Acute Cystitis

What is acute cystitis?

Acute cystitis (ah-kyute sis-tie-tis) is an infection of your bladder.

“Acute” means that the infection develops suddenly and rises sharply.

Is acute cystitis the same as a UTI?

A urinary tract infection (UTI) is an infection of your urinary system. A UTI may affect one or more parts of your urinary system, which includes your kidneys, ureters, bladder or urethra.

Acute cystitis is an infection that only affects your bladder.

What is acute cystitis with hematuria?

In some cases of acute cystitis, you may have blood in your pee (hematuria). In cases of acute cystitis with hematuria, the hematuria may be either gross or microscopic.

Microscopic hematuria is when you have blood cells in your pee that your healthcare provider can only see with a microscope. Your pee looks pale or deep yellow.

Gross hematuria is when you have enough blood in your pee that you can see it with your naked eye. Your pee may look pink or red.

Who does acute cystitis affect?

Anyone can get acute cystitis. However, those 65 and older, as well as women and people assigned female at birth (AFAB), are more likely to develop acute cystitis.

There are many reasons why women and people AFAB are more likely to have acute cystitis. These include:

• Shorter urethra. The urethra is the tube through which pee leaves your body. In women and people AFAB, the urethra is 1 to 2 inches (in) long. In men and people assigned male at birth (AMAB), the urethra is about 6 inches long. Bacteria can enter your body through your meatus (the opening of your urethra). In women and people AFAB, bacteria have a shorter distance to travel to infect them compared to men and people AMAB.
• Urethra location. In women and people AFAB, the urethra is closer to the rectum. The proximity increases the chances of infection. Your rectum holds feces (poop), which contains bacteria that may cause acute cystitis.
• Sexual intercourse. Sexual intercourse and other forms of sexual contact allow bacteria around the vagina to enter the urethra.
• Certain types of birth control. Some types of birth control (contraception) may increase your chances of developing acute cystitis. Spermicidal gels, creams, foams and suppositories may irritate your vagina and promote bacterial growth. Diaphragms are round pieces of flexible rubber with rigid rims. You insert a diaphragm into your vagina, and it rests against your cervix. A diaphragm may push against your urethra, making it difficult to completely empty your bladder when peeing. Bacteria can grow in the urine that remains in your bladder.

The following may also increase your odds of getting acute cystitis:

• Urinary catheters.
• Diabetes.
• Fecal incontinence.
• An enlarged prostate or blockages that affect your urethra.
• Pregnancy.

How common is acute cystitis?

Acute cystitis is common.

Approximately 40% of women and people AFAB will have acute cystitis or a bacterial infection in another part of their urinary tract at some point in their lives. People who have gone through menopause (postmenopausal) may be more likely to get acute cystitis. When estrogen levels decline after menopause, bacteria multiply. Vaginal tissue also thins, which makes it easier for bacteria to enter the urethra.

Approximately 12% of men and people AMAB will have acute cystitis or a bacterial infection in another part of their tract at some point in their lives.

What are the symptoms of acute cystitis?

Symptoms of acute cystitis include:

• Feeling like you need to pee frequently, even right after you’ve recently peed.
• A burning sensation or pain while peeing.
• Smelly pee.
• Cloudy pee.
• Blood in your pee (hematuria).
• Urinary incontinence.
• Pain in your penis.
• Pain during sex.
• Cramping in your lower back or the lower part of your abdomen.
• Fatigue.
• Mild fever.

Mental changes or confusion (more common in those 65 or older).

What is the main cause of acute cystitis?

The main cause of acute cystitis is Escherichia coli (E. coli). E. coli is a bacterium in your intestines. It can enter your urinary tract as a result of not properly wiping or cleaning yourself after a bowel movement (pooping). It’s responsible for over 90% of all cases of acute cystitis.

Can stress bring on acute cystitis?

No, stress can’t bring on acute cystitis.

However, stress can trigger interstitial cystitis (IC). IC is a chronic bladder condition that causes pressure, discomfort or pain around your bladder.

Is acute cystitis contagious?

Acute cystitis isn’t contagious. You can’t spread or contract the infection through close contact or sex.

How is acute cystitis diagnosed?

Your healthcare provider can diagnose acute cystitis by reviewing your symptoms and conducting tests. Tests include:

• Urinalysis. A urinalysis (urine test) examines the visual, chemical and microscopic aspects of your pee. Your healthcare provider will examine your pee sample for red blood cells, white blood cells and bacteria. The presence of these can indicate an infection.
• Urine culture. A urine culture helps your healthcare provider identify what bacteria are responsible for your acute cystitis. It helps them identify the most effective antibiotic to treat your infection.

In some cases, acute cystitis may not respond to antibiotics, or you may get acute cystitis repeatedly. Your healthcare provider may recommend the following to help diagnose an infection or bladder injury.

• Ultrasound. An ultrasound is a noninvasive imaging test that allows your healthcare provider to take a detailed look at your bladder or other components of your urinary tract.
• Computed tomography (CT) scan. A CT scan is a noninvasive imaging test that produces 3D images of your bladder and urinary tract.
• Cystoscopy. Your healthcare provider will use a special instrument (cystoscope) to look inside your bladder from your urethra. Your healthcare provider typically uses a numbing gel so you don’t feel pain in your urethra. In rare cases, they may use general anesthesia so you aren’t awake and won’t feel any pain.

What is the fastest way to get rid of acute cystitis?

Antibiotics are the fastest way to get rid of acute cystitis. Your healthcare provider will prescribe specific antibiotics after evaluating your overall health and determining what type of bacteria is present in your pee.

For a mild bladder infection, women and people AFAB usually need to take antibiotics for three days. Men and people AMAB typically need to take antibiotics for seven to 14 days.

If you’re pregnant or have other conditions such as diabetes or a kidney infection, you’ll likely need to take antibiotics for seven to 14 days.

It’s important to finish your full course of antibiotics, even if you start to feel better. If you don’t finish your full course of medicine, your acute cystitis may come back and be more challenging to treat.

What should I drink if I have acute cystitis?

If you have acute cystitis, you should drink plenty of water throughout the day. Drinking a lot of water helps you pee more, which helps flush out the bacteria responsible for your infection.

Should I drink cranberry juice if I have acute cystitis?

Many people believe unsweetened cranberry juice can help treat or prevent acute cystitis.

Researchers believe that unsweetened cranberry juice or cranberry supplements may help treat or prevent acute cystitis. However, they’re unsure how cranberries work to treat it. They’re also not sure how much cranberry juice you need to drink for it to be effective.

One popular theory is that cranberries make your pee more acidic. More acid in your pee makes it difficult for bacteria to grow.

Another popular theory is that cranberry nutrients make it difficult for bacteria to stick to the walls of your bladder.

What medications are used to treat acute cystitis?

You must treat acute cystitis to get rid of the infection. Antibiotics are medicines that kill the bacteria responsible for acute cystitis.

Your healthcare provider will prescribe an antibiotic that best fights the particular bacteria responsible for your infection. Common acute cystitis antibiotics include:

• Nitrofurantoin (Macrobid®).
• Sulfamethoxazole - trimethoprim (Bactrim®).
• Fosfomycin (Monurol®).
• Pivmecillinam (Selexid®).

How long does acute cystitis last?

You should feel better within a few days or a week after you start your course of antibiotics.

What happens if I don’t treat acute cystitis?

It’s important to get treatment if you have acute cystitis. If you don’t treat acute cystitis, you run the risk of developing other complications, including:

• Sepsis.
• Acute kidney injury.
• Abscess formation.
• Gas in your bladder wall (emphysematous cystitis).

How can I reduce my risk of getting acute cystitis?

The following tips can reduce your risk of getting acute cystitis:

• Practice good hygiene. For women and people AFAB, your urethra is shorter and closer to your rectum. This makes it easier for bacteria to move from your rectum to your urethra. It’s a good idea to wipe from front to back after pooping. People who menstruate should also regularly change their pads, tampons or other period hygiene products.
• Drink plenty of fluids. Drinking a lot of fluids, especially water, helps remove harmful bacteria from your urethra. Try to drink between six to eight glasses (48 to 64 oz.) of water per day.
• Pee before and after sex. Peeing before and after sex helps remove harmful bacteria from your urethra.
• Use different birth control. Using spermicide and diaphragms may increase your chances of getting acute cystitis. Talk to your healthcare provider about other birth control options.
• Wear loose underwear and pants. Tight underwear and pants can trap heat and moisture around your groin. Heat and moisture can create an ideal environment for bacteria to spread quickly. You should also change your underwear regularly and wear cotton underwear or underwear made out of synthetic materials. Cotton absorbs moisture. Synthetic materials wick away moisture.

Talk to your healthcare provider about estrogen cream or pills if you’re menopausal or postmenopausal. These medications change the pH (how acidic or basic water is) of your vagina, which may help prevent acute cystitis.

What can I expect if I have acute cystitis?

With diagnosis and treatment, the outlook for people with acute cystitis is good. Most people feel better after just a few days.

How do I take care of myself?

The best way to care for yourself is to follow your healthcare provider’s instructions. It’s important to finish your full course of antibiotics, even if you start to feel better. If you don’t finish your full course of medicine, your acute cystitis may come back and be more challenging to treat.

When should I see my healthcare provider?

Call your healthcare provider if you have symptoms of acute cystitis.

If your healthcare provider has diagnosed you with acute cystitis and your symptoms aren’t going away after a week, contact them again. You may need a different antibiotic.

What questions should I ask my healthcare provider?

• How do you know that I have acute cystitis?
• If I don’t have acute cystitis, what other condition might I have?
• How did I get acute cystitis?
• What bacteria caused my acute cystitis?
• For how long and at what times of the day should I take my medicine?
• How should I store my medicine?
• When will I start to feel better?
• Do I need to schedule a follow-up appointment?

What is the difference between acute cystitis and pyelonephritis?

Acute cystitis is an infection of your bladder.

Pyelonephritis is an infection of your kidneys. The same bacteria that cause acute cystitis cause pyelonephritis. The bacteria migrate through your urethra, into your bladder, up the tubes that connect your bladder to your kidneys (ureters) and into your kidneys.

A note from Cleveland Clinic

Acute cystitis is a common condition that affects your bladder. It most commonly affects women and people assigned female at birth. If you notice symptoms of acute cystitis, talk to your healthcare provider. They’ll prescribe an antibiotic to clear up the infection. It’s important to finish your full course of medicine, or it can come back.

To prevent acute cystitis, drink plenty of fluids and practice proper hygiene.