Treatment of Chronic Cystitis in Children

Chronic inflammatory processes of the urinary bladder’s wall dominate in the structure of urologic diseases in children, but the issue of their treatment still remains very acute. Despite the use of modern methods of treatment, children with chronic recurrent cystitis constitute a significant part of the total number of hospitalized patients (19 to 21%). In recent years quite many morphological studies of the bladder’s mucosa during inflammatory diseases were held. However, the mechanism that leads to the damage of the urothelium in chronic cystitis and factor that determines the type of metaplasia during inflammation of the bladder are unclear. Endoscopic examination, in some cases, does not allow differentiating inflammatory from tumor-like lesions of the mucosa. Destructive lesions of the bladder’s mucosa occur during exacerbation of chronic inflammation or severe, far gone acute inflammation. Therefore, conducting endovesical biopsy is necessary for clarifying forms of chronic cystitis and identifying urothelial hyperplasia or dysplasia and is critical in the diagnosis of diseases of the urinary bladder. It is still unclear under what endoscopic and morphological forms of recurrent cystitis in children neurogenic bladder disorders are more frequent and for what form of recurrent cystitis most pronounced neurogenic bladder dysfunctions are more likely to occur. The nature and extent of neurogenic disorders in children with various forms of recurrent cystitis in the late periods after antireflux surgeries remain unexplored.