Symptoms, diagnosis and treatment of cystopyelitis

By Cristiano Antonino On Mar 25, 2023

Cystopyelitis is an inflammation, usually caused by bacteria, affecting the bladder and the renal pelvis. The pathogens responsible for the infection may colonise one of the two structures before the other or affect both at the same time

Symptoms of cystopyelitis can be different

People suffering from this inflammation often present with pain and burning during urination.

In addition, among the most common symptoms are a feeling of weight in the lower abdomen and the emission of urine containing pus.

When the disease affects the renal pelvis, symptoms may include fever, violent changes in body temperature, excessive sweating, chills and pain in the lower back.

Treatment for cystopyelitis can be different and is common to other urinary tract infections

Usually, cystopyelitis is treated in the same way as cystitis.

Medications are used, which are chosen according to the result of the bacterial urine culture and blood tests.

Cystopelitis is a condition that often affects women, especially during pregnancy, but can also occur in immunocompromised persons, who have urinary tract obstructions, suffer from diabetes or have frequent sexual intercourse.

What is cystopyelitis?

The term cystopyelitis is derived from the Greek and indicates an inflammation of the renal pelvis.

The symptoms of cystopyelitis vary depending on the area of the urinary tract affected and the degree of inflammation present.

The disease is caused by pathogenic organisms spreading through the ureter in an ascending manner to the bladder and finally to the renal pelvis.

The aetiological agents of cystopyelitis can be diverse.

Certainly, among them are those typically responsible for other inflammations of the urinary tract.

Among the most common are bacteria such as Escherichia coli and other forms of gram-negative bacteria.

Infection by these microorganisms can induce an inflammatory response in the urinary tract.

If this infection reaches the kidney, it can be termed cystopyelonephritis.

Symptoms

The symptoms of cystopyelitis are different, depending on the stage of the disease.

Symptoms usually appear quickly and, just as quickly, can worsen, affecting the lower back with pain that can reach the groin region.

The symptoms mainly affect the lower abdomen and lumbar area of the back.

In addition, the most common symptoms include urinary urgency, the sensation of incomplete emptying of the bladder, the perception of a weight in the lower abdomen, radiating pain in the groin area, and pollakiuria, i.e. an increase in the number of urinations throughout the day.

A typical systemic symptom of cystopielitis may be fever, resulting in a rise in body temperature, even abruptly.

With fever, chills, excessive sweating, urine output of pus, vomiting, nausea and asthenia may occur.

Summarising the most common symptoms are:

Pain in the abdomen, lower abdomen, groin, back (particularly in the lumbar region)
Chills
Colic
Fever
Pyuria
Sweating
Cloudy, foul-smelling urine with the presence of traces of blood
Vomiting
Nausea
Dysuria
Pollakiuria
Stranguria

Cystopyelitis is a fairly common problem

Specifically, this condition frequently affects women during pregnancy.

In fact, the symptoms described above may occur during this period.

In the last trimester, particularly due to the pressure exerted by the foetus on the urinary tract, the possibility of urinary stagnation increases, which increases the risk of developing infections.

The causes of cystopilegia are diverse and one of the most frequent is certainly the invasion of bacteria following tests or invasive procedures.

It is common for symptoms of bacterial inflammation and problems with the urinary system to occur following cystoscopies or catheterisations.

Certain diseases may predispose patients to the development of bacterial inflammation, such as diabetes.

Immunocompromised persons, due to taking medication or being affected by specific diseases, also have a weaker immune system and struggle to cope with pathogens.

In men, cystopaelitis can be favoured by the concomitant presence of diseases affecting the prostate, such as prostatitis or prostatic hypertrophy.

Certainly, the main cause of cystopielitis is the stagnation of urine inside the bladder, which can cause urinary reflux.

This creates ideal conditions for bacterial proliferation and the development of inflammation.

Diagnosis

Diagnosing cystopyelitis, as with other inflammations of the urinary tract, is important in order to determine which treatment to proceed with.

These diseases, if not recognised and treated in time, can lead to more or less serious complications that can make the treatment process even more difficult.

Certainly, for the diagnosis of cystopyelitis, it is necessary to visit one’s general practitioner.

Following an accurate medical history, the professional may recommend a visit to a specialist or prescribe any tests to be carried out to confirm the diagnosis.

With the anamnesis it is possible to get an initial overview of the patient’s state of health, through a brief interview and by performing an objective test.

The anamnesis makes it possible to reconstruct the patient’s medical history and to obtain some important information for the diagnosis.

These include: what the symptoms are and when they appeared, at what time of day they occur with greater intensity, whether they are related to an action the patient performs, whether there is any pathology (such as diabetes) and what the patient’s lifestyle is.

With this information, the doctor will be able to formulate some diagnostic hypotheses.

Following this initial examination, a visit to a specialist or further tests may be advisable.

These include a urine test

By analysing the urine it is possible to detect the presence of various components such as white blood cells, nitrites, haemoglobin and leucocyte esterase that may be suggestive of an ongoing infectious process.

In order to investigate the causes of cystopilegia and establish the diagnosis with certainty, a microbiological urine test is very often required.

Through the latter, also known as urinoculture, the presence of the bacteria responsible for the infection can be directly detected.

Treatments

Treatments for cystopyelitis can be different, depending on the underlying cause of the inflammation.

However, the remedies for this condition are mainly pharmacological; alternative medicine treatments are not effective and there is no indication for surgery.

Medications for the treatment of cystopyelitis may differ by drug class or dosage and include:

antibiotics
analgesic drugs
antispasmodic remedies

In addition, certain patient behaviours can help resolve the problem more quickly, such as consuming an appropriate amount of water or refraining from eating excessively salty food.

How to prevent cystopalitis

While there are effective therapies for treating urinary tract infections, there are also strategies for preventing their occurrence.

These include:

Regularising sexual activity: this factor can be responsible for the onset of urinary tract infections. Very frequent and/or unprotected intercourse with several partners can increase the risk.
Hydration: this is essential to prevent cystopelitis and other urinary tract infections. Drinking plenty of water encourages the elimination of these bacteria through the urine, as well as achieving a certain degree of intestinal mobility that can make evacuations more constant and prevent the proliferation of bacteria. It is essential that water be taken predominantly away from meals. In fact, excessive water intake during lunch or dinner can dilute the gastric juices, slowing down the digestion process.
Decreasing the pH of urine can be important as this prevents bacteria from adhering to the walls of the urinary tract. To do this, it is necessary to change one’s diet. A diet rich in fruit and vegetables can help with this.

In addition to consuming at least 1.5 to 2 litres of water a day, it is necessary to vary vegetables, cereals and fruit, paying attention to seasonality.

The latter is important, not only for one’s health, but also for economic and ecological reasons.

In addition, the consumption of garlic, onions and herbs, as well as low-fat fresh cheeses and raw extra virgin olive oil is advisable.

Finally, the consumption of red meat and salt should be moderated.

Avoid foods and drinks such as: alcohol, coffee, sausages, pickled products, spices, tea, spicy foods, sugary drinks and fatty condiments, such as mayonnaise, ketchup, mustard, butter, lard, margarine and fried foods.

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