Hemorrhagic Cystitis: Symptoms and Treatment

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

In urological practice, there are situations in which the inflammatory process reaches the deep layers of the bladder walls, affecting the blood vessels, breaking 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 serious complications that arise when the disease is not diagnosed in a timely manner.

Condition Characteristics

With the development of hematuria in the context of acute or chronic inflammatory lesions of the bladder walls, blood fragments are released after bladder emptying. In case a hemorrhagic form of the inflammatory process develops, blood fragments are released in chunks throughout the act of urination, staining the urine a dirty brown or red color. With this disease, not only does the color change, but also the smell of the urine. Urine has a foul odor that resembles 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 severe damage to the urinary region. The danger of this condition lies not only in the fact that, from the local focus of the infection, it can spread throughout the body, but also in the fact that prolonged blood loss over time leads to the development of anemia due to iron deficiency.

In the context of a decrease in hemoglobin levels, the process of oxygen delivery to all organs and tissues is interrupted, which is fraught with serious consequences. An equally serious complication of this disease is obstruction (blockage) of the urethral canal or bladder lumen with a blood clot. Although hemorrhagic cystitis can occur with the same frequency in people, regardless of age and gender, most of the time this condition is diagnosed in elderly men with benign prostatic hyperplasia. In addition to infectious factors, this serious disease can occur both in the context of uncontrolled and prolonged ingestion of certain groups of drugs (cytostatics), as well as when exposed to ionizing radiation in the human body.

Occurrence causes

In comparison with other types of inflammatory lesions of the bladder walls, hemorrhagic cystitis often occurs under the influence of infectious pathogens of a viral nature. Other triggering factors for the development of this disease include:

  1. Violation of natural urine excretion due to mechanical factors. These factors include congenital or acquired urinary tract defects, strictures, connective tissue adhesions, urethral canal deformities. In addition, the natural passage of urine can be disturbed as a result of obstruction of the bladder lumen or urethral canal with calculi in urolithiasis. Benign and malignant neoplasms can interrupt the process of emptying the bladder cavity.
  2. Regular artificial restriction of the urination process, which negatively affects urinary muscle tone and the condition of blood vessels.
  3. Decreased contractility of smooth muscle elements in the bladder region or the so-called neurogenic bladder.
  4. Oppression of the organism's defenses, as a result of which favorable conditions are created for the penetration and reproduction of pathogens. This disease often occurs in the context of immunodeficiency in thyroid gland pathologies, diabetes mellitus, as well as during menopause.
  5. Incorrect adherence to personal and intimate hygiene rules, resulting in ascending bladder infection.
  6. The presence of a foreign body in the urethral canal.

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

disease symptoms

The clinical symptomatology of the hemorrhagic form of inflammatory lesions of the bladder walls does not radically differ from the symptoms of acute infectious cystitis. A characteristic sign of this disease is the presence of blood in the urine during the entire act of urination.

lower abdominal pain with hemorrhagic cystitis

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

  1. Frequent need 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 small amounts of urine, with a characteristic red or brown color, in addition to an unpleasant odor.
  3. Decreased performance, weakness, malaise, chills, fever.
  4. Cramp or pulling pain in the suprapubic region that radiates to the perineum, right or left iliac region.
  5. An increase 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 symptoms listed. Only the presence of blood in the urine remains unchanged.

diagnostic methods

The clinical symptomatology characteristic of the hemorrhagic form of inflammatory lesions of the bladder walls allows the specialist physician to make a preliminary diagnosis based on the analysis of the patient's complaints. To confirm the clinical diagnosis, each person with characteristic complaints receives the following examination options:

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


The etiological treatment of the disease includes the use of drugs with an antibacterial, antiviral or antifungal effect. In situations where the hemorrhagic form of cystitis occurs with prolonged use of certain medications, it is recommended that the patient completely exclude the ingestion of medications or replace the names. Complex drug therapy for this disease includes taking the following drug groups:

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

To prevent blockage of the bladder lumen and urethral canal, a urological catheter can be placed in the patient, through which saline solution with sodium chloride, antibiotics or antiseptic solutions will be instilled in the bladder.

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

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