Urogenital Imaging

Cystitis, interstitial

a rare idiopathic disease characterized pathologically by fibrosis of the deeper layers of the bladder wall and clinically by frequency, nocturia, and suprapubic pain aggravated by bladder distension. The disease predominantly affects middle-aged women. The aetiology is unknown, but may be autoimmune in nature, since antinuclear antibodies are frequently present. Urinary tract infection is not thought to be responsible for the bladder wall fibrosis, because the urine is usually clear. In advanced disease the ureterovesical junction becomes dysfunctional, with the development of reflux. Ultimately, the bladder becomes thinned, and may ulcerate and bleed.

Intravenous urography is usually normal, unless reflux has developed, when nonobstructive hydroureteronephrosis may be present. Cystography demonstrates a small volume bladder with a smooth or irregular wall. Reflux may also be seen. The main role of radiology in interstitial cystitis is in the exclusion of other diagnosis.

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