Introduction. Encrusting cystitis (IC) is a rare chronic inflammatory disease of the bladder with damage to the mucous membrane by incrustations and formation of stones.
Objective: to improve the efficiency of treatment of patients with chronic incrusting cystitis.
Materials and methods. A randomized, prospective, single-center study included 33 patients with IC: Group I – 18 patients who underwent surgical treatment (endoscopic removal of stones and incrustations from the bladder cavity), antibacterial therapy based on urine culture results, oral L-methionine for 1 month, and bladder instillations with a solution with an acidic pH; Group II – 15 patients who underwent the same treatment, but without bladder instillations.
Results. The age of patients ranged from 39 to 78 years. In 32 (96.9%) cases, there was a history of bladder catheterization. In both groups, al- kaline urine reaction, hematuria and leukocyturia were detected. Bacteriuria was detected in 24 (72.7%) patients with IC. CU was not detected in any patient. The dynamics of the general urine analysis 1 month after treatment in both groups demonstrated a reliable improvement in comparison with the preoperative data, thus: in group I, leukocyturia decreased from 88.8±23.3 in field of view to 8.6±5.7 in field of view, the urine pH level decreased from 7.9±0.2 to 6.0±0.4; in group II, leukocyturia – from 67.8±7.0 in field of view to 29.1±17.0 in field of view; urine pH level – from 8.2±0.3 to 7.0±0.7 (p<0.05). After 3 months, efficacy was achieved in 18 (100%) cases in Group I, while in Group II, recurrence of IC was detected in 13 (86.7%) cases.
Conclusion. A comprehensive approach to the treatment of encrusting cystitis (endoscopic removal of encrustations/calculi in the bladder lumen, intravesical instillations of solutions with an acidic pH, antibacterial therapy based on culture results, and oral medications that lower urine pH) has improved the effectiveness of treatment for patients with this disease.
