urovestВестник урологииUrology Herald2308-6424Rostov State Medical University10.21886/2308-6424-2025-13-2-103-118urovest-1059Research ArticleОБЗОРЫ ЛИТЕРАТУРЫREVIEWS ARTICLEИнкрустирующий цистит, вызванный Corynebacterium urealyticum: систематический обзорEncrusting cystitis caused by Corynebacterium urealyticum: literature reviewhttps://orcid.org/0000-0003-3355-4547НестероваО. Ю.NesterovaO. Yu.

Ольга Юрьевна Нестерова — канд. мед. наук 

Москва

Olga Yu. Nesterova — Cand.Sc.(Med) 

Moscow 

oy.nesterova@gmail.comhttps://orcid.org/0000-0001-7558-589XДзитиевВ. К.DzitievV. K.

Виталий Казиханович Дзитиев — канд. мед. наук 

Москва

Vitaly K. Dzitiev — Cand.Sc.(Med) 

Moscow 

vitdok@mail.ruhttps://orcid.org/0000-0001-9466-7567СорокинН. И.SorokinN. I.

Николай Иванович Сорокин — д-р мед. наук  

Москва

Nikolay I. Sorokin — Dr.Sc.(Med) 

Moscow 

nisorokin@mail.ruhttps://orcid.org/0000-0003-4518-634XСтригуновА. А.StrigunovA. A.

Андрей Алексеевич Стригунов — канд. мед. наук 

Москва

Andrey A. Strigunov — Cand.Sc.(Med) 

Moscow 

an-strigunov@yandex.ruhttps://orcid.org/0000-0002-6268-5282КоробоваА. Г.KorobovaA. G.

Анна Геннадьевна Коробова — канд. мед. наук 

Москва

Anna G. Korobova — Cand.Sc.(Med) 

Moscow 

akorobova@mc.msu.ruhttps://orcid.org/0000-0002-3992-7319ЖестковИ. А.ZhestkovI. A.

Жестков Иван Алексеевич 

Москва

Ivan A. Zhestkov 

Moscow 

zhestkovvanya@yandex.ruhttps://orcid.org/0009-0000-9115-7799БурлаковИ. Д.BurlakovI. D.

Илья Дмитриевич Бурлаков 

Москва

Ilya D. Burlakov 

Moscow 

forffmmsu@gmail.comhttps://orcid.org/0000-0003-4251-7545КамаловА. А.KamalovA. A.

Армаис Альбертович Камалов — д-р мед. наук, профессор, академик РАН 

Москва

Armais A. Kamalov — Dr.Sc.(Med), Full Prof., Acad. of the RAS

Moscow 

armais.kamalov@rambler.ruМосковский государственный университет им. М. В. ЛомоносоваРоссияLomonosov Moscow State University (Lomonosov University)Russian Federation202508062025132103118Copyright © Нестерова О.Ю., Дзитиев В.К., Сорокин Н.И., Стригунов А.А., Коробова А.Г., Жестков И.А., Бурлаков И.Д., Камалов А.А., 20252025Нестерова О.Ю., Дзитиев В.К., Сорокин Н.И., Стригунов А.А., Коробова А.Г., Жестков И.А., Бурлаков И.Д., Камалов А.А.Nesterova O.Y., Dzitiev V.K., Sorokin N.I., Strigunov A.A., Korobova A.G., Zhestkov I.A., Burlakov I.D., Kamalov A.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.urovest.ru/jour/article/view/1059

Инкрустирующий цистит представляет собой крайне редкую форму хронического воспаления мочевого пузыря, характеризующуюся кальцификацией стенки, наиболее частым возбудителем, которого является Corynebacterium urealyticum — грамположительная мультирезистентная палочка. Патогенность C. urealyticum ассоциирована с её высокой уреазной активностью, запускающей каскад расщепления мочевины на углекислый газ и аммиак, приводя тем самым к гипераммониурии и алкализации мочи уже в первые 24 часа. Наиболее значимыми предрасполагающими факторами для развития инкрустирующего цистита являются инородные тела в органах мочевыводящей системы, такие как уретральный катетер, нефростома, внутренние мочеточниковые стенты, а также наличие эндоскопических операций на органах мочевыводящей системы в анамнезе. Предположение относительно наличия C. urealyticum в моче должно возникать в случае стерильной мочи по результатам микробиологического исследования с использованием стандартных сред, высоком рН мочи (как правило, до 9), кристаллурии, обнаружении инкрустаций по результатам визуализирующих методов диагностики. Выделение C. urealyticum требует культивирования в течения 48 – 72 часов при 37°C на среде, обогащённой кровью или углекислым газом, однако описаны случаи обнаружения данного возбудителя только спустя 90 часов культивирования. Лечение инкрустирующего цистита должно состоять из трёх основных элементов: антибактериальной терапии, закисления мочи и удаления инкрустаций, содержащих биоплёнки возбудителя. В рамках проведённого в данной работе систематического обзора проанализированы описанные клинические случаи инкрустирующего цистита, а также применяемые разными специалистами варианты лечения.

Encrusting cystitis represents an exceptionally rare form of chronic bladder inflammation, characterized by bladder wall calcification. The predominant causative agent is Corynebacterium urealyticum, a gram-positive multidrugresistant bacillus. The pathogenic potential of C. urealyticum is attributed to its elevated urease activity, which initiates a cascade of urea decomposition into carbon dioxide and ammonia. This process results in hyperammoniuria and urine alkalization within the initial 24-hour period. The most significant predisposing factors for encrusting cystitis development include the presence of foreign bodies within the urinary system, such as urethral catheters, nephrostomy tubes, and internal ureteral stents, as well as a history of endoscopic urinary system interventions. Diagnostic suspicion of C. urealyticum presence in urine should be raised in cases of sterile urine according to standard microbiological examination results, elevated urine pH (typically up to 9.0 pH), crystalluria, and the detection of encrustations via imaging diagnostic modalities. Isolation of C. urealyticum necessitates cultivation for 48-72 hours at 370C on a medium enriched with blood or carbon dioxide; however, pathogen detection has been documented only after 90h of cultivation in certain instances. Therapeutic management of encrusting cystitis should encompass three primary components: antibacterial therapy, urinary acidification, and removal of encrustations harboring pathogen biofilms. The systematic review conducted within this study involved the analysis of documented clinical cases of encrusting cystitis, as well as an evaluation of treatment modalities employed by various specialists.

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The authors declare that there are no conflicts of interest present.