Catheter-induced cystitis: evaluation by cystosonography

The bladders of 23 patients with indwelling catheters were examined by ultrasound and cystoscopy. Twelve of the 23 showed changes consistent with bullous cystitis, a catheter-induced reaction of the bladder mucosa that may simulate a bladder tumor on intravenous urography and sonography. The changes seen included a thickened mucosa that was smooth in the early stages, becoming redundant and polypoid in later stages. The mucosa was usually hypoechoic and the lesions were localized on the posterior wall or were diffuse and more severe, depending on the length of catheterization. It is concluded that the sonographic findings in the appropriate clinical setting are suggestive of this entity. Although cystoscopy is not often indicated, cystoscopic findings are diagnostic and biopsy is, therefore, unnecessary.