Pathology of the Bladder, Urethra and Vagina

Cystitis: Acute bladder inflammation is usually caused by coliforms and is associated with infections of the urethra and vagina. Communication with the gut predisposes to anaerobic bacterial infection. Granulomatous inflammation is seen with Mycobacterium Tuberculosis in association with renal tuberculosis and in patients with bladder carcinoma who have received Bacillus Calmette-Guerin (BCG) immunotherapy. Schistosomia Hematobium-associated inflammation predisposes to squamous cell carcinoma (SCC) of the bladder. Interstitial cystitis, commonly seen in middle-aged women, is characterised by tiny pinpoint haemorrhages on the bladder wall. The associated painful bladder syndrome is poorly understood and variably attributed to autoimmunity, unidentified allergies, unidentified infectious agents, increased cytotoxicity to cationic metabolites, defective surface epithelial layer function, role of mast cells and genetic predisposition, among others. Emphysematous cystitis is associated with immune-compromised states, uncontrolled diabetes and neurogenic bladder, and shows gas-filled cysts. Classic haemorrhagic cystitis is a side effect of cyclophosphamide therapy.