Follicular cystitis: Description, Causes and Risk FactorsChronic cystitis characterized by small mucosal nodules due to lymphocytic infiltration.Follicular cystitis is the mucosa of the bladder is studded with nodules of various sizes, containing lymph follicles with germinal centers.Follicular cystitis is typically seen in the background of chronic cystitis. The underlying etiology can be infectious in nature, such as Salmonella (Rod-shaped Gram-negative enterobacteria; cause typhoid fever and food poisoning; can be used as a bioweapon) infection in the urinary tract, but follicular cystitis can also be seen during intravesical chemotherapy, Bacille Calmette-Guerin (BCG) - therapy, or following irradiation to the pubic area.The disease is common in chronic urinary tract infection. Small brownish nodules observed by cystoscopy, are often surrounded by inflammatory mucosa, but sometimes can be seen in the normal mucosa between nodules. Diseases are common in the trigone of the bladder or the bottom of bladder.In long-standing cases, the mucous membrane becomes very much thickened, affecting its capacity for retaining urine. The surface is not red and velvety, but assumes a purplish or slate color. Its surface is covered with a muco-pus, with here and there an ulcerated patch. There is enlargement of the follicles, and there may be so much obstruction of the ureteral orifices as to cause dilatation of the ureter and pelvis of the kidney, followed by hydronephrosis.Symptoms:Clinically, signs and symptoms are not particularly reliable. Patients may be asymptomatic, or may experience dysuria, frequency, urgency and suprapubic pain.Urine may be grossly cloudy.Diagnosis:Cytologically it differs from chronic cystitis with prominent lymphocytosis by the presence of cellular elements from the germinal centers of lymphoid follicles, reminiscent of the cytologic findings in follicular cervicitis, with possible additional epithelial cytologic atypias from the overlying urothelium, which frequently undergoes reactive changes (hyperplastic, metaplastic, and ulcerative). The practical aspect of recognition of this entity in cytologic specimens is avoiding diagnostic errors of possible malignancy (lymphoid or other), and also of other forms of inflammatory disease, such as granulomatous type, with a different clinical significance.

Follicular Cystitis Treatment:

The treatment is to control the infection, and is symptomatic treatment. There is no single treatment option for follicular cystitis. An effective course of treatment for one patient may not work for another. Antibiotics are prescribed if infection accompanies inflammation of the bladder. Drugs used to treat follicular cystitis are some of the same ones used to treat chronic cystitis. These may include bladder coatings, antidepressants and antihistamines. Antispasmodics and bladder anaesthetics may also be used.Surgical options, such as bladder augmentation or cystectomy, are sometimes considered, but only as a last resort after all other options have been exhausted.NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.