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Liu Y, Yang W, Zhao L, Liang Z, Shen W, Hou Q, Wang Z, Jiang J, Ying S. Immune analysis of expression of IL-17 relative ligands and their receptors in bladder cancer: comparison with polyp and cystitis. BMC Immunol 2016; 17:36. [PMID: 27716046 PMCID: PMC5048669 DOI: 10.1186/s12865-016-0174-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Accepted: 09/23/2016] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Bladder cancer, cystitis and bladder polyp are the most common urinary system diseases all over the world. Our former research results show that IL-17A and IL-17 F contribute to the pathogenesis of benign prostatic hyperplasia (BPH) and prostate cancer (Pca) while IL-17E interacting with IL-17RB might have an anti-tumor effect. RESULTS Using imunohistochemistry, we systemically compared immunoreactivity of ligands (IL-17A, E and F) and receptors (IL-17RA, IL-17RB and IL-17RC) of IL-17 family, infiltration of inflammatory cells and changes of structural cells (fibroblast cells, smooth muscle and vascular endothelial cells) in sections of bladder tissues from subjects with bladder cancer, cystitis and bladder polyp. Compared with subjects with cystitis, immunoreactivity for IL-17A, IL-17 F and IL-17RC was significantly elevated in the group of bladder cancer (p < 0.01), while immunoreactivity of IL-17E, IL-17RA and IL-17RB, and the infiltrating neutrophils were decreased (p < 0.05). The numbers of infiltrating lymphocytes and phagocytes and CD31+ blood vessels and immunoreactivity of CD90+ fibroblasts were also elevated in patients with bladder cancer compared with those of cystitis. The patterns of IL-17 ligands and receptors, and inflammatory cells and structural cells varied in cystitis, bladder polyp and bladder cancer. In bladder cancer, immunoreactivity of IL-17E and IL-17 F was positively correlated with smooth muscles and lymphocytes, respectively. In addition, immunoreactivity of IL-17A and IL-17E was positively correlated with their receptors IL-17RA and IL-17RB respectively. CONCLUSIONS The data suggest that changed patterns of expression of the IL-17 cytokine family ligands and receptors might be associated with infiltration of inflammatory cells and structural cells (CD90+ fibroblasts and CD31+ blood vessels), which might also contribute to occurrence and development in bladder cancer.
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Affiliation(s)
- Yanbo Liu
- The Clinical Immunology Research Centre, Beihua University, No. 3999 Binjiang Road, Jilin City, Jilin, China
| | - Wanguo Yang
- The Clinical Immunology Research Centre, Beihua University, No. 3999 Binjiang Road, Jilin City, Jilin, China
| | - Lijing Zhao
- The Pathophysiology department of basic medical college, Jilin University, NO. 126, Xinmin street, Changchun City, Jilin, China
| | - Zuowen Liang
- The Andrology Department of the First Hospital, Jilin University, NO. 71 Xinmin street, Changchun City, Jilin, China
| | - Weigao Shen
- The Clinical Immunology Research Centre, Beihua University, No. 3999 Binjiang Road, Jilin City, Jilin, China
| | - Qinlong Hou
- The Clinical Immunology Research Centre, Beihua University, No. 3999 Binjiang Road, Jilin City, Jilin, China
| | - Zhenjiang Wang
- The Clinical Immunology Research Centre, Beihua University, No. 3999 Binjiang Road, Jilin City, Jilin, China
| | - Jing Jiang
- The Clinical Immunology Research Centre, Beihua University, No. 3999 Binjiang Road, Jilin City, Jilin, China
| | - Sun Ying
- The Clinical Immunology Research Centre, Beihua University, No. 3999 Binjiang Road, Jilin City, Jilin, China. .,Guy's Hospital, AALB, 5th Floor Tower Wing, London, SE1 9RT, UK.
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Doiron RC, Tolls V, Irvine-Bird K, Kelly KL, Nickel JC. Clinical Phenotyping Does Not Differentiate Hunner Lesion Subtype of Interstitial Cystitis/Bladder Pain Syndrome: A Relook at the Role of Cystoscopy. J Urol 2016; 196:1136-40. [DOI: 10.1016/j.juro.2016.04.067] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2016] [Indexed: 12/30/2022]
Affiliation(s)
| | - Victoria Tolls
- Department of Urology, Queen’s University, Kingston, Ontario, Canada
| | - Karen Irvine-Bird
- Department of Urology, Queen’s University, Kingston, Ontario, Canada
| | - Kerri-Lynn Kelly
- Department of Urology, Queen’s University, Kingston, Ontario, Canada
| | - J. Curtis Nickel
- Department of Urology, Queen’s University, Kingston, Ontario, Canada
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Abstract
Although pelvic pain is a symptom of several structural anorectal and pelvic disorders (eg, anal fissure, endometriosis, and pelvic inflammatory disease), this comprehensive review will focus on the 3 most common nonstructural, or functional, disorders associated with pelvic pain: functional anorectal pain (ie, levator ani syndrome, unspecified anorectal pain, and proctalgia fugax), interstitial cystitis/bladder pain syndrome, and chronic prostatitis/chronic pelvic pain syndrome. The first 2 conditions occur in both sexes, while the latter occurs only in men. They are defined by symptoms, supplemented with levator tenderness (levator ani syndrome) and bladder mucosal inflammation (interstitial cystitis). Although distinct, these conditions share several similarities, including associations with dysfunctional voiding or defecation, comorbid conditions (eg, fibromyalgia, depression), impaired quality of life, and increased health care utilization. Several factors, including pelvic floor muscle tension, peripheral inflammation, peripheral and central sensitization, and psychosocial factors, have been implicated in the pathogenesis. The management is tailored to symptoms, is partly supported by clinical trials, and includes multidisciplinary approaches such as lifestyle modifications and pharmacological, behavioral, and physical therapy. Opioids should be avoided, and surgical treatment has a limited role, primarily in refractory interstitial cystitis.
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Affiliation(s)
- Adil E Bharucha
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Mayo Clinic, Rochester, MN.
| | - Tae Hee Lee
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Mayo Clinic, Rochester, MN
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Update on Urinary Tract Markers in Interstitial Cystitis/Bladder Pain Syndrome. Female Pelvic Med Reconstr Surg 2016; 22:16-23. [PMID: 26571430 DOI: 10.1097/spv.0000000000000224] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Interstitial cystitis (IC)/painful bladder syndrome/bladder pain syndrome (BPS) is a chronic hypersensory condition of unknown etiology. Moreover, the optimal modality for diagnosing IC remains disputed. Several urinary markers have been investigated that may have potential utility in the diagnosis or confirmation of IC/BPS. Thus, inflammatory mediators, proteoglycans, urinary hexosamines, proliferative factors, nitric oxide (NO), BK polyomavirus family, and urothelial proinflammatory gene analysis have been found to correlate with varying degrees with the clinical diagnosis or cystoscopic findings in patients with IC/BPS. The most promising urinary biomarker for IC/BPS is antiproliferative factor, a sialoglycopeptide that has demonstrated inhibitory effects on urothelial cell proliferation and a high sensitivity and specificity for IC/BPS symptoms and clinical findings. In this article, we review the urinary markers, possible future therapies for IC/BPS, and the clinical relevance and controversies regarding the diagnosis of IC/BPS.
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Shim JS, Kang SG, Park JY, Bae JH, Kang SH, Park HS, Moon DG, Cheon J, Lee JG, Kim JJ, Oh MM. Differences in Urodynamic Parameters Between Women With Interstitial Cystitis and/or Bladder Pain Syndrome and Severe Overactive Bladder. Urology 2016; 94:64-9. [PMID: 27130264 DOI: 10.1016/j.urology.2016.04.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2016] [Revised: 04/04/2016] [Accepted: 04/04/2016] [Indexed: 11/17/2022]
Affiliation(s)
- Ji Sung Shim
- Department of Urology, Korea University Medical Center, Seoul, Republic of Korea
| | - Sung Gu Kang
- Department of Urology, Korea University Medical Center, Seoul, Republic of Korea
| | - Jae Young Park
- Department of Urology, Korea University Medical Center, Seoul, Republic of Korea
| | - Jae Hyun Bae
- Department of Urology, Korea University Medical Center, Seoul, Republic of Korea
| | - Seok Ho Kang
- Department of Urology, Korea University Medical Center, Seoul, Republic of Korea
| | - Hong Seok Park
- Department of Urology, Korea University Medical Center, Seoul, Republic of Korea
| | - Du Geon Moon
- Department of Urology, Korea University Medical Center, Seoul, Republic of Korea
| | - Jun Cheon
- Department of Urology, Korea University Medical Center, Seoul, Republic of Korea
| | - Jeong Gu Lee
- Department of Urology, Korea University Medical Center, Seoul, Republic of Korea
| | - Je Jong Kim
- Department of Urology, Korea University Medical Center, Seoul, Republic of Korea
| | - Mi Mi Oh
- Department of Urology, Korea University Medical Center, Seoul, Republic of Korea.
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Cox A, Golda N, Nadeau G, Curtis Nickel J, Carr L, Corcos J, Teichman J. CUA guideline: Diagnosis and treatment of interstitial cystitis/bladder pain syndrome. Can Urol Assoc J 2016; 10:E136-E155. [PMID: 27790294 PMCID: PMC5065402 DOI: 10.5489/cuaj.3786] [Citation(s) in RCA: 83] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Ashley Cox
- Department of Urology, Dalhousie University, Halifax, NS, Canada
| | - Nicole Golda
- Department of Urology, North York General Hospital, Toronto, ON, Canada
- Department of Surgery, University of Toronto, Toronto, ON, Canada
| | | | | | - Lesley Carr
- Department of Surgery, University of Toronto, Toronto, ON, Canada
| | | | - Joel Teichman
- University of British Columbia, Vancouver, BC, Canada
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Update on the Pathology and Diagnosis of Interstitial Cystitis/Bladder Pain Syndrome: A Review. Int Neurourol J 2016; 20:13-7. [PMID: 27032552 PMCID: PMC4819162 DOI: 10.5213/inj.1632522.261] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 03/04/2016] [Indexed: 01/22/2023] Open
Abstract
Interstitial cystitis/bladder pain syndrome (IC/BPS) is characterized by bladder discomfort, urinary frequency, urgency, and pelvic pain. The etiology and pathogenesis of this condition is still unknown and remains diagnosed by exclusion. The histologic findings are also neither specific for diagnosis nor correlated with symptoms. However, the definition and diagnostic criteria for the condition was established in the last decade. In this paper, we review the changes in the definition, terminology, and diagnostic scheme of IC/BPS, and summarize the histologic findings. We also briefly discuss some new pathologic suggestions and new urinary markers, focusing on the most promising ones.
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Revisiting the Role of Potassium Sensitivity Testing and Cystoscopic Hydrodistention for the Diagnosis of Interstitial Cystitis. PLoS One 2016; 11:e0151692. [PMID: 26999787 PMCID: PMC4801189 DOI: 10.1371/journal.pone.0151692] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Accepted: 03/02/2016] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES To revisit the diagnostic roles of cystoscopic hydrodistention and the potassium sensitivity test (PST) for the diagnosis of interstitial cystitis (IC). METHODS We prospectively enrolled 214 patients clinically diagnosed with IC, 125 non-IC patients who underwent video urodynamic studies and PST, and another 144 non-IC patients who underwent cystoscopic hydrodistention before transurethral surgery. The sensitivity, specificity, and positive and negative predictive values were calculated for the PST and glomerulations after cystoscopic hydrodistention. RESULTS After cystoscopic hydrodistention, glomerulations developed in 211/214 (98.6%) IC patients and 61/144 (42.4%) of the non-IC patients including patients with stones (45/67, 67%), hematuria (2/5, 40%), and stress urinary incontinence (SUI) (6/17, 35%). When positive glomerulation was defined as grade 2 or more, the sensitivity was 61.7%. The PST was positive in 183/214 (85.5%) IC patients and 7/17 (41%) with hypersensitive bladder, 7/32 (22%) with detrusor overactivity, 5/27 (18%) with SUI, 2/21 (10%) with lower urinary tract symptoms, and 2/25 (8%) with bladder outlet obstruction. The PST had a sensitivity of 85.5% and a specificity of 81.6% for diagnosis of IC. IC patients with a positive PST had a significantly smaller urgency sensation capacity, smaller voided volume, and greater bladder pain score. CONCLUSIONS Both the PST and glomerulations after hydrodistention are sensitive indicators of IC, but the specificity of glomerulations in the diagnosis of IC is lower than that of the PST. A positive PST is associated with a more hypersensitive bladder and bladder pain, but not the grade of glomerulations in IC patients. Neither test provided 100% diagnostic accuracy for IC, we might select patients into different subgroups based on different PST and hydrodistention results, not for making a diagnosis of IC but for guidance of different treatments.
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Davis NF, Gnanappiragasam S, Thornhill JA. Interstitial cystitis/painful bladder syndrome: the influence of modern diagnostic criteria on epidemiology and on Internet search activity by the public. Transl Androl Urol 2016; 4:506-11. [PMID: 26816850 PMCID: PMC4708563 DOI: 10.3978/j.issn.2223-4683.2015.06.08] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Interstitial cystitis/painful bladder syndrome (IC/PBS) is a chronic debilitating condition that is characterised by suprapubic pain and urinary symptoms such as urgency, nocturia and urinary frequency. The prevalence of the condition is increasing due to more inclusive diagnostic criteria. Herein, we review the evolving epidemiology of IC/PBS and investigate health seeking behaviour for the condition through Internet search activity. Study selection was performed in accordance with PRISMA. In addition, global search trends for the terms ‘Interstitial Cystitis’ and ‘Painful Bladder Syndrome’ from 2005 to 2015 were also evaluated using the ‘Google Trends’ search application. The mean search activity per month was recorded and mean activity at annual intervals calculated. Regional search activity by country and city was also measured. Prevalence rates for IC/PBS vary according to diagnostic criteria and range from 2% to 17.3% among the general population. Increased prevalence is associated with female gender and females with one first-degree relative affected. There has been an increase in global mean search activity for IC/PBS on an annual basis since 2005. The greatest increase in search activity was in USA, Canada, United Kingdom, Australia, Ireland and India respectively. The top five cities for search activity for IC/PBS were in the USA. As diagnostic criteria for IC/PBS continues to become more inclusive it is likely that the prevalence will continue to increase. This is particularly true for the USA and Canada as these regions have demonstrated the greatest increase in Internet search activity for IC/ PBS.
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Affiliation(s)
- Niall F Davis
- Department of Urology, Tallaght Hospital, Dublin, Ireland
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60
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Abstract
Interstitial cystitis/bladder pain syndrome (IC/BPS) is a common and frequently misdiagnosed disorder in men. Hallmark symptoms are the presence of chronic discomfort attributed to the urinary bladder associated with bladder filling and relieved with bladder emptying, often associated with irritative voiding symptoms, in the absence of any other identifiable cause. It is often grouped with another common clinical entity, chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). Men with IC/BPS often suffer from a delay in diagnosis and subsequent treatment, often being categorized as having prostatitis, benign prostatic hyperplasia, or epididymitis before the correct diagnosis is reached. The etiology of IC/BPS is poorly understood, and its pathogenesis may involve multiple pathways leading to a common clinical entity. Diagnostic criteria continue to evolve over time as the understanding of IC/BPS improves, and a clinical diagnosis with properly performed history and physical exam is suitable for diagnosis after other processes such as infection, radiation, or pharmaceutical exposure are appropriately excluded. No set pathological findings, biomarkers, or phenotypic descriptions have been universally accepted as a result of conflicting studies. Guidelines for diagnostic and treatment options are limited by available data, and few studies incorporate substantial numbers of male patients. Reported outcomes for common therapies are mixed or have not yet been subjected to study in rigorous placebo-controlled clinical trials in men. Lessons learned from the treatment of CP/CPPS can be applied to IC/BPS, by favoring a phenotypically directed, multimodal approach rather than a stepwise algorithm as advocated by current practice guidelines.
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Affiliation(s)
- Hans C Arora
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Daniel A Shoskes
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH 44195, USA
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61
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Wennevik GE, Meijlink JM, Hanno P, Nordling J. The Role of Glomerulations in Bladder Pain Syndrome: A Review. J Urol 2016; 195:19-25. [DOI: 10.1016/j.juro.2015.06.112] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/24/2015] [Indexed: 10/23/2022]
Affiliation(s)
| | - Jane M. Meijlink
- International Painful Bladder Foundation, Rotterdam, The Netherlands
| | - Philip Hanno
- Department of Urology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jørgen Nordling
- Department of Urology, University of Copenhagen, Copenhagen, Denmark
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Zhang W, Yao YS, Lin ME, Xie WJ, Pan WW. Unexplained association between cystitis glandularis and interstitial cystitis in females: a retrospective study. Int Urogynecol J 2015; 26:1835-41. [PMID: 26231232 DOI: 10.1007/s00192-015-2780-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Accepted: 06/23/2015] [Indexed: 10/23/2022]
Abstract
INTRODUCTION AND HYPOTHESIS An increasing number of female patients have received comorbid diagnoses of cystitis glandularis (CG) and interstitial cystitis (IC) at our institution. In addition, most of these patients suffer from coexisting obstructive lower urinary tract diseases (OLUTDs). In this study, we aimed to present evidence of the possible association between CG and IC and analyze the clinical features of this association. METHODS We retrospectively reviewed the charts of 395 female patients diagnosed with CG and/or IC. The patients were divided into three groups: group A (CG only), group B (IC only), and group C (CG+IC). Chi-squared tests were applied to compare the prevalence rates of CG in patients with IC and in the general population, the prevalence rates of IC in patients with CG and in the general population, and the prevalence rates of OLUTD in the three patient groups. RESULTS The prevalence rate of IC in patients with CG was significantly higher than that in the general population, while the prevalence rate of CG in patients with IC was also significantly higher than that in the general population. For groups A, B, and C, 93 (39.2 %), 30 (44.1 %), and 58 (64.4 %) cases respectively presented with OLUTDs, and the prevalence rate of OLUTDs varied significantly among the three groups. CONCLUSIONS This retrospective study found a possible association between CG and IC, and coexisting OLUTDs influenced this association.
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Affiliation(s)
- Wei Zhang
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 West Yanjiang Road, Guangzhou, 510120, People's Republic of China.,Department of Urology, People's Hospital of Jieyang, 107 Tianfu Road, Jieyang, 522000, People's Republic of China
| | - You-sheng Yao
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 West Yanjiang Road, Guangzhou, 510120, People's Republic of China.
| | - Ming-en Lin
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 West Yanjiang Road, Guangzhou, 510120, People's Republic of China
| | - Wei-jie Xie
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 West Yanjiang Road, Guangzhou, 510120, People's Republic of China
| | - Wen-wei Pan
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 West Yanjiang Road, Guangzhou, 510120, People's Republic of China
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Intravesical Sodium Chondroitin Sulphate to Treat Overactive Bladder: Preliminary Result. Int Neurourol J 2015; 19:85-9. [PMID: 26126437 PMCID: PMC4490319 DOI: 10.5213/inj.2015.19.2.85] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Accepted: 05/11/2015] [Indexed: 11/24/2022] Open
Abstract
Purpose: This study aimed to verify the efficacy and safety of intravesical treatment with sodium chondroitin sulfate (CS) in patients with overactive bladder (OAB) who are refractory to previous antimuscarinic treatment. Methods: This study was performed between June 2012 and January 2015 and included 31 consecutive women (mean age, 42.10±7.34 years) with OAB who had been previously treated with two types of antimuscarinic drugs. The results of gynecologic and cystoscopic examinations were normal, and OAB comorbidity was absent. Treatment with intravesical instillations containing 40 mL CS (0.2%; 2 mg/mL) was administered for 6 weeks; after weekly treatments, monthly treatments were administered. The OAB-validated 8 (OAB-V8) symptom scores, nocturia, frequency, urgency, urge incontinence, and urinary volumes measured by uroflowmetry were evaluated for all the patients. The values obtained before the treatment were statistically compared with those obtained six months after the treatment. Results: The duration of the symptoms was 18.36±6.19 months. A statistically significant improvement of the patients’ conditions was observed in terms of the OAB-V8 symptom scores, nocturia, frequency, urgency, urge incontinence, and urinary volumes measured by uroflowmetry after the treatment. Conclusions: Despite the limitations of this study, the outcomes confirmed that CS therapy is safe and effective for the treatment of OAB.
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Darrieutort-Laffite C, André V, Hayem G, Saraux A, Le Guern V, Le Jeunne C, Puéchal X. Sjögren's syndrome complicated by interstitial cystitis: A case series and literature review. Joint Bone Spine 2015; 82:245-50. [DOI: 10.1016/j.jbspin.2014.12.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 12/11/2014] [Indexed: 10/24/2022]
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Meijlink JM. Interstitial cystitis and the painful bladder: a brief history of nomenclature, definitions and criteria. Int J Urol 2015; 21 Suppl 1:4-12. [PMID: 24807485 DOI: 10.1111/iju.12307] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2013] [Accepted: 08/28/2013] [Indexed: 11/29/2022]
Abstract
"Practically every author writing on this subject has suggested a new name which only adds to the confusion and multiplication" (Kretschmer H, 1922). Despite multiple names and many definitions and classifications over the past two centuries, the medical world is no closer to discovering the cause or causes of this enigmatic bladder disorder, currently known as interstitial cystitis, bladder pain syndrome or painful bladder syndrome and hypersensitive bladder. International consensus on nomenclature, definitions and diagnosis is now essential to ensure that studies are carried out on the same basis, thereby generating meaningful data that can be relied on for further use. In our electronic age, multiple names and definitions cause confusion for researchers, clinicians and patients, even leading to the patient's diagnosis being unrecognized by authorities, resulting in refusal to reimburse treatment or provide social benefits. As the key to the puzzle lies in the patients, with all their symptoms and comorbidities, and as patients are directly affected by changes in nomenclature and definitions, patient organization representatives should be given every opportunity to participate in discussions on guidelines, taxonomy, definitions and terminology.
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Affiliation(s)
- Jane M Meijlink
- International Painful Bladder Foundation, Rotterdam, the Netherlands
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66
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Yoshimura N, Oguchi T, Yokoyama H, Funahashi Y, Yoshikawa S, Sugino Y, Kawamorita N, Kashyap MP, Chancellor MB, Tyagi P, Ogawa T. Bladder afferent hyperexcitability in bladder pain syndrome/interstitial cystitis. Int J Urol 2015; 21 Suppl 1:18-25. [PMID: 24807488 DOI: 10.1111/iju.12308] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Accepted: 08/27/2013] [Indexed: 12/30/2022]
Abstract
Bladder pain syndrome/interstitial cystitis is a disease with lower urinary tract symptoms, such as bladder pain and urinary frequency, which results in seriously impaired quality of life of patients. The extreme pain and urinary frequency are often difficult to treat. Although the etiology of bladder pain syndrome/interstitial cystitis is still not known, there is increasing evidence showing that afferent hyperexcitability as a result of neurogenic bladder inflammation and urothelial dysfunction is important to the pathophysiological basis of symptom development. Further investigation of the pathophysiology will lead to the effective treatment of patients with bladder pain syndrome/interstitial cystitis.
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Affiliation(s)
- Naoki Yoshimura
- Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
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67
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Lee MH, Wu HC, Lin JY, Tan TH, Chan PC, Chen YF. Development and evaluation of an E-health system to care for patients with bladder pain syndrome/interstitial cystitis. Int J Urol 2015; 21 Suppl 1:62-8. [PMID: 24807502 DOI: 10.1111/iju.12336] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Accepted: 10/04/2013] [Indexed: 01/06/2023]
Abstract
OBJECTIVES Bladder pain syndrome/interstitial cystitis (BPS/IC) is a chronic disease that highly degrades the quality of life for patients. In the present study, Internet intervention was used to care for bladder pain syndrome/interstitial cystitis patients to alleviate their pain and bothering symptoms. METHODS Healthcare education was carried out through the Internet by asking the patients, who were randomly divided into study (40 patients) and control (40 patients) groups, to check possible sensitive foods, habits, and behaviors weekly to remind and consolidate important rules for promoting quality of life. The symptom flares consultation through short message service with the Internet used to elevate healthcare efficiency was undertaken. Questionnaires, including Short Form 36 health survey, O'Leary-Sant symptom and problem indices, as well as visual analog scales pain and urgency scales, were used to evaluate quality of life and disease severity improvements before and after information and communication technology intervention. The outcome was evaluated at week 8. RESULTS The quality of life of both the control and study groups was significantly improved. The quality of life and visual analog scales for the patients in the study group with information and communication technology intervention showed a much greater improvement compared with the patients in the control group (P < 0.05). CONCLUSIONS The E-health system was shown to be effective in improving quality of life of bladder pain syndrome/interstitial cystitis patients through intervention of Internet healthcare education and short message service for the consolidation of healthy behavior and lifestyle in the 8-week follow up.
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Affiliation(s)
- Ming-Huei Lee
- Department of Management Information System, Central Taiwan University of Science and Technology, Taichung, Taiwan; Department of Urology, Feng Yuan Hospital, Ministry of Health and Welfare, Taichung, Taiwan
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Kuo HC. Potential urine and serum biomarkers for patients with bladder pain syndrome/interstitial cystitis. Int J Urol 2015; 21 Suppl 1:34-41. [PMID: 24807491 DOI: 10.1111/iju.12311] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Accepted: 08/13/2013] [Indexed: 11/30/2022]
Abstract
There is a lack of consensus on the pathophysiology of bladder pain syndrome/interstitial cystitis. The chronic pain symptoms of bladder pain syndrome/interstitial cystitis refractory to local treatment could be a result of central nervous system sensitization and persisting abnormalities in the bladder wall, which activate the afferent sensory system. Evidence also shows that bladder pain syndrome/interstitial cystitis is a heterogeneous syndrome and that the two subtypes, the ulcerative (classic) and non-ulcerative types, represent different disease entities. There is a need for non-invasive markers for the differential diagnoses of the subtypes of bladder pain syndrome/interstitial cystitis, and between bladder pain syndrome/interstitial cystitis and bladder sensory disorders, such as hypersensitive bladder syndrome or overactive bladder. Bladder pain syndrome/interstitial cystitis, but not overactive bladder, involves an aberrant differentiation program in the bladder urothelium that leads to altered synthesis of several proteoglycans, cell adhesion and tight junction proteins, and bacterial defense molecules. These findings have led to the rationale for identifying urinary biomarkers to detect bladder pain syndrome/interstitial cystitis in patients with frequency urgency syndrome. Recently, the markers that have been the focus of the most research are antiproliferative factor, epidermal growth factor, heparin-binding epidermal growth factor, glycosaminoglycans and bladder nitric oxide. In addition, inflammatory proteins in the urine and serum play important roles in the pathogenesis of bladder pain syndrome/interstitial cystitis. The urinary proteome is an easily accessible source of biomarkers for differentiation between inflammatory bladder disorders. Analysis of multiple urinary proteins and serum cytokines could provide a diagnostic basis for bladder pain syndrome/interstitial cystitis, and could be a tool for the differential diagnosis of bladder pain syndrome/interstitial cystitis and other sensory bladder disorders.
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Affiliation(s)
- Hann-Chorng Kuo
- Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan
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Hanno PM, Erickson D, Moldwin R, Faraday MM. Diagnosis and treatment of interstitial cystitis/bladder pain syndrome: AUA guideline amendment. J Urol 2015; 193:1545-53. [PMID: 25623737 DOI: 10.1016/j.juro.2015.01.086] [Citation(s) in RCA: 430] [Impact Index Per Article: 47.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/16/2015] [Indexed: 12/30/2022]
Abstract
PURPOSE The purpose of this amendment is to provide an updated clinical framework for the diagnosis and treatment of interstitial cystitis/bladder pain syndrome based upon data received since the publication of original guideline in 2011. MATERIALS AND METHODS A systematic literature review using the MEDLINE(®) database (search dates 1/1/83-7/22/09) was conducted to identify peer-reviewed publications relevant to the diagnosis and treatment of IC/BPS. This initial review yielded an evidence base of 86 treatment articles after application of inclusion/exclusion criteria. The AUA update literature review process, in which an additional systematic review is conducted periodically to maintain guideline currency with newly published relevant literature, was conducted in July 2013. This review identified an additional 31 articles, which were added to the evidence base of this Guideline. RESULTS Newly incorporated literature describing the treatment of IC/BPS was integrated into the Guideline with additional treatment information provided as Clinical Principles and Expert Opinions when insufficient evidence existed. The diagnostic portion of the Guideline remains unchanged from the original publication and is still based on Expert Opinions and Clinical Principles. CONCLUSIONS The management of IC/BPS continues to evolve as can be seen by an expanding literature on the topic. This document constitutes a clinical strategy and is not intended to be interpreted rigidly. The most effective approach for a particular patient is best determined by the individual clinician and patient. As the science relevant to IC/BPS evolves and improves, the strategies presented will require amendment to remain consistent with the highest standards of care.
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Affiliation(s)
- Philip M Hanno
- American Urological Association Education and Research, Inc., Linthicum, Maryland
| | - Deborah Erickson
- American Urological Association Education and Research, Inc., Linthicum, Maryland
| | - Robert Moldwin
- American Urological Association Education and Research, Inc., Linthicum, Maryland
| | - Martha M Faraday
- American Urological Association Education and Research, Inc., Linthicum, Maryland
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Clinical and Psychological Parameters Associated with Pain Pattern Phenotypes in Women with Interstitial Cystitis/Bladder Pain Syndrome. J Urol 2015; 193:138-44. [DOI: 10.1016/j.juro.2014.07.108] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2014] [Indexed: 12/30/2022]
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Gülpınar O, Kayış A, Süer E, Gökçe Mİ, Güçlü AG, Arıkan N. Clinical comparision of intravesical hyaluronic acid and hyaluronic acid-chondroitin sulphate therapy for patients with bladder pain syndrome/interstitital cystitis. Can Urol Assoc J 2014; 8:E610-4. [PMID: 25295131 DOI: 10.5489/cuaj.2036] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Patients with a history of bladder pain syndrome/interstitial cystitis (BPS/IC) and who responded poorly or unsatisfactorily with previous treatment were compared taking intravesical hyaluronic acid (HA) or hyaluronic acid-chondroitin sulphate (HA-CS). METHODS Patients were treated with intravesical instillation with 50 mL sterile sodium hyalurinic acid (Hyacyst, Syner-Med, Surrey, UK) (n = 32) and sodium hyaluronate 1.6% sodium chondroitin sulphate 2% (Ialuril, Aspire Pharma, UK) (n = 33). Intravesical instillations were performed weekly in first month, every 15 days in the second month and monthly in third and fourth months, for a total of 8 doses. Patients were evaluated using a visual analog pain scale (VAS), interstitial cystitis symptom index (ICSI), interstitial cystitis problem index (ICPI), voiding diary for frequency/nocturia, cystometric bladder capacity and voided volume at the beginning and at 6 months. All patients had a potassium sensitivity test (PST) initially. Wilcoxon and Mann-Whitney U tests were used for statistical analysis. RESULTS In total, 53 patients met the study criteria. There were 30 patients in the HA-CS group (mean age: 48.47) and 23 patients in the HA group (mean age: 49.61) (p > 0.05). The initial PST was positive in 71.7% patients (38/53) overall with no difference between groups (p > 0.05). Responses for VAS, ICCS, ICPS, 24-hour frequency/nocturia statistically improved in both groups at 6 months. There was no significant difference in symptomatic improvement (p > 0.05). Eight patients had mild adverse events. CONCLUSION HA and HA/CS instillation can be effective in BPS/IC patients who do not respond to conservative treatment. An important limitation of our study is that the HA dosage of the 2 treatment arms were different. It would be more appropriate with same HA dosage in both groups; however, there was no commercially available glycosaminoglycan (GAG) substance with same HA dosage for single and combination therapy. Large, long-term randomized studies are required to determine if there is a difference between these treatments.
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Affiliation(s)
- Omer Gülpınar
- Department of Urology, Ankara University, Ankara, Turkey
| | - Aytaç Kayış
- Department of Urology, Ankara University, Ankara, Turkey
| | - Evren Süer
- Department of Urology, Ankara University, Ankara, Turkey
| | | | | | - Nihat Arıkan
- Department of Urology, Ankara University, Ankara, Turkey
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Qu HC, Zhang W, Yan S, Liu YL, Wang P. Urinary nerve growth factor could be a biomarker for interstitial cystitis/painful bladder syndrome: a meta-analysis. PLoS One 2014; 9:e106321. [PMID: 25181532 PMCID: PMC4152268 DOI: 10.1371/journal.pone.0106321] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2014] [Accepted: 07/29/2014] [Indexed: 01/15/2023] Open
Abstract
To examine whether urinary nerve growth factor (NGF) could serve as a biomarker for interstitial cystitis/painful bladder syndrome (IC/PBS), we conducted a comprehensive meta-analysis of 9 studies. Among the studies considered, patients with IC/PBS had higher urinary NGF and NGF/Cr levels compared to those of healthy people (SMD = 1.94, 95%CI = 0.79-3.08, P = 0.0009 and SMD = 1.79, 95%CI = 0.65-2.93, P = 0.002, respectively). In addition, there was a significant difference between patients with IC/PBS and patients with overactive bladder (OAB) symptoms with respect to the urinary NGF and NGF/Cr levels (SMD = -0.62, 95%CI = -1.00--0.24, P = 0.001 and SMD = -0.70, 95%CI = -1.01--0.39, P<0.0001, respectively). Furthermore, patients had a significantly lower urinary NGF level after successful treatment (SMD = 1.74, 95%CI = 0.32-3.17, P = 0.02). In conclusion, urinary NGF could be a useful biomarker for the diagnosis of OAB, a urinary biomarker for the differential diagnosis of IC/PBS and OAB (when a critical urinary NGF or NGF/Cr level is needed), and a predictive biomarker to help guide treatment.
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Affiliation(s)
- Hong-Chen Qu
- Department of Urological Surgery, The Fourth Affiliated Hospital of China Medical University, Shenyang, Liaoning, P. R. China
| | - Wei Zhang
- Department of Orthodontics, The Dental Affiliated Hospital of China Medical University, Shenyang, Liaoning, P. R. China
| | - Shi Yan
- Department of Urological Surgery, The Third Hospital of Shenyang, Shenyang, Liaoning, P. R. China
| | - Yi-Li Liu
- Department of Urological Surgery, The Fourth Affiliated Hospital of China Medical University, Shenyang, Liaoning, P. R. China
| | - Ping Wang
- Department of Urological Surgery, The Fourth Affiliated Hospital of China Medical University, Shenyang, Liaoning, P. R. China
- * E-mail:
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Choi BH, Jin LH, Kim KH, Han JY, Kang JH, Yoon SM, Park CS, Lee T. Mast cell activation and response to tolterodine in the rat urinary bladder in a chronic model of intravesical protamine sulfate and bacterial endotoxin-induced cystitis. Mol Med Rep 2014; 10:670-6. [PMID: 24859757 DOI: 10.3892/mmr.2014.2262] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2013] [Accepted: 03/27/2014] [Indexed: 11/05/2022] Open
Abstract
The aim of the present study was to use an animal model of interstitial cystitis (IC) in order to investigate the histology and function of the bladder, with a particular focus on mast cell degranulation and response to detrusor overactivity (DO) to tolterodine. A total of 18 female Sprague‑Dawley rats were used. In 12 rats, lipopolysaccharide (LPS) was intravesically instilled following the induction of IC by protamine sulfate (PS) and six rats were subjected to sham instillations. Following 1 month, cystometry was performed. The effects of tolterodine were tested in half of the animals with IC. All rats in the IC group demonstrated DO during the filling phase and no significant changes in the frequency or pressure compared with that following tolterodine injection were identified. Histological examination revealed a significant increase in the total number of infiltrated mast cells in IC rats compared with that in the sham rats (P<0.05). Degranulated mast cells were evident in 80% of rats with IC; however, they were not apparent in the sham rats. Urinary bladder inflammation, similar to that in human IC in terms of degranulated mast cells and bladder function, was induced in rats. The animal model used in the present study provided insight into the pathophysiological mechanisms underlying the ineffectiveness of anticholinergics in patients with overlapping IC and overactive bladder (OAB).
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Affiliation(s)
- Bo-Hwa Choi
- Department of Pharmacology, Inha University College of Medicine by BK 21 Project, Incheon 400-711, South Korea
| | - Long-Hu Jin
- Department of Urology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, P.R. China
| | - Khae-Hawn Kim
- Department of Urology, Gachon University Gil Medical Center, Incheon 405-760, South Korea
| | - Jee-Young Han
- Department of Pathology, Inha University College of Medicine by BK 21 Project, Incheon 400-711, South Korea
| | - Ju-Hee Kang
- Department of Pharmacology, Inha University College of Medicine by BK 21 Project, Incheon 400-711, South Korea
| | - Sang-Min Yoon
- Department of Urology, Inha University College of Medicine by BK 21 Project, Incheon 400-711, South Korea
| | - Chang-Shin Park
- Department of Pharmacology, Inha University College of Medicine by BK 21 Project, Incheon 400-711, South Korea
| | - Tack Lee
- Department of Urology, Inha University College of Medicine by BK 21 Project, Incheon 400-711, South Korea
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Chelimsky T, Chelimsky G, McCabe NP, Louttit M, Hijaz A, Mahajan S, Sanses T, Buffington CT, Fenton B, Janicki T, Ialacci S, Veizi E, Zhang D, Daneshgari F, Elston R, Janata J. Interstitial Cystitis - Elucidation of Psychophysiologic and Autonomic Characteristics (the ICEPAC Study): design and methods. J Pain Res 2014; 7:243-53. [PMID: 24855387 PMCID: PMC4020893 DOI: 10.2147/jpr.s58853] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND AND PURPOSE Interstitial cystitis/bladder pain syndrome (IC/BPS) is relatively common and associated with severe pain, yet effective treatment remains elusive. Research typically emphasized the bladder's role, but given the high presence of systemic comorbidities, the authors hypothesized a pathophysiologic nervous system role. This paper reports the methodology and approach to study the nervous system in women with IC/BPS. The study compares neurologic, urologic, gynecologic, autonomic, gastrointestinal, and psychological features of women with IC/BPS, their female relatives, women with myofascial pelvic pain (MPP), and healthy controls to elucidate the role of central and peripheral processing. METHODS AND RESULTS In total, 228 women (76 IC/BPS, 76 MPP, 38 family members, and 38 healthy controls) will be recruited. Subjects undergo detailed screening, structured neurologic examination of limbs and pelvis, tender point examination, autonomic testing, electrogastrography, and assessment of comorbid functional dysautonomias. Interpreters are blinded to subject classification. Psychological and stress response characteristics are examined with assessments of stress, trauma history, general psychological function, and stress response quantification. As of December 2012, data collection is completed for 25 healthy controls, 33 IC/BPS ± MPP, eight MPP, and three family members. Recruitment rate is accelerating and strategies emphasize maintaining and encouraging investigator participation in study science, internet advertising, and presentations to pelvic pain support groups. CONCLUSION The study represents a comprehensive, interdisciplinary approach to sampling autonomic and psychophysiologic characteristics of women with IC/BPS. Despite divergent opinions on study methodologies based on specialty experiences, the study has proven feasible to date and different perspectives have proved to be one of the greatest study strengths.
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Affiliation(s)
- Thomas Chelimsky
- The Medical College of Wisconsin, Departments of Neurology and Gastroenterology, Milwaukee, WI, USA
| | - Gisela Chelimsky
- The Medical College of Wisconsin, Departments of Neurology and Gastroenterology, Milwaukee, WI, USA
| | - N Patrick McCabe
- Case Western Reserve University, Department of Neurology, Cleveland, OH, USA
| | - Megan Louttit
- University Hospitals Case Medical Center, School of Medicine, Cleveland, OH, USA
| | - Adonis Hijaz
- University Hospitals Case Medical Center, School of Medicine, Cleveland, OH, USA
| | - Sangeeta Mahajan
- University Hospitals Case Medical Center, School of Medicine, Cleveland, OH, USA
| | - Tatiana Sanses
- University Hospitals Case Medical Center, School of Medicine, Cleveland, OH, USA
| | - Ca Tony Buffington
- The Ohio State University, Department of Veterinary Clinical Sciences, Columbus, OH, USA
| | - Bradford Fenton
- Summa Health System, Department of Gynecology, Akron, OH, USA
| | - Thomas Janicki
- University Hospitals Case Medical Center, School of Medicine, Cleveland, OH, USA
| | - Sarah Ialacci
- Case Western Reserve University, Department of Neurology, Cleveland, OH, USA
| | - Elias Veizi
- University Hospitals Case Medical Center, School of Medicine, Cleveland, OH, USA
| | - Di Zhang
- Case Western Reserve University, Department of Neurology, Cleveland, OH, USA
| | - Firouz Daneshgari
- Case Western Reserve University, Department of Neurology, Cleveland, OH, USA ; University Hospitals Case Medical Center, School of Medicine, Cleveland, OH, USA
| | - Robert Elston
- Case Western Reserve University, Department of Neurology, Cleveland, OH, USA
| | - Jeffrey Janata
- Case Western Reserve University, Department of Neurology, Cleveland, OH, USA ; University Hospitals Case Medical Center, School of Medicine, Cleveland, OH, USA
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Lucon M, Martins JR, Leite KRM, Soler R, Nader HB, Srougi M, Bruschini H. Evaluation of the metabolism of glycosaminoglycans in patients with interstitial cystis. Int Braz J Urol 2014; 40:72-9. [PMID: 24642152 DOI: 10.1590/s1677-5538.ibju.2014.01.11] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2012] [Accepted: 07/24/2013] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Painful bladder syndrome/interstitial cystitis (PBS/IC) pathogenesis is not fully known, but evidence shows that glycosaminoglycans (GAG) of bladder urothelium can participate in its genesis. The loss of these compounds facilitates the contact of urine compounds with deeper portions of bladder wall triggering an inflammatory process. We investigated GAG in urine and tissue of PBS/IC and pure stress urinary incontinence (SUI) patients to better understand its metabolism. MATERIALS AND METHODS Tissue and urine of 11 patients with PBS/IC according to NIDDK criteria were compared to 11 SUI patients. Tissue samples were analyzed by histological, immunohistochemistry and immunofluorescence methods. Statistical analysis were performed using t Student test and Anova, considering significant when p < 0.05. RESULTS PBS/IC patients had lower concentration of GAG in urine when compared to SUI (respectively 0.45 ± 0.11 x 0.62 ± 0.13 mg/mg creatinine, p < 0.05). However, there was no reduction of the content of GAG in the urothelium of both groups. Immunofluorescence showed that PBS/IC patients had a stronger staining of TGF-beta, decorin (a proteoglycan of chondroitin/dermatan sulfate), fibronectin and hyaluronic acid. CONCLUSION the results suggest that GAG may be related to the ongoing process of inflammation and remodeling of the dysfunctional urothelium that is present in the PBS/IC.
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Affiliation(s)
- Marcos Lucon
- Division of Urology, University of Sao Paulo Medical School, Sao Paulo, SP, Brazil
| | - João Roberto Martins
- Division of Molecular Biology, Federal University of Sao Paulo, Sao Paulo, SP, Brazil
| | | | - Roberto Soler
- Division of Urology, Federal University of Sao Paulo, Sao Paulo, SP, Brazil
| | - Helena B Nader
- Division of Molecular Biology, Federal University of Sao Paulo, Sao Paulo, SP, Brazil
| | - Miguel Srougi
- Division of Urology, University of Sao Paulo Medical School, Sao Paulo, SP, Brazil
| | - Homero Bruschini
- Division of Urology, University of Sao Paulo Medical School, Sao Paulo, SP, Brazil
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Castro-Diaz D, Cardozo L, Chapple CR, Espuña M, Kelleher C, Kirby M, Milsom I, Sievert KD, Tubaro A. Urgency and pain in patients with overactive bladder and bladder pain syndrome. What are the differences? Int J Clin Pract 2014; 68:356-62. [PMID: 24373133 DOI: 10.1111/ijcp.12317] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The Overactive Bladder Syndrome (OAB) and the Bladder Pain Syndrome/Interstitial Cystitis (BPS/IC) are different urological conditions sharing 'urgency' as a common symptom. The aim of this review is to address our existing knowledge and establish how these symptoms are interrelated and to determine whether or not there is a common link between both symptoms complexes that help to distinguish one from the other. METHODS Pubmed was used to obtain references for this non-systematic review aiming to discuss differences between OAB and BPS/IC. Guidelines of several professional associations and discussions based on expert opinion from the authors were implemented. RESULTS Whilst in BPS the hallmark symptom is pain on bladder filling, urgency is the defining symptom of OAB. Whilst it is likely that the pain in BPS/IC arises from local inflammation in the bladder wall, the nature of urgency as a symptom, its origin, and the relationship between urgency and pain, as well as the different afferent mechanisms associated with the genesis of these sensory symptoms, remains unknown. Although the aetiology of both OAB and PBS/IC is unclear, the influence of environmental factors has been suggested. Both are chronic conditions with very variable symptom resolution and response to therapy. The relationship with voiding dysfunction, gynaecological causes of chronic pelvic pain or the possible alteration of the hypothalamic-pituitary-adrenal axis and psychological disorders has not been established. Inflammation has been suggested as the common link between OAB and BPS/IC. CONCLUSIONS OAB and BPS/IC are different symptoms complexes that share urgency as a common symptom. None of them have a specific symptom although pain on bladder filling is the hallmark symptom in BPS/IC. Bladder pain with urgency should be a trigger for referral to the provider with appropriate knowledge and expertise in this disease state, whereas the management of OAB should be part of normal routine care in the community.
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Affiliation(s)
- D Castro-Diaz
- Servicio de Urologia, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain
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Bladder Pain Syndrome: Where Do We Stand Now? CURRENT BLADDER DYSFUNCTION REPORTS 2014. [DOI: 10.1007/s11884-013-0214-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Birder LA. Urinary bladder, cystitis and nerve/urothelial interactions. Auton Neurosci 2013; 182:89-94. [PMID: 24412640 DOI: 10.1016/j.autneu.2013.12.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Accepted: 12/12/2013] [Indexed: 12/20/2022]
Abstract
A hallmark of functional pain syndromes, such as bladder pain syndrome/interstitial cystitis (BPS/IC) is pain in the absence of demonstrable infection or pathology of the viscera or associated nerves. There are no clear definitions of this syndrome, no proven etiologies and no effective treatments able to eradicate the symptoms. This condition is characterized by suprapubic pain, associated with bladder filling and can also be accompanied by a persistent strong desire to void, increased frequency of urination and nocturia. Severe cases of this disorder, which affects primarily women, can have considerable impact on the quality of life of patients due to extreme pain and urinary frequency, which are often difficult to treat. In addition, BPS/IC patients may also suffer co-morbid conditions where pain is a common symptom (such as irritable bowel syndrome, fibromyalgia). Theories explaining the pathology of bladder pain syndrome are many and include an altered bladder lining and possible contribution of a bacterial agent.
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Affiliation(s)
- Lori A Birder
- Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States; Department Pharmacology & Chemical Biology, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States.
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Osman NI, Cartwright R, Tikkinen KAO, Mangera A, Ellsworth P, Chapple CR. What was hot at the ICS meeting 2013? Neurourol Urodyn 2013; 33:2-8. [PMID: 24302326 DOI: 10.1002/nau.22526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Accepted: 10/25/2013] [Indexed: 11/08/2022]
Affiliation(s)
- Nadir I Osman
- Department of Urology, Royal Hallamshire Hospital, Sheffield, United Kingdom
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Chrysanthopoulou EL, Doumouchtsis SK. Challenges and current evidence on the management of bladder pain syndrome. Neurourol Urodyn 2013; 33:1193-201. [DOI: 10.1002/nau.22475] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2013] [Accepted: 07/09/2013] [Indexed: 11/10/2022]
Affiliation(s)
- Eleftheria L. Chrysanthopoulou
- Department of Obstetrics and Gynaecology; St George's Healthcare NHS Trust/St George's University of London; London United Kingdom
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Sun Y, Fang Z, Ding Q, Zheng J. Effect of amitriptyline in treatment interstitial cystitis or bladder pain syndrome according to two criteria: does ESSIC criteria change the response rate? Neurourol Urodyn 2013; 33:341-4. [PMID: 23744795 DOI: 10.1002/nau.22407] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2012] [Accepted: 03/06/2013] [Indexed: 11/05/2022]
Abstract
AIMS The European Society for the Study of Interstitial Cystitis (ESSIC) recommended that interstitial cystitis (IC) should be replaced by bladder pain syndrome (BPS), which focused more attention on the painful or discomfort feeling related to bladder and weakened the importance of cystoscopy in diagnosis process. Our study aimed to explore whether this alteration changed the treatment outcomes of amitriptyline and whether cystoscopy was meaningful for the treatment of this disease. METHODS We conducted a retrospective study including 25 IC patients fulfilled the National Institute of Diabetes and Digestive and Kidney Disease (NIDDK) criteria and 42 BPS patients diagnosed according to ESSIC criteria. All the patients received amitriptyline with a self-uptitration protocol. We compared the response rates of two groups by a patient reported global response assessment after 3 months and reclassified all the 67 patients according to ESSIC criteria, the response rates of different BPS types were also assessed. RESULTS There was no significant difference of response rate between IC patients (12/25, 48%) and BPS patients (19/42, 45.2%) according to different criteria (P = 0.337). The response rate of BPS type 1 (13/30, 43.3%) was similar to that of type 2 or 3 (18/37, 48.6%) (P = 0.664). CONCLUSIONS ESSIC criteria did not decrease the response rate of amitriptyline treatment for BPS patients compared to IC patients with complaint of bladder pain or discomfort. Cystoscopy showed no predictive effect for the treatment outcome of amitriptyline.
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Affiliation(s)
- Yaofei Sun
- Department of Urology, Huashan Hospital, Fudan University, Shanghai, China
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Gamper M, Viereck V, Eberhard J, Binder J, Moll C, Welter J, Moser R. Local immune response in bladder pain syndrome/interstitial cystitis ESSIC type 3C. Int Urogynecol J 2013; 24:2049-57. [PMID: 23670165 PMCID: PMC3838592 DOI: 10.1007/s00192-013-2112-0] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2013] [Accepted: 04/06/2013] [Indexed: 01/17/2023]
Abstract
INTRODUCTION AND HYPOTHESIS Bladder pain syndrome/interstitial cystitis (BPS/IC) is identified based on subjective symptoms which lead to heterogeneous patient populations. Previous studies using gene expression arrays for BPS/IC with Hunner's lesions [European Society for the Study of Interstitial Cystitis (ESSIC) type 3C], a subtype of the condition discernible by cystoscopy, have revealed characteristic immune responses and urothelial abnormalities. This current study aimed to further characterize this subtype using a gene expression panel. We hypothesized that B-cell activation with high levels of urinary antibody concentration would be found. METHODS Cold-cup bladder biopsies, catheterized urine and blood were collected from 15 BPS/IC ESSIC type 3C patients, 11 non-inflammatory overactive bladder (OAB) patients and eight healthy controls. Gene expression in biopsies was quantified by real-time quantitative polymerase chain reaction (RT-qPCR), immunohistochemistry was performed on bladder tissue and urinary immunoglobulins G and A were quantified by enzyme-linked immunosorbent assay. Statistical analyses included the Kruskal-Wallis test for non-parametric data and post hoc tests identified differences between groups. RESULTS High expression of T- and B-cell markers (CTLA4, CD20, CD79A, IGH@), low expression of urothelial markers (KRT20, UPK1B, UPK3A), focal lymphoid aggregates in the submucosa and high immunoglobulin concentration in urine were found exclusively in BPS/IC ESSIC type 3C patients. Results for OAB were in intermediate ranges between the other two groups and UPK1B even reached significantly lower expression when compared to healthy controls. CONCLUSIONS BPS/IC ESSIC type 3C is characterized by a local adaptive immune response with elevated urinary antibody concentrations. Quantification of urinary immunoglobulin levels could be used for a non-invasive diagnosis of BPS/IC ESSIC type 3C.
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Affiliation(s)
- Marianne Gamper
- IKBT, Institut für Klinische Biomedizinische Forschung Thurgau, Lauchefeld 31, 9548, Matzingen, Switzerland,
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83
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LEE MH, LIN ATL, KUO HC, CHEN YF. Clinical Characteristic Picture and Impact of Symptoms on Quality of Life of Interstitial Cystitis Patients in Taiwan. Low Urin Tract Symptoms 2013; 6:20-5. [DOI: 10.1111/luts.12013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2012] [Revised: 12/06/2012] [Accepted: 12/30/2012] [Indexed: 11/29/2022]
Affiliation(s)
- Ming-Huei LEE
- Department of Urology, Department of Health, Executive Yuan; Fong-Yuan Hospital; Taichung Taiwan
- Department of Healthcare Administration; Central Taiwan University of Science and Technology; Taichung Taiwan
| | - Alex Tong-Long LIN
- Division of Urology, Department of Surgery; Taipei Veterans General Hospital; Taipei Taiwan
| | - Hann-Chorng KUO
- Department of Urology; Buddhist Tzu Chi General Hospital; Hualien Taiwan
| | - Yung-Fu CHEN
- Department of Healthcare Administration; Central Taiwan University of Science and Technology; Taichung Taiwan
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84
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Nomiya A, Naruse T, Niimi A, Nishimatsu H, Kume H, Igawa Y, Homma Y. On- and post-treatment symptom relief by repeated instillations of heparin and alkalized lidocaine in interstitial cystitis. Int J Urol 2013; 20:1118-22. [DOI: 10.1111/iju.12120] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2012] [Accepted: 01/20/2013] [Indexed: 11/28/2022]
Affiliation(s)
- Akira Nomiya
- Department of Urology; Graduate School of Medicine; The University of Tokyo; Tokyo Japan
| | - Takashi Naruse
- Department of Community Health Nursing; Graduate School of Medicine; The University of Tokyo; Tokyo Japan
| | - Aya Niimi
- Department of Urology; Graduate School of Medicine; The University of Tokyo; Tokyo Japan
| | - Hiroaki Nishimatsu
- Department of Urology; Graduate School of Medicine; The University of Tokyo; Tokyo Japan
| | - Haruki Kume
- Department of Urology; Graduate School of Medicine; The University of Tokyo; Tokyo Japan
| | - Yasuhiko Igawa
- Continence Medicine; Graduate School of Medicine; The University of Tokyo; Tokyo Japan
| | - Yukio Homma
- Department of Urology; Graduate School of Medicine; The University of Tokyo; Tokyo Japan
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85
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Neuhaus J, Schwalenberg T. Intravesical treatments of bladder pain syndrome/interstitial cystitis. Nat Rev Urol 2012. [DOI: 10.1038/nrurol.2012.217] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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86
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Nickel JC, Tripp DA, Pontari M, Moldwin R, Mayer R, Carr LK, Doggweiler R, Yang CC, Mishra N, Nordling J. Childhood sexual trauma in women with interstitial cystitis/bladder pain syndrome: a case control study. Can Urol Assoc J 2012; 5:410-5. [PMID: 22154637 DOI: 10.5489/cuaj.11110] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND The impact of early lifetime trauma on symptom severity and quality of life of patients with interstitial cystitis/bladder pain syndrome (IC/BPS) has not been fully elucidated. We wanted to determine and compare the prevalence and impact of childhood traumatic events, with an emphasis on childhood sexual abuse, on patient symptoms, quality of life and other biopsychosocial parameters. METHODS Subjects (female patients with IC/BPS and controls without IC/BPS) completed psychosocial phenotyping questionnaires, including a demographics/history form, and validated questionnaires focused on presenting symptoms (IC symptom indices, pain), psychosocial parameters (depression, anxiety, pain catastrophizing, sexual functioning, social support) and quality of life. Participants also completed the Childhood Traumatic Events Scale. RESULTS Questionnaires were completed by 207 IC/BPS patients and 117 controls matched for age, partner status and education. It was found that before 17 years of age, the IC/BPS cases reported higher prevalence of "raped or molested" compared to controls (24.0% vs. 14.7%; p = 0.047). Within the IC/BPS group, cases reporting previous sexual abuse endorsed greater sensory pain, depression and poorer physical quality of life at the present time compared to IC cases without a sexual abuse history. In the controls only, those reporting previous sexual abuse endorsed more depression, anxiety, stress, social maladjustment poorer mental quality of life in the present time. When the analysis was corrected for potential multiple comparison error, none of the findings remained significant in either the IC/BPS or control groups. INTERPRETATION Childhood traumatic events, in particular sexual abuse and extreme illness, are reported as more common in IC/BPS patients than controls. Early trauma, such as the occurrence of sexual abuse, is associated with some differences in patient adjustment (e.g., pain, quality of life, depression) but this impact appears to be, at most, very modest.
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87
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Chelimsky G, Heller E, Buffington CAT, Rackley R, Zhang D, Chelimsky T. Co-morbidities of interstitial cystitis. Front Neurosci 2012; 6:114. [PMID: 22907988 PMCID: PMC3415690 DOI: 10.3389/fnins.2012.00114] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2012] [Accepted: 07/10/2012] [Indexed: 12/30/2022] Open
Abstract
Introduction: This study aimed to estimate the proportion of patients with interstitial cystitis/painful bladder syndrome (IC/BPS) with systemic dysfunction associated co-morbidities such as irritable bowel syndrome (IBS) and fibromyalgia (FM). Materials and Methods: Two groups of subjects with IC/BPS were included: (1) physician diagnosed patients with IC/BPS and (2) subjects meeting NIDDK IC/PBS criteria based on a questionnaire (ODYSA). These groups were compared to healthy controls matched for age and socio-economic status. NIDDK criteria required: pain with bladder filling that improves with emptying, urinary urgency due to discomfort or pain, polyuria >11 times/24 h, and nocturia >2 times/night. The ODYSA instrument evaluates symptoms pertaining to a range of disorders including chronic fatigue, orthostatic intolerance, syncope, IBS, dyspepsia, cyclic vomiting syndrome, headaches and migraines, sleep, Raynaud’s syndrome, and chronic aches and pains. Results: IC/BPS was diagnosed in 26 subjects (mean age 47 ± 16 years, 92% females), 58 had symptoms of IC/BPS by NIDDK criteria (mean age 40 ± 17 years, 79% females) and 48 were healthy controls (mean age 31 ± 14 years, mean age 77%). Co-morbid complaints in the IC/BPS groups included gastrointestinal symptoms suggestive of IBS and dyspepsia, sleep abnormalities with delayed onset of sleep, feeling poorly refreshed in the morning, waking up before needed, snoring, severe chronic fatigue and chronic generalized pain, migraines, and syncope. Discussion: Patients with IC/BPS had co-morbid central and autonomic nervous system disorders. Our findings mirror those of others in regard to IBS, symptoms suggestive of FM, chronic pain, and migraine. High rates of syncope and functional dyspepsia found in the IC/BPS groups merit further study to determine if IC/BPS is part of a diffuse disorder of central, autonomic, and sensory processing affecting multiple organs outside the bladder.
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Affiliation(s)
- Gisela Chelimsky
- Department of Pediatric Gastroenterology, Medical College of Wisconsin Milwaukee, WI, USA
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88
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Measuring the success of combined intravesical dimethyl sulfoxide and triamcinolone for treatment of bladder pain syndrome/interstitial cystitis. Int Urogynecol J 2012; 24:303-11. [DOI: 10.1007/s00192-012-1832-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2011] [Accepted: 05/10/2012] [Indexed: 11/26/2022]
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89
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Osman NI, Chapple CR. Lower urinary tract symptoms revisited. Int J Clin Pract 2012; 66:527-9. [PMID: 22607503 DOI: 10.1111/j.1742-1241.2012.02928.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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90
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Yoost JL, Hertweck SP, Loveless M. Diagnosis and treatment of interstitial cystitis in adolescents. J Pediatr Adolesc Gynecol 2012; 25:162-71. [PMID: 21600805 DOI: 10.1016/j.jpag.2011.03.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2011] [Accepted: 03/24/2011] [Indexed: 10/18/2022]
Abstract
Interstitial cystitis (IC), or painful bladder syndrome, is characterized by irritative voiding symptoms and can be a challenging problem that affects children and adolescents. Diagnosis and management in children and adolescents is challenging because of strict diagnostic criteria and the paucity of investigations focusing on this age group, which often can lead to delayed or missed diagnosis. Clinical features suggestive of IC include bladder pain, urgency, frequency, nocturia, and pressure. Symptoms may wax and wane and often are exacerbated by menstruation, intercourse, dietary triggers, and stress. Diagnosis can be made by history, physical exam findings such as suprapubic tenderness, voiding diaries, and exclusion of other etiologies. Some diagnostic tests such as the potassium sensitivity test and cystoscopy are invasive and often impractical in younger patients. Treatment of IC consists of a multimodal approach that should be tailored to the individual needs of the patient. Therapies for younger patients include oral medication, intravesical therapy, cystoscopy with hydrodistention, and conservative measures such as dietary modification. This review of the literature focuses on diagnosing IC in younger patients and on what treatment modalities are appropriate and effective for this age group.
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Affiliation(s)
- J L Yoost
- Department of Obstetrics, Gynecology and Women's Health, University of Louisville, KY, USA.
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91
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Tripp DA, Nickel JC, Wong J, Pontari M, Moldwin R, Mayer R, Carr LK, Doggweiler R, Yang CC, Mishra N, Nordling J. Mapping of pain phenotypes in female patients with bladder pain syndrome/interstitial cystitis and controls. Eur Urol 2012; 62:1188-94. [PMID: 22633363 DOI: 10.1016/j.eururo.2012.05.023] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2012] [Accepted: 05/09/2012] [Indexed: 12/30/2022]
Abstract
BACKGROUND Many bladder pain syndrome/interstitial cystitis (BPS/IC) patients report multiple pain locations outside the pelvis. No research has examined pain using a whole-body diagram, pain-associated adjustment factors, or the impact of pain in multiple body areas on patients' quality of life (QoL). OBJECTIVE Compare and contrast pain in BPS/IC patients and controls using a whole-body diagram (visible body areas). Examine the association between patient adjustment factors and greater number of body pain areas (pain phenotypes). DESIGN, SETTING, AND PARTICIPANTS Validated questionnaires were collected from diagnosed, tertiary-care, outpatient, female BPS/IC patients (n=193) and age-matched controls (n=115). Scales included a body pain area diagram, demographics/history, pain severity, BPS/IC symptoms, pain, depression, catastrophizing, and QoL. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Cross-tabulation and analysis of variance models addressed the patient and control differences. RESULTS AND LIMITATIONS Patients reported more pain than controls in all reported body areas. Four pain phenotypes were created based on increasing counts of body locations (BPS/IC only, BPS/IC+plus 1-3 additional locations, BPS/IC plus 4-9, BPS/IC ≥ 10). Patients reported more body pain locations, pain, urinary symptoms, depression, catastrophizing, and diminished QoL than controls. The increased-pain phenotype was associated with poorer psychosocial adjustment and diminished physical QoL, but catastrophizing and low scores for mental QoL remained stable across all patient groups. This study was cross-sectional, relying on correlation-based analyses, thus causality cannot be established. CONCLUSIONS Patients reported numerous systemic pain symptoms outside the areas associated with the bladder/pelvic region, and increased numbers of body pain sites were associated with poorer patient outcomes (ie, pain severity, depression). This study illustrates the significant negative impact of pain on patient adjustment in BPS/IC. These findings suggest that clinicians carefully consider pain location distributions and the potential impact of body pain phenotypes during patient evaluation and treatment planning.
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Affiliation(s)
- Dean A Tripp
- Department of Psychology, Queen's University, Kingston, ON, Canada.
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92
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Katz L, Tripp DA, Nickel JC, Mayer R, Reimann M, van Ophoven A. Disability in women suffering from interstitial cystitis/bladder pain syndrome. BJU Int 2012; 111:114-21. [DOI: 10.1111/j.1464-410x.2012.11238.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Laura Katz
- Department of Psychology; Queen's University; ON; Canada
| | - Dean A. Tripp
- Department of Psychology, Anesthesiology & Urology; Queen's University; ON; Canada
| | | | - Robert Mayer
- Department of Urology; University of Rochester Medical Center; Rochester; NY; USA
| | - Maria Reimann
- Department of Neuro-Urology; University Hospital of Bochum; Herne; Germany
| | - Arndt van Ophoven
- Department of Neuro-Urology; University Hospital of Bochum; Herne; Germany
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93
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Matsuoka PK, Haddad JM, Pacetta AM, Baracat EC. Intravesical treatment of painful bladder syndrome: a systematic review and meta-analysis. Int Urogynecol J 2012; 23:1147-53. [DOI: 10.1007/s00192-012-1686-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2011] [Accepted: 01/25/2012] [Indexed: 11/28/2022]
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94
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Tyagi P, Killinger K, Tyagi V, Nirmal J, Chancellor M, Peters KM. Urinary chemokines as noninvasive predictors of ulcerative interstitial cystitis. J Urol 2012; 187:2243-8. [PMID: 22503040 DOI: 10.1016/j.juro.2012.01.034] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2011] [Indexed: 01/14/2023]
Abstract
PURPOSE Based on basic research findings an increase in chemokines and cytokines (CXCL-1 and 10, nerve growth factor and interleukin-6) is considered responsible for inflammation and afferent sensitization. In this cross-sectional study we tested the hypothesis that select chemokines are increased in the urine of patients with ulcerative and nonulcerative interstitial cystitis/painful bladder syndrome. MATERIALS AND METHODS Midstream urinary specimens were collected from 10 patients with ulcerative and nonulcerative interstitial cystitis/painful bladder syndrome, respectively, and from 10 asymptomatic controls. Urinary levels of 7 cytokines were measured by a human cytokine/chemokine assay. Nerve growth factor was measured by enzyme-linked immunosorbent assay. RESULTS Urinary levels of most chemokines/cytokines were tenfold to 100-fold lower in asymptomatic controls vs patients with ulcerative and nonulcerative interstitial cystitis/painful bladder syndrome. Univariate comparison of 8 tested proteins in the ulcerative vs nonulcerative groups revealed a significant fivefold to twentyfold increase in CXCL-10 and 1, interleukin-6 and nerve growth factor (ANOVA p<0.001). CONCLUSIONS Differential expression of chemokines in ulcerative and nonulcerative subtypes of interstitial cystitis/painful bladder syndrome suggests differences in paracrine signaling between the 2 entities.
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Affiliation(s)
- Pradeep Tyagi
- Department of Urology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
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95
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Andersen AV, Granlund P, Schultz A, Talseth T, Hedlund H, Frich L. Long-term experience with surgical treatment of selected patients with bladder pain syndrome/interstitial cystitis. ACTA ACUST UNITED AC 2012; 46:284-9. [DOI: 10.3109/00365599.2012.669789] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Aage Valdemar Andersen
- Department of Urology, Oslo University Hospital,
Rikshospitalet, Oslo, Norway
- Department of Urology, Sørlandet Hospital,
Arendal, Norway
| | - Petter Granlund
- Department of Urology, Oslo University Hospital,
Rikshospitalet, Oslo, Norway
- Department of Surgery, Section of Urology, Central Hospital,
Karlstad, Sweden
| | - Alexander Schultz
- Department of Urology, Oslo University Hospital,
Rikshospitalet, Oslo, Norway
| | - Trygve Talseth
- Department of Urology, Oslo University Hospital,
Rikshospitalet, Oslo, Norway
| | - Hans Hedlund
- Department of Urology, Oslo University Hospital,
Rikshospitalet, Oslo, Norway
| | - Lars Frich
- Department of Urology, Oslo University Hospital,
Aker, Oslo, Norway
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96
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Risk factors that affect the treatment of interstitial cystitis using intravesical therapy with a dimethyl sulfoxide cocktail. Int Urogynecol J 2012; 23:1533-9. [PMID: 22426874 DOI: 10.1007/s00192-012-1699-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2011] [Accepted: 02/09/2012] [Indexed: 10/28/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Dimethyl sulfoxide (DMSO) bladder instillation is a standard therapy for interstitial cystitis (IC); however, there are varying degrees of success. We hypothesize that first-line intravesical therapy with a DMSO cocktail will optimize treatment outcome. METHODS Ninety women with newly diagnosed IC were enrolled consecutively for the treatment. The IC symptom and problem index was used as an outcome measure. RESULTS Six (6.7%) patients dropped out of the treatment due to intolerable bladder irritation. Fifty-five (65.5%) of the remaining 84 patients, who completed the treatment, experienced ≧50% symptomatic improvement. After a regression analysis, three clinical variables were found to affect treatment adversely, i.e., the presence of advanced cystoscopic glomerulations, microscopic hematuria, and urodynamic detrusor underactivity, respectively. CONCLUSIONS Our results suggest bladder instillation with a DMSO cocktail may well be considered as first-line therapy for IC patients. However, there exists a subgroup of nonresponders who may have severe disease.
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98
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Nordling J, Fall M, Hanno P. Global concepts of bladder pain syndrome (interstitial cystitis). World J Urol 2011; 30:457-64. [DOI: 10.1007/s00345-011-0785-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2011] [Accepted: 10/12/2011] [Indexed: 11/24/2022] Open
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99
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Sugihara T, Yasunaga H, Horiguchi H, Nakamura M, Nomiya A, Nishimatsu H, Matsuda S, Homma Y. Admissions related to interstitial cystitis in Japan: An estimation based on the Japanese Diagnosis Procedure Combination database. Int J Urol 2011; 19:86-9. [DOI: 10.1111/j.1442-2042.2011.02883.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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100
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New aspects in the differential diagnosis and therapy of bladder pain syndrome/interstitial cystitis. Adv Urol 2011; 2011:639479. [PMID: 22028706 PMCID: PMC3199109 DOI: 10.1155/2011/639479] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2011] [Revised: 04/08/2011] [Accepted: 07/13/2011] [Indexed: 12/27/2022] Open
Abstract
Diagnosis of bladder pain syndrome/interstitial cystitis (BPS/IC) is presently based on mainly clinical symptoms. BPS/IC can be considered as a worst-case scenario of bladder overactivity of unknown origin, including bladder pain. Usually, patients are partially or completely resistant to anticholinergic therapy, and therapeutical options are especially restricted in case of BPS/IC. Therefore, early detection of patients prone to develop BPS/IC symptoms is essential for successful therapy. We propose extended diagnostics including molecular markers. Differential diagnosis should be based on three diagnostical “columns”: (i) clinical diagnostics, (ii) histopathology, and (iii) molecular diagnostics. Analysis of molecular alterations of receptor expression in detrusor smooth muscle cells and urothelial integrity is necessary to develop patient-tailored therapeutical concepts. Although more research is needed to elucidate the pathomechanisms involved, extended BPS/IC diagnostics could already be integrated into routine patient care, allowing evidence-based pharmacotherapy of patients with idiopathic bladder overactivity and BPS/IC.
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