood clots. Although hemorrhagic cystitis can occur with the same frequency in humans, regardless of age or gender, it is most commonly diagnosed in elderly men with benign prostatic hyperplasia. In addition to infectious agents, this serious disease can occur with long-term, uncontrolled intake of certain groups of drugs (cytostatics) and exposure to ionizing radiation from the human body.

Causes of occurrence

Compared to other types of inflammatory lesions of the bladder wall, hemorrhagic cystitis is often caused by infectious pathogens of a viral nature. Other provoking factors in the development of the disease are:

  1. Violation of the natural excretion of urine due to mechanical factors. These factors include congenital or acquired urinary tract disorders, stenoses, connective tissue adhesions, and deformities of the urethra. In addition, blockage of the lumen of the bladder or urethra with urolithiasis with tartar can interfere with the natural flow of urine. Benign and malignant tumors can disrupt the process of emptying the bladder cavity.
  2. Regular artificial restriction of the urination process, which negatively affects the tone of the urinary tract muscles and the condition of the blood vessels.
  3. Decreased contractility of smooth muscle elements in the bladder region or so-called neurogenic bladder.
  4. Suppression of the body's defenses, resulting in favorable conditions for the penetration and multiplication of pathogens. Very often, this disease occurs in the background of immunodeficiency in the pathologies of the thyroid gland, diabetes mellitus, and during menopause.
  5. Improper adherence to personal and intimate hygiene rules will result in ascending bladder infection.
  6. Presence of foreign body in the urethral canal.

In addition, this disease is often diagnosed in women during childbirth and breastfeeding, which is caused by the suppression of the body's defenses due to humoral (hormonal) factors.

Symptoms of the disease

The clinical signs of the bleeding form of inflammatory lesions of the bladder walls are not radically different from those of acute infectious cystitis. A characteristic sign of this disease is the presence of blood in the urine throughout the period of urination.

lower abdominal pain with hemorrhagic cystitis

The disease can be identified by the following non-specific characteristics:

  1. Frequent urge to empty the bladder cavity, accompanied by intense pain, cuts, and discomfort. In hemorrhagic cystitis, the frequency of urination can reach 40 per day, especially at night.
  2. Removal of a minimum dose of urine with a characteristic red or brown color and an unpleasant odor.
  3. Decreased performance, weakness, general malaise, chills, fever.
  4. Spasmodic or tensile pain in the suprapubic region that radiates to the perineum, the right or left hip region.
  5. Rise in body temperature to 37, 5-38, 5 degrees.

Depending on the state of the body's defenses, a person may not complain about all of the symptoms listed. Only the presence of blood in the urine remains unchanged.

Diagnostic methods

The characteristic clinical signs of the hemorrhagic form of inflammatory lesions of the bladder walls allow physicians to make a preliminary diagnosis based on an analysis of the patient's complaints. In order to confirm the clinical diagnosis, the following examination options are assigned to any person with characteristic complaints:

  1. General clinical and bacteriological examination of urine. With the development of this disease, there will be marked hematuria in the general analysis of urine.
  2. A PCR technique for urinalysis that allows the identification of pathogenic microorganisms of a viral nature.
  3. General blood test.
  4. Ultrasound examination of the kidneys and bladder to identify bladder stones, tumors, defects, and deformities.


The etiological treatment of the disease involves the use of antibacterial, antiviral or antifungal drugs. In situations where a bleeding form of cystitis occurs with long-term use of certain medications, the patient is advised to completely exclude the intake of medications or substitute names. Complex drug therapy for the disease involves the use of the following groups of drugs:

  1. Anticonvulsants.
  2. Antiviral drugs.
  3. Antibacterial agents.
  4. Non-steroidal anti-inflammatory drugs that have analgesic effects.
  5. Hemostatic drugs.
  6. Multivitamin complexes containing vitamin K and ascorbic acid.
  7. Medicinal products based on herbal ingredients with urea septic action (infusion and decoction of a bear grape herb).

To prevent bladder lumen and urethral obstruction, a urological catheter can be inserted into the patient to infuse saline with sodium chloride, antibiotics, or antiseptic solutions.

If this condition developed in childhood, the child is usually placed in an inpatient ward for comprehensive diagnosis and treatment. For children with a similar diagnosis, several days of bed rest is recommended. The basis for the complex treatment of hemorrhagic cystitis is antiviral or antibacterial drugs.

General preventive measures to reduce the likelihood of developing the disease include moderate physical activity, hardening, prevention of hypothermia, adherence to personal and intimate hygiene rules, and rejection of a rational diet and bad habits. When diagnosing hemorrhagic cystitis at an early stage, you can overcome the disease within 10-15 days using an integrated therapeutic approach.