The Association between Chronic Inflammation and Recurrent Cystitis in Women

Recurrent urinary tract infection is a common infectious disease seen in the clinic. It is very prevalent in women; as many as 15% of women develop urinary tract infection each year, and at least 25% have one or more recurrences. Chronic inflammation and increased urothelial apoptosis reflect a common pathophysiology in various lower urinary tract dysfunctions, causing bladder storage symptoms. It has been suggested that chronic inflammation could be associated with overactive detrusor and increased levels of urinary nerve growth factor and creatinine. The level of urinary nerve growth factor may decrease after an effective antimuscarinic therapy. Recurrent urinary tract infection could be prevented by using nonsteroidal anti-inflammatory drugs or cyclooxygenase-2 inhibitors. Intravesical hyaluronate and chondroitin sulfate reduce the incidence of recurrent bacterial cystitis, and treatment with hyaluronate targets bacterial adherence to the bladder mucosa in interstitial cystitis/bladder pain syndrome. This article reviews the pathophysiology of chronic inflammation of the bladder and investigates the association between chronic inflammation and recurrent urinary tract infection.