The clinical significant of cystitis cystica in girls: results of a prospective study.

Twenty-two girls with recurrent urinary tract infection and endoscopically proved cystitis cystica were studied prospectively to determine control of infection with long-term, continuous nitrofurantoin or sulfisoxazole (6 to 12 months), effect on the bladder changes and rate of recurrence of infection after discontinuation of medication. Infection was controlled equally with both drugs but, despite adequate control, 24% had evidence of cystic changes upon completion of the treatment period. An additional 44% became reinfected during the 1-year followup with no drugs. Only one-third of those presenting with urinary frequency, urgency and urge incontinence had improvement of these symptoms with control of infection alone. It appears that childhood cystitis cystica is the response of the bladder to long-term, inadequately treated bacterial lower urinary tract infection. Many months to years of continuous medication are required for healing. Toilet retraining, in addition to anticholinergics, also may be necessary to achieve urinary control.