Acute cystitis

At a glance

  • The main symptoms of cystitis are pain or burning when peeing and the urge to “go” more often.
  • It is far more common in women than in men.
  • Antibiotics help fast – but aren’t always needed.
  • Uncomplicated cystitis usually goes away without any trouble.


Photo of a woman on a sofa chatting on the phone

Cystitis is a type of urinary tract (UTI) where the bladder is inflamed. Many women know the symptoms all too well. These include frequent trips to the bathroom and a stinging and burning sensation when peeing. Although the symptoms are often very unpleasant, there are effective treatments.

Uncomplicated cystitis usually clears up without any problems. Antibiotics are effective, but they aren't always needed.

Unfortunately, there's no sure-fire way to reliably prevent cystitis, and much of the common advice on preventing it hasn't been scientifically tested.


Cystitis makes you pee more often, and that can be painful or cause a burning sensation. So you not only have to go to the toilet more often; going to the toilet can be very unpleasant too.

Many women find that it's particularly painful when their bladder is almost or completely empty. The urge to pee often comes very suddenly and they quickly need to get to a bathroom – but often only a small amount of urine (pee) comes out. Some women have difficulties holding back urine, which can be very distressing. The urine may be cloudy in color and have an unusual smell, and sometimes has blood in it.

The pain might spread across your entire abdomen (belly) or into your back. Severe cystitis can make you feel generally ill, weak and irritable, and affect your sleep.

Sometimes urine tests detect although the person doesn't have any noticeable symptoms. That is called “asymptomatic bacteriuria.” It is usually harmless.


Uncomplicated cystitis is an of the mucous membranes lining the bladder. It is normally caused by bacteria outside the body that get into the urethra (the tube that leads to the bladder), enter the bladder and then grow there.

Risk factors

Having sex increases the risk of getting cystitis because it increases the likelihood of entering the urethra. Sperm-killing creams and gels (spermicides) and contraceptive diaphragms can also increase the risk somewhat.

Pregnant women are more likely to get cystitis. Other high-risk groups include people who have a urinary or anatomical changes in their urinary tract, as well as people who have diabetes, multiple sclerosis or a urological disease.

Women who have already had cystitis are also more likely to get it again. It is more common after menopause.


Women are much more likely than men to get cystitis because their urethra is shorter, which makes it easier for to enter the bladder. About 10 out of 100 women have cystitis at least once a year. Half of those women have it again within one year.


If the symptoms stay in the lower urinary tract (the bladder and the urethra) and there are no risk factors for severe cystitis or complications, then the cystitis is referred to as "uncomplicated." This is easy to treat and usually goes away without any trouble.

The cystitis is "complicated" if there's a greater risk of it leading to other medical problems (complications). This is the case in, for example,

  • men,
  • people with a weakened ,
  • those who already have kidney damage and
  • people who have anatomical abnormalities or changes in their urinary tract.

If there's a higher risk of the spreading to the kidneys, it is considered to be a complicated case of cystitis too. If the travel up the ureters (the tubes that lead from the bladder to the kidneys) and into the kidneys, they can cause an inflammation of the renal pelvis. This is called .

You should urgently seek a doctor or go to a hospital if you have cystitis and the following symptoms develop:

  • Pain near the kidneys (flank pain)
  • Fever
  • Nausea and vomiting

These symptoms may be a sign of , which can be dangerous and should be treated quickly to avoid long-term damage. Pyelonephritis is very rare, though.


Your doctor can assess whether you have uncomplicated cystitis based on your medical history and symptoms. You can also give a urine sample at the doctor's office, where they can examine it using a test strip. If your symptoms lead to a clear , you usually won't need to do any other urine tests.

Ultrasound can be used to examine your kidneys and bladder. This examination is typically only done if you have complicated cystitis or if it keeps coming back. X-rays and an examination known as a cystoscopy are also done in very rare cases, for instance if you have severe cystitis that keeps coming back. A cystoscopy is a procedure that involves inserting a tube with a small camera at the end of it (an ) into the urethra and guiding it through to the bladder. The doctor can look at the images produced by the camera to see whether there is anything abnormal on the wall of the bladder.

Often, just a visit to your family doctor is enough. But you can also go to see a gynecologist or urologist.


Sometimes cystitis comes "out of the blue" and there is no clear cause. Women who get cystitis a lot can try to look out for typical triggers in everyday life. If these triggers can't be avoided and you still have recurrent cystitis, you can take medication to prevent cystitis.

Although this medication can effectively prevent cystitis, it needs to be used regularly. And it has side effects.

Learn more

Preventing cystitis


For many women, cystitis is a one-time unpleasant issue. For others, it's a recurrent bothersome problem. Antibiotics usually help to relieve acute cystitis quite fast and shorten the duration of the disease. But you don't always need to take . Uncomplicated cystitis clears up in 30 to 50 out of 100 women within one week even if they don't use – and not using generally isn't expected to result in complications. If someone has complicated cystitis, though, it will definitely have to be treated with . You can talk to your doctor about whether it makes sense for you to use .

If you have mild to moderate symptoms, you can use painkillers like acetaminophen (paracetamol) or ibuprofen instead. They can relieve the pain until the body has fought off the itself. There are also some household remedies that are believed to help – such as drinking a lot of fluids and applying heat.

Benseler A, Anglim B, Zhao ZY et al. Antibiotic prophylaxis for urodynamic testing in women: a systematic review. Int Urogynecol J 2021; 32(1): 27-38.

Carey MR, Vaughn VM, Mann J et al. Is Non-Steroidal Anti-Inflammatory Therapy Non-Inferior to Antibiotic Therapy in Uncomplicated Urinary Tract Infections: a Systematic Review. J Gen Intern Med 2020; 35(6): 1821-1829.

Deutsche Gesellschaft für Allgemeinmedizin und Familienmedizin (DEGAM). Brennen beim Wasserlassen. S3-Leitlinie und Anwenderversion der S3-Leitlinie Harnwegsinfektionen. AWMF-Registernr.: 053-001. 2018.

Deutsche Gesellschaft für Urologie (DGU). Interdisziplinäre S3 Leitlinie: Epidemiologie, Diagnostik, Therapie, Prävention und Management unkomplizierter, bakterieller, ambulant erworbener Harnwegsinfektionen bei erwachsenen Patienten. Aktualisierung 2017. AWMF-Registernr.: 034-044. 2017.

Falagas ME, Kotsantis IK, Vouloumanou EK et al. Antibiotics versus placebo in the treatment of women with uncomplicated cystitis: a meta-analysis of randomized controlled trials. J Infect 2009; 58(2): 91-102.

Jent P, Berger J, Kuhn A et al. Antibiotics for Preventing Recurrent Urinary Tract Infection: Systematic Review and Meta-analysis. Open Forum Infect Dis 2022; 9(7): ofac327.

Malterud K, Baerheim A. Peeing barbed wire. Symptom experiences in women with lower urinary tract infection. Scand J Prim Health Care 1999; 17(1): 49-53.

Ong Lopez AM, Tan CJ, Yabon AS et al. Symptomatic treatment (using NSAIDS) versus antibiotics in uncomplicated lower urinary tract infection: a meta-analysis and systematic review of randomized controlled trials. BMC Infect Dis 2021; 21(1): 619.

Scott AM, Clark J, Mar CD et al. Increased fluid intake to prevent urinary tract infections: systematic review and meta-analysis. Br J Gen Pract 2020; 70(692): e200-e207.

Zalmanovici Trestioreanu A, Green H, Paul M et al. Antimicrobial agents for treating uncomplicated urinary tract infection in women. Cochrane Database Syst Rev 2010; (10): CD007182.

IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

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Updated on February 27, 2023

Next planned update: 2026


Institute for Quality and Efficiency in Health Care (IQWiG, Germany)

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