Cystitis and Urinary Tract Infections Review

Flashcards covering the identification, referral criteria, pharmacological treatment, and self-management of cystitis and lower UTIs.

Cystitis

A bladder infection or lower urinary tract infection (UTI) characterized by normal symptoms such as frequency, urgency, and dysuria.

Dysuria

The burning or painful sensation experienced when passing only a few drops of urine.

Upper UTI Symptoms

Symptoms that require immediate referral to a GP, including pain in the lower back, loin, or flank.

Systemic Infection Symptoms

General signs of infection such as fever, nausea, and vomiting that necessitate a GP referral.

Haematuria

The presence of blood in the urine; it may indicate a severe UTI, kidney stones (if painful), or bladder/kidney cancer (if painless).

Vaginal Atrophy

A condition in post-menopausal women that can mimic cystitis symptoms and requires referral to a GP.

Recurrent Cystitis

Cystitis that occurs frequently, which may be an indicator of underlying diabetes.

Alkalising Agents

Medications that help make urine more alkaline to relieve dysuria symptoms, but do not treat the underlying bacterial infection.

Potassium Citrate

An alkalising agent available as a mixture or $3\,g$ granules (e.g., Cystopurin®); it can cause hyperkalaemia and is contraindicated with K-sparing diuretics or ACE inhibitors.

Sodium Citrate

An alkalising agent (e.g., Cymalon®) available as $4\,g$ granules; it is contraindicated in patients with hypertension or heart disease due to sodium-induced fluid retention.

K-sparing diuretics

A class of medication (e.g., spironolactone) that is contraindicated with potassium citrate use because of the risk of severe hyperkalaemia.

Indwelling urinary catheter

A device used by catheterised patients that, if present during cystitis symptoms, requires a GP referral.

Empty Bladder Technique

A self-management method where a patient waits $20$ seconds after passing urine and then strains to empty final drops; leaning back may also help.

Cystopurin®

A brand of Potassium Citrate $3\,g$ granules for oral solution used for the effective relief of cystitis symptoms.

Cymalon®

A brand of Sodium Citrate $4\,g$ granules for oral solution used to relieve the burning pain of cystitis.

Referral Criteria for Age

All children under the age of $16$ years presenting with cystitis symptoms must be referred to a GP.

Referral Criteria for Males

All male patients presenting with cystitis symptoms must be referred to a GP.

Symptom Duration for Referral

Symptoms lasting longer than $2$ days or not improving after treatment require a GP referral.

WATER Rules

A mnemonic for cystitis prevention: Avoid irritants, Drink water normally, Take time to empty bladder, Erase bacteria (wipe front to back), and Relieve after sex (urinate after intercourse).

Natural Recovery Timeline

The period after which cystitis will typically get better on its own, usually within $3$ days.