Cystitis Glandularis Treatment

Cystitis glandularis or glandular cystitis involves the nonmalignant (noncancerous) change or transformation of the mucosal cells lining the bladder; mucosal cells produce mucin, a lubricant. These transformed mucosal cells form lesions in the form of nodules (lumps) or growths called polyps. A polyp is essentially a tumor on a stalk. The lesions result in discomfort during urination, urinary obstruction and bleeding. Untreated cystitis glandularis can ultimately lead to chronic kidney failure and possibly bladder cancer.

Causes of Cystitis Glandularis

• Cystitis glandularis is usually caused by chronic or continuing irritation of the bladder, for example, in paraplegic individuals with nonfunctioning bladders; patients who have been catheterized for a long time; persistent or repeated urinary tract infections; bladder stones; bladder exstrophy, a congenital condition in which part of the bladder is outside the body; or a neurogenic bladder, interference with nerve impulses that control urination. The cystitis glandularis lesions that develop can be small and limited in extent or large and progressive.

Conservative Treatment Options

• Conservative treatment involves removing the source of irritation that results in the chronic inflammatory process that leads to cystitis glandularis. Treatments include long-term antibiotic therapy to eliminate chronic urinary tract infections, replacing in-dwelling (permanent) catheters with periodic catheterization as needed, removing bladder stones and treating a neurogenic (overactive or underactive) bladder with medications or periodic catheterization. These treatments work best for small lesions, but they are not necessarily curative; cystitis glandularis can recur.

Moderate Treatment Options

• If there is severe obstruction of the ureters, tubes leading from kidneys to the bladder, a nephrostomy tube may be inserted through the back into the kidney to drain urine before any other therapy can be applied.
  Cystitis glandularis tissues can be destroyed using a process called transurethral resection. An instrument is inserted into the bladder through the urethra, the tube that conducts urine from the bladder to the outside of the body. The instrument uses an electric current to destroy the lesions.

Aggressive Treatment Options

• Aggressive treatment options are reserved for patients who were not helped by more conservative therapies. Bladder augmentation involves surgically enlarging the size of the bladder to increase capacity, but it does not eliminate bladder and urinary irritation or urethral obstruction. Ureteral reimplantation is used to repositioning the way a wrongly attached ureter connects to the bladder in order to prevent the backup of urine into the kidney, which can lead to chronic infection.

Extreme Treatment Option

• Radical cystectomy is removal of the bladder and surrounding tissues and lymph glands. This surgery is the last resort of patients who have failed all other therapies and who are in danger of developing or who have already developed uremia, the buildup of toxic wastes in the blood stream because of failure of the kidney to remove those wastes. Bladder removal eliminates all problems resulting from cystitis glandularis. Surgical risks include erectile dysfunction and incontinence, inability to hold urine.