CYSTITIS CYSTICA – CHRONIC URINARY BLADDER INFLAMMATION IN CHILDREN

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.