Hemorrhagic cystitis: symptoms and treatment

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

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

Characteristics of the condition

With the development of hematuria on the background of acute or chronic inflammatory lesions of the walls of the bladder, the release of blood fragments occurs after emptying the bladder. In case of development of a hemorrhagic form of the inflammatory process, the blood fragments are excreted in portions throughout the act of urination, staining the urine dirty brown or red. In this disease changes not only the color but also the smell of urine. Urine acquires a foul odor reminiscent of rust. Depending on the severity 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 serious damage to the urinary tract. The danger of this condition lies not only in the fact that the local focus of the infection can spread throughout the body, but also in the fact that prolonged blood loss over time leads to the development of iron deficiency anemia.

Against the background of decreasing hemoglobin indices, the process of oxygen supply to all organs and tissues is disrupted, which is fraught with serious consequences. An equally serious complication of this disease is obstruction (blockage) of the urethral canal or the lumen of the bladder with a blood clot. Despite the fact that hemorrhagic cystitis can occur with the same frequency in men, regardless of age and gender, this condition is most often diagnosed in older men who have benign prostatic hyperplasia. In addition to infectious factors, this serious disease can occur against the background of prolonged uncontrolled intake of certain groups of drugs (cytostatics), as well as exposure to ionizing radiation on the human body.


Compared to other types of inflammatory lesions of the bladder wall, hemorrhagic cystitis often occurs under the influence of infectious pathogens of viral nature. Other provoking factors for the development of this disease include:

  1. Disruption of the natural excretion of urine due to mechanical factors. These factors include congenital or acquired defects of the urinary tract, strictures, adhesions of connective tissue, deformities of the urethral canal. In addition, the natural passage of urine may be impaired as a result of obstruction of the bladder lumen or urethral canal with tartar in urolithiasis. Benign and malignant neoplasms can disrupt the process of emptying the bladder cavity.
  2. Regular artificial restriction of the process of urination, which adversely affects the tone of the urinary muscles and the condition of blood vessels.
  3. Reduction of the contractility of the smooth muscle elements of the bladder area or the so-called neurogenic bladder.
  4. Suppression of the body's defenses, as a result of which favorable conditions are created for the penetration and reproduction of pathogens. Very often this disease occurs against the background of immunodeficiency in pathologies of the thyroid gland, diabetes mellitus, as well as during menopause.
  5. Improper observance of the rules of personal and intimate hygiene, resulting in an ascending bladder infection.
  6. The presence of a foreign body in the urethral canal.

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

Symptoms of the disease

The clinical symptoms of the hemorrhagic form of inflammatory lesions of the bladder wall do not differ radically from the symptoms of acute infectious cystitis. A characteristic feature of this disease is the presence of blood in the urine throughout the act of urination.

lower abdominal pain with hemorrhagic cystitis

The disease can be recognized by the following non-specific signs:

  1. Frequent urges to empty the bladder cavity, which are accompanied by severe pain, cuts and discomfort. In hemorrhagic cystitis, the frequency of urination can reach 40 times a day, mainly at night.
  2. Removal of minimal portions of urine, which has a characteristic red or brown color, as well as an unpleasant odor.
  3. Decreased ability to work, weakness, malaise, chills, fever.
  4. Perceiving or pulling pain in the suprapubic region, which radiates to the perineum, right or left iliac 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 of all the listed symptoms. Only the presence of blood in the urine remains unchanged.

Diagnostic methods

The characteristic clinical symptoms of the hemorrhagic form of inflammatory lesions of the bladder wall allow medical professionals to make a preliminary diagnosis based on the analysis of the patient's complaints. To confirm the clinical diagnosis of any person with characteristic complaints, the following examination options are prescribed:

  1. General clinical and bacteriological examination of urine. With the development of this disease in the general analysis of urine there will be a pronounced hematuria.
  2. PCR technique for the study of urine, which allows to identify pathogenic microorganisms of a viral nature.
  3. General blood test.
  4. Ultrasound examination of the kidneys and bladder to identify stones, neoplasms, defects and deformities of the urinary tract.


The etiological treatment of this disease includes the use of drugs with antibacterial, antiviral or antifungal action. In situations where the hemorrhagic form of cystitis occurs with prolonged use of certain drugs, the patient is advised to completely exclude medication or change the names. The complex drug therapy of this disease includes the following groups of drugs:

  1. Antispasmodics.
  2. Antiviral drugs.
  3. Antibacterial agents.
  4. Non-steroidal anti-inflammatory drugs that have an analgesic effect.
  5. Hemostatic drugs.
  6. Multivitamin complexes containing vitamin K and ascorbic acid.
  7. Medicines based on herbal ingredients with uraseptic effect (infusion and decoction of bearberry herb).

To prevent obstruction of the bladder lumen and urethral canal, the patient may be fitted with a urological catheter through which saline, antibiotics, or antiseptic solutions will be instilled into the bladder.

If this pathological condition has developed in childhood, then the child, as a rule, is hospitalized for comprehensive diagnosis and treatment. For children with such a diagnosis, bed rest for a few days is recommended. The basis of the complex treatment of hemorrhagic cystitis are antiviral or antibacterial drugs.

General preventive measures that reduce the likelihood of developing this disease include moderate physical activity, hardening, prevention of hypothermia, compliance with the rules of personal and intimate hygiene, as well as rational nutrition and rejection of bad habits. By diagnosing hemorrhagic cystitis at an early stage, using an integrated therapeutic approach, you can overcome the disease within 10-15 days.