BMJ 1996;313:1079 (26 October)

Letters

Postmenopausal cystitis

Bladder cancer may be a cause, but interstitial cystitis is an unusual differential diagnosis

EDITOR,--Linda Cardozo is right to draw attention to the problem of postmenopausal cystitis and the use of topical oestrogens in its treatment.1 Topical oestrogens are almost certainly underused in this condition. From the urological perspective, however, certain important points should be emphasised.

Firstly, ultrasonography is probably preferable to intravenous urography for imaging. Ultrasonography will quantify residual urine and detects renal and bladder calculi better than plain radiography. Ureteric stones (which ultrasonography will probably miss) are virtually never the isolated cause of recurrent infections. Ultrasonography spares the patient irradiation and the finite risk of a reaction to contrast medium.

Secondly, bladder cancer is an important consideration in postmenopausal women who present with irritative voiding symptoms. There can be few urologists who have not seen patients referred late with bladder tumours after inappropriate management for other presumed causes . . . [Full text of this article]


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Relevant Article

Postmenopausal cystitis
Linda Cardozo
BMJ 1996 313: 129. [Extract] [Full Text]

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