Emphysematous Cystitis: Risk Factors, Symptoms, Diagnosis, Treatment

Emphysematous cystitis is a rare type of urinary tract infection that leads to gas build-up in and around the urinary bladder. Although the real cause of gas build-up is not known but it is believed to be caused by three types of bacteria, which are Escherichia coli, Klebsiella pneumoniae, and Enterobacter species.⁽¹⁾

There are a few factors that may increase the risk of a person suffering from emphysematous cystitis.

Emphysematous cystitis is more common in people over 60 years of age. A review found that the average age of people with this condition was 65.7 for men and 69.3 for women.⁽¹⁾

Diabetes is considered the most common risk factor for emphysematous cystitis. Research shows that half the number of people with emphysematous cystitis have diabetes and also urinary tract infection occurs more likely in those with diabetes.⁽²⁾

Neurogenic bladder is a condition in which there is a lack of bladder control and is caused due to spinal cord, brain, and nerve problems.

This condition is often associated with Alzheimer’s disease, cerebral palsy and multiple sclerosis. A neurogenic bladder can also be due to diabetes and herniated disk.

Obstructive uropathy blocks the urine flow in the urinary tract and can affect one or both kidneys.

A person with a weakened immune system is more likely to suffer from emphysematous cystitis.

Someone with an indwelling urethra catheter is more at risk of emphysematous cystitis as this type of catheter stays in place for a few months after insertion

Those with chronic urinary tract infections are more at risk of developing emphysematous cystitis.

Pain in the abdomen is the main symptom of emphysematous cystitis and more than half of people with this condition report abdominal pain.⁽³⁾

Other symptoms of emphysematous cystitis include:

• Urinary urgency, which leads to frequent urination
• Dysuria, burning and tingling in the urine
• Pneumaturia, the passage of air in the urine
• Fever

Emphysematous cystitis can be asymptomatic. It is therefore important for people with the risk of emphysematous cystitis to be aware of the symptoms.

Early diagnosis of Emphysematous cystitis is important for proper treatment and a delay can lead to adverse outcomes.

The symptoms of a person are evaluated and tests are conducted which include urinalysis and imaging scans.

Urinalysis can look for blood, pus, bacteria, and sugar in the urine. An imaging test can help in looking for air in the urinary tract and around the bladder. The tests done are ultrasound, x-ray, and CT scans. These help in ruling out the other possible causes of pain in the abdomen.

Most cases of emphysematous cystitis are treated with antibiotics. Some advanced cases would need surgery.

The treatment of emphysematous cystitis usually lasts for 4 weeks and the duration depends on the severity of the infection, medical history, and other complications. As the antibiotics absorb the infection the body reabsorbs the gas relieving the person from the discomfort.

Other comorbidities such as diabetes are treated. This helps in the prevention of recurrence of the condition.

The outlook of emphysematous cystitis is good, but the treatment should not be delayed as it can lead to a life-threatening kidney infection known as emphysematous pyelonephritis.

Emphysematous cystitis is a rare type of urinary tract infection and can be treated well if detected early. Therefore, anyone experiencing its symptoms should contact a doctor quickly to prevent avoidable complications.