The role of bladder ultrasound in the differential diagnosis of the acute phase of recurrent viral cystitis

Alkhashash A.M.S., Goncharov I.D., Palenyi A.I., Mezhidova A.D., Ibishev Kh.S., Kogan M.I.

1) Rostov State Medical University, Rostov-on-Don, Russia; 2) Rostov State Medical University Urology Research Institute, Rostov-on-Don, Russia; 3) Professional Medical Center, Rostov-on-Don, Russia; 4) Rostov Clinical Hospital – Southern District Medical Center of the Federal Medical and Biological Agency of Russia, Rostov-on-Don, Russia

Introduction. Chronic recurrent cystitis (CRC) is one of the most common urinary tract diseases in women, characterized by a recurrent course. Diagnosis of CRC requires a comprehensive approach, including clinical assessment, laboratory, and instrumental methods. One of the key non-invasive methods used in the diagnosis and differential diagnosis of CRC of any origin is bladder ultrasound.
Study objective: To study the ultrasound characteristics of the bladder in patients with CRC depending on the etiologic viral factor.
Materials and methods: This prospective study included 162 sexually active women aged 20–45 years who had previously been diagnosed with CRC. Depending on the viral etiology identified by PCR diagnostics, patients with CRC were divided into three groups: Group 1 (n=121) – CRC of human papillomavirus etiology (CRC PVE), Group 2 (n=30) – CRC caused by the herpes virus (CRC GE), and Group 3 (n=11) – CRC caused by the Epstein-Barr virus (CRC EBE). Statistical data on bladder volume and wall thickness, as well as the presence of pathological formations, were compared.
Results. In CRC PVE, bladder wall thickening (> 5 mm in 45.4% of patients), fibrous changes (51.3%), and polypoid formations (51.2%, primarily in the Lieto triangle) were noted. In cases of viral cystitis associated with hepatic encephalopathy, localized thickening of the trigone wall was observed (30%), while in cases of chronic cystitis associated with the Epstein-Barr virus, changes were minimal: volume loss in 20% and bladder sediment in 20%.
Conclusions: Bladder ultrasound is an informative, noninvasive method that allows for the assessment of structural and functional changes in viral cystitis and the identification of an etiologic factor. However, definitive diagnosis requires a comprehensive examination, including clinical data, laboratory (including PCR), and endoscopic (cystoscopy) tests.

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About the Authors

Corresponding author: Kh.S. Ibishev – Doctor of Medical Sciences, Professor, Department of Urology and Human Reproductive Health (with a course in pediatric urology-andrology), Rostov State Medical University, Rostov-on-Don, Russia; e-mail: ibishev22@mail.ru

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