Bladder ultrasound in the differential diagnosis of variably-aetiologic chronic recurrent cystitis

   Introduction. In recent years, there has been a shift in the perspective on the pathogenic basis of infectious and inflammatory diseases of the lower urinary tract. This change is due to the paradigm of non-sterility of urine and the urinary tract. As a result, the long-held view of the etiological structure, pathogenesis, and methods of diagnosis and treatment is being revised.

   Objective. To study ultrasound changes in the bladder wall of patients with chronic recurrent cystitis (CRC) depending on the etiologic factor.

   Materials & Methods. The prospective study involved 177 sexually active women aged 20 – 45 years who had previously been diagnosed with CRC during an exacerbation. Depending on the etiologic factor, they were divided into three groups: Group 1 (n = 96) — papillomavirus CRC (PV-CRC), Group 2 (n = 70) — bacterial CRC (B-CRC), and Group 3 (n = 11) — candidal CRC (C-CRC). To perform a bladder ultrasound, scanner «Philips En Visor» CHD was used using in the B-mode.

   Results. The study data analysis on the bladder volume in patients of groups 1 and 2 showed significant differences from the results of group 3. When assessing the ultrasound data for residual urine, no clinically significant deviations were found in any of the groups. Regarding the bladder wall thickening, there are reliable differences between the studied groups: in most patients from group 1 and almost all patients in group 3, the bladder wall thickness exceeded standard values.

   Conclusion. CRC is a multi-causal disease, and the etiological factor determines its pathogenetic basis. Ultrasound examination of the bladder can serve as a screening method for CRC, providing clues about the nature of infectious and inflammatory processes in the bladder.

1. Naboka Yu.L., Gudyma I.A., Kogan M.I., Ibishev Kh.S., Chernitskaya M.L. Microbial spectrum of urine and bladder biopsies in women with chronic recurrent cystitis. Urologiia. 2013;(4):16-18. (In Russian). eLIBRARY ID: 20589096; EDN: RIOILB

2. Naboka J.L., Kogan M.I., Mordanov S.V., Ibishev Kh.S., Ilyash A.V., Gudima I.A. Bacterial-viral Urine Microbiota in Uncomplicated Recurrent Infection of the Lower Urinary Tract: Results of Pilot Study. Urology Herald. 2019;7(4):13-19. (In Russian). DOI: 10.21886/2308-6424-2019-7-4-13-19.

3. Gyaurgiev T. A., Kuzmenko A. V., Vakhtel V. M., Lukyanovich P. A. Treatment of patients with chronic recurrent bacterial cystitis in the acute stage in combination with phototherapy using the «Svetozar» apparatus. System analysis and management in biomedical systems. 2014;13(4):821-824. (In Russian). eLIBRARY ID: 22705367; EDN: TCWKFL

4. Kuzmenko A.V., Kuzmenko V.V., Gyaurgiev T.A. Efficacy of immunomodulators as part of complex therapy for chronic recurrent cystitis in women. Urologiia. 2019;(2):9-14. (In Russian). DOI: 10.18565/urology.2019.2.9-14

5. Kulchavenya E.V., Neimark A.I., Tsukanov A.Yu., Plugin P.S., Neimark A.B., Razdorskaya M.V. Anthropometric characteristics of patients suffering from chronic cystitis. Urology Herald. 2023;11(2):56-64. (In Russian). DOI: 10.21886/2308-6424-2023-11-2-56-64

6. Ibishev Kh. S. Some aspects of the treatment of persistent lower urinary tract infection in women. Urologiia. 2014;(5):30-34. (In Russian). eLIBRARY ID: 22809341; EDN: TFDOHL

7. Glybochko P.V., Kogan M.I., Naboka YU.L., eds. Infections and inflammation in urology. Moscow: Medforum, 2019. (In Russian). ISBN 978-5-9500559-5-9

8. Gadzhieva Z.K., Kazilov Yu.B. Features of the prevention of recurrent lower urinary tract infections. Urologiia. 2016;(3):65-76. (In Russian). eLIBRARY ID: 26436155; EDN: WGNBJX

9. Ibishev KH.S., Lapteva T.O., Krakhotkin D.V., Ryabenchenko N.N. The role of human papillomavirus infection in the development of recurrent lower urinary tract infection. Urologiia. 2019;(5):134-137. (In Russian). doi: 10.18565/urology.2019.5.136-139

10. Kosova I.V., Barsegian V.A., Loran O.B., Sinyakova L.A., Luk’ianov I.V., Kolbasov D.N., Kruzhalov A.N., Alieva M.I. Etiological factors of voiding disorders in females. Consilium Medicum. 2022;24(7):451-455. (In Russian). DOI: 10.26442/20751753.2022.7.201791

11. Ibishev Kh.S., Krahotkin D.V., Mammadov V.K., Singe A.I. The effectiveness of Alloferon in the complex therapy of chronic recurrent papillomavirus cystitis. Urologiia. 2021;4:35-40. (In Russian). DOI 10.18565/urology.2021.4.35-40

12. Krakhotkin D.V. The role of papillomavirus infection in the development of recurrent lower urinary tract infection. [Dissertation] Rostov-on-Don, 2021. (In Russian). Accessed June 6 2024. URL: https://www.dissercat.com/content/rol-papillomavirusnoi-infektsii-v-razvitii-retsidiviruyushchei-infektsii-nizhnikh-mochevykh

13. Ibishev K.S., Krakhotkin D.V., Lapteva T.O., Todorov S.S., Ryabenchenko N.N., Mantsov A.A., Kogan M.I. Endoscopic and morphological signs of chronic recurrent papillomavirus cystitis. Urologiia. 2021; 3:45-49. (In Russian). DOI: 10.18565/urology.2021.3.45-49

14. Mamedov V.K., Krakhotkin D.V. Endoscopic and morphological methods in the differential diagnosis of chronic recurrent cystitis. 8^th final scientific session of young scientists of Rostov State Medical University. Rostov-on-Don: Collection of materials. 2021;69-70. (In Russian). eLIBRARY ID: 47932256; EDN: ZCWHSY

15. Sinyakova L.A. Infections of the lower urinary tract in women - problems and mistakes. Urologiia. 2021;(1):140-145. (In Russian). DOI: 10.18565/urology.2021.1.140-145

16. Jones-Freeman B, Chonwerawong M, Marcelino VR, Deshpande AV, Forster SC, Starkey MR. The microbiome and host mucosal interactions in urinary tract diseases. Mucosal Immunol. 2021;14(4):779-792. DOI: 10.1038/s41385-020-00372-5

17. Ibishev K.S., Malinovskaya V.V., Parfyonov V.V. Treatment of persistent infection of the lower urinary tract in women. Attending doctor. 2014;(9):90-93. (In Russian). eLIBRARY ID: 22022340; EDN: SNXUGT

18. Zaleska-Dorobisz U, Biel A, Sokołowska-Dąbek D, Olchowy C, Łasecki M. Ultrasonography in the diagnosis of hemorrhagic cystitis - a complication of bone marrow transplantation in pediatric oncology patients. J Ultrason. 2014 Sep;14(58):258-72. DOI: 10.15557/JoU.2014.0026

19. Gooding GA. Varied sonographic manifestations of cystitis. J Ultrasound Med. 1986 Feb;5(2):61-3. DOI: 10.7863/jum.1986.5.2.61

20. Ibishev Kh.S., Lapteva T.O., Todorov S.S., Goncharov I.D., Alkhashash A., Mamedov V.K. Pathomorphological criteria for differential diagnosis of leukoplakia and chronic recurrent papillomavirus cystitis. Urologiia. 2024;(3):28-32. (In Russian). DOI: 10.18565/urology.2024.3.28-32

21. Gooding GA. Sonography of Candida albicans cystitis. J Ultrasound Med. 1989;8(3):121-124. DOI: 10.7863/jum.1989.8.3.121