Cystitis Glandularis: Diagnosis, Monitoring, and Treatment Options

glandular cystitis

On December 1, 2012, the bladder biopsy report stated the diagnosis as: Urinary bladder (neck), transurethral biopsy, cystitis glandularis.
The specimen submitted consists of 2 pieces of mucosal tissue measuring up to 0.3 cm in greatest dimension.
All for section.
NOTE: Xone.

I previously discovered hematuria during a urinalysis, which led me to undergo a cystoscopy.
There was only one instance of hematuria, and I have not experienced it again since then.
I have only had one cystoscopy.

1.
I previously asked a doctor online, and they responded that cystitis glandularis is benign, but there is a small chance it could develop into malignancy.

2.
Currently, I go to the hospital every three months to check my urine for hematuria, and there has been no hematuria.
Is this examination sufficient? Are there any additional tests I should consider for more safety?
3.
If there is a possibility of it developing into malignancy, why can't the doctor remove the area that might become malignant? Thank you, doctor.

ERIC, 30~39 year old female. Ask Date: 2020/04/14

Dr. Li Xinyi reply Urology

If the biopsy report is benign and the doctor also considers it benign, there is generally no issue.
Even if you remove or cauterize it, there is no evidence to suggest that this would be beneficial; in fact, it may lead to complications such as inflammation, hematuria, and dysuria.
Following up with urine tests every three months is reasonable.
As for whether further examinations, such as a cystoscopy, are necessary, that should be discussed with your doctor.

Reply Date: 2020/04/14

More Info

Cystitis glandularis is a condition characterized by the presence of glandular tissue in the bladder, often resulting from chronic irritation or inflammation. It is important to understand the implications of this diagnosis, particularly regarding its potential for malignancy, monitoring strategies, and treatment options.

1. Understanding Cystitis Glandularis:
Cystitis glandularis is generally considered a benign condition. However, there is a recognized risk that it can progress to malignancy, particularly in cases where there is significant chronic irritation or inflammation. The presence of glandular tissue can be a response to various irritants, including recurrent urinary tract infections, bladder stones, or exposure to certain chemicals.
2. Diagnosis and Monitoring:
Your diagnosis was confirmed through a transurethral biopsy, which is the gold standard for diagnosing bladder conditions. The fact that you experienced hematuria (blood in urine) prompted further investigation, which is a common approach in urology to rule out more serious conditions, including bladder cancer. Since your follow-up urine tests have shown no blood, this is a positive sign.
Monitoring every three months with urine tests is a reasonable approach, especially if you have no symptoms or evidence of complications. However, it is essential to maintain regular follow-ups with your urologist. Depending on your clinical history and any changes in your symptoms, additional imaging studies or repeat cystoscopy may be warranted.
3. Further Investigations:
While urine tests are crucial for monitoring, they may not be sufficient alone. If there are any changes in your symptoms or if hematuria recurs, your physician may recommend a repeat cystoscopy to visually inspect the bladder and possibly take additional biopsies. Imaging studies, such as ultrasound or CT scans, can also be helpful in assessing the bladder and surrounding structures for any abnormalities.

4. Treatment Options:
The treatment for cystitis glandularis primarily focuses on addressing the underlying cause of irritation. If there are contributing factors such as infections or irritants, these should be managed appropriately. In some cases, if the glandular changes are extensive or if there is a significant risk of progression to malignancy, surgical intervention may be considered. This could involve resection of affected areas or more extensive procedures, depending on the extent of the disease and the clinical judgment of your urologist.

5. Surgical Considerations:
The question of why a potentially malignant area cannot be simply removed is complex. Surgical intervention is typically reserved for cases where there is clear evidence of malignancy or when the risk of progression is deemed significant. In the case of cystitis glandularis, if the lesions are not causing significant symptoms or complications, and if there is no definitive evidence of malignancy, the risks associated with surgery may outweigh the benefits.
In conclusion, cystitis glandularis is generally a benign condition, but it requires careful monitoring due to its potential for malignancy. Regular follow-ups with your urologist, urine tests, and possibly repeat cystoscopy are essential components of your management plan. If you have any concerns or if your symptoms change, do not hesitate to reach out to your healthcare provider for further evaluation and guidance.

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