Eosinophilic cystitis

　　1. Etiology

　　The etiology of eosinophilic cystitis is not yet clear. However, it is generally believed to be related to various stimuli, such as bacteria, drugs, foreign proteins, and food allergens. These allergens act as immunostimulants, forming immune complexes in the bladder, leading to eosinophil infiltration, destroying bladder tissue, and subsequently causing lysosomal release, further aggravating bladder inflammation. Foods that may be related to the disease include oranges, tomatoes, chocolate, tea, coffee, cocoa, milk, and various seasonings. Some patients have found that symptoms are significantly reduced and the frequency of attacks is significantly reduced when they stop consuming the above foods and beverages. Drugs that may be related include sulfonamides, sodium dicoumarin, sodium salicylate, etc. In addition, condoms, vaginal suppositories, and spermicidal gels can be contact allergens. The deposition of schistosome eggs in the bladder wall can form schistosomal eosinophilic granuloma. Drug and food allergens are more likely to cause diffuse cystitis, while damage caused by parasites is localized.

　　2. Pathogenesis

　　Eosinophilic bladder mucosal erythema, edema, ulceration, and velvety changes. If it is hyperplastic damage, it may be similar to papilloma and grape-like sarcoma, and sometimes there are nodules the size of soybean or mung bean, or present as fine granular protrusions. The lower end of the ureter is involved and narrowed, which can cause bilateral renal and ureteral hydrops. Biopsy shows fibrosis, local necrosis, and a large number of eosinophils infiltrating the entire bladder wall, some of which are bladder eosinophilic granuloma.

　　When the lesion involves both lower segments of the ureters, it can cause upper urinary tract obstruction and hydrops, which are the main complications of this disease. Other complications include the following concurrent diseases:

　　1. Common complications include stones with pain, tumors with hematuria, and urethral stricture with difficulty in urination, etc.

　　2. Swelling and pain in the affected side of the waist due to hydrops.

　　3. Concurrent infection may have chills, fever, and pyuria.

　　4. Cystic mass on the affected side of the waist.

　　5. Bilateral obstruction may lead to chronic renal insufficiency and uremia.

　　Hematuria or pyuria, frequent urination, urgency, dysuria, pain during urination does not diminish after urination, difficulty in urination, severe cases may even appear urinary retention, symptoms often recur and tend to be chronic, patients often have a history of allergy or asthma.

　　Although the etiology of this disease is not yet clear, carefully identifying the cause of sensitization and reducing or avoiding antigenic stimulation are important measures for preventing the disease. If there are symptoms of allergic rhinitis such as seasonal runny nose, sneezing, and nasal congestion, it is advisable to actively undergo allergen testing. If there is a positive allergen, desensitization treatment should be carried out, which can effectively prevent the occurrence of eosinophilic cystitis.

　　Blood routine examination may show an increase in eosinophils, and urine routine examination may show proteinuria, hematuria, or pyuria, with negative midstream urine culture.

　　1. IVU:It can show ureteral dilation or reflux.

　　2. Cystoscopy:Visible wide-based neoplasms in the bladder, mostly located on the posterior wall of the bladder and around the ureteral orifice. Biopsy is helpful for confirming the diagnosis, and pathological examination shows a large number of eosinophils infiltrating the bladder mucosa.

　　I. Foods to Eat in Cystitis

　　1. Drink plenty of water, maintaining a daily urine output of at least 1500 milliliters or more.

　　2. Eat more diuretic foods, such as watermelons, grapes, pineapples, celery, pears, etc.

　　3. Clams, corn, mung beans, and scallion whites can help alleviate symptoms such as frequent urination, urgency, and dysuria.

　　II. Foods to Avoid in Cystitis

　　1. Avoid eating sour and spicy刺激性 food, such as strong alcohol, chili, balsamic vinegar, sour fruits, etc.

　　2. Avoid eating citrus fruits, as they can cause alkaline urine, which is conducive to bacterial growth.

　　3. Caffeine can cause bladder neck contraction and cause spasmodic pain in the bladder, so it is advisable to drink less coffee.

　　III. Prevention of Cystitis

　　In addition to attention to diet, cystitis should also pay attention to prevention in daily life, mainly including the following preventive measures:

　　1. Pay attention to hygiene

　　Cystitis often occurs due to unclean perineum, bacteria ascending from the urethra, leading to infection, so it is necessary to change underwear frequently, clean often, and pay attention to the cleanliness of the perineum, and pay attention to sexual hygiene.

　　2. Urination should be completed

　　Each time urination should be completed, leaving no residual urine in the bladder. It is advisable to urinate once after each sexual intercourse.

　　I. Treatment

　　1. Use antihistamines and corticosteroids.

　　2. Carefully search for allergens, avoid antigenic stimulation, and perform desensitization therapy.

　　3. Secondary infection should be treated with antibiotics, and anticholinergic drugs such as Shenningting can be used for obvious urinary tract irritation symptoms.

　　4. Local lesions can be treated by electrocoagulation, electrocision, or partial cystectomy.

　　II. Prognosis

　　The prognosis of this disease is good, but due to its association with allergic factors, there is a possibility of recurrence.