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Tanaka T. Editorial Comment from Dr Tanaka to Non-bladder conditions in female Taiwanese patients with interstitial cystitis/hypersensitive bladder syndrome. Int J Urol 2014; 21:810. [DOI: 10.1111/iju.12510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Tomoaki Tanaka
- Department of Urology; Osaka City University Graduate School of Medicine; Osaka Japan
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Jiang YH, Liu HT, Kuo HC. Urothelial dysfunction and chronic inflammation in patients with spinal cord injuries at different levels and correlation with urodynamic findings. Neurourol Urodyn 2014; 34:757-62. [DOI: 10.1002/nau.22650] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2014] [Accepted: 06/05/2014] [Indexed: 12/25/2022]
Affiliation(s)
- Yuan-Hong Jiang
- Department of Urology; Buddhist Tzu Chi General Hospital and Tzu Chi University; Hualien Taiwan
| | - Hsin-Tzu Liu
- Department of Urology; Buddhist Tzu Chi General Hospital and Tzu Chi University; Hualien Taiwan
- Institute of Pharmacology and Toxicology; Tzu Chi University; Hualien Taiwan
| | - Hann-Chorng Kuo
- Department of Urology; Buddhist Tzu Chi General Hospital and Tzu Chi University; Hualien Taiwan
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103
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Peng CH, Kuo HC. The sociodemographic and clinical predictors of symptom severity in patients with refractory interstitial cystitis/bladder pain syndrome. Tzu Chi Med J 2014. [DOI: 10.1016/j.tcmj.2014.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Kajiwara M, Inoue S, Kobayashi K, Ohara S, Teishima J, Matsubara A. Therapeutic efficacy of narrow band imaging-assisted transurethral electrocoagulation for ulcer-type interstitial cystitis/painful bladder syndrome. Int J Urol 2014; 21 Suppl 1:57-60. [PMID: 24807500 DOI: 10.1111/iju.12350] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Accepted: 11/08/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Narrow band imaging cystoscopy can increase the visualization and detection of Hunner's lesions. A single-center, prospective clinical trial was carried out aiming to show the effectiveness of narrow band imaging-assisted transurethral electrocoagulation for ulcer-type interstitial cystitis/painful bladder syndrome. METHODS A total of 23 patients (19 women and 4 men) diagnosed as having ulcer-type interstitial cystitis/painful bladder syndrome were included. All typical Hunner's lesions and suspected areas identified by narrow band imaging were electrocoagulated endoscopically after the biopsy of those lesions. Therapeutic efficacy was assessed prospectively by using visual analog scale score of pain, O'Leary-Sant's symptom index, O'Leary-Sant's problem index and overactive bladder symptom score. RESULTS The mean follow-up period was 22 months. All patients (100%) experienced a substantial improvement in pain. The average visual analog scale pain scores significantly decreased from 7.3 preoperatively to 1.2 1 month postoperatively. A total of 21 patients (91.3%) who reported improvement had at least a 50% reduction in bladder pain, and five reported complete resolution. Daytime frequency was significantly decreased postoperatively. O'Leary-Sant's symptom index, O'Leary-Sant's problem index and overactive bladder symptom score were significantly decreased postoperatively. However, during the follow-up period, a total of six patients had recurrence, and repeat narrow band imaging-assisted transurethral electrocoagulation of the recurrent lesions was carried out for five of the six patients, with good response in relieving bladder pain. CONCLUSIONS Our results showed that narrow band imaging-assisted transurethral electrocoagulation could be a valuable therapeutic alternative in patients with ulcer-type interstitial cystitis/painful bladder syndrome, with good efficacy and reduction of recurrence rate.
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Affiliation(s)
- Mitsuru Kajiwara
- Department of Urology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Hiroshima, Japan
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Jhang JF, Jiang YH, Kuo HC. Potential therapeutic effect of intravesical botulinum toxin type A on bladder pain syndrome/interstitial cystitis. Int J Urol 2014; 21 Suppl 1:49-55. [DOI: 10.1111/iju.12317] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2013] [Accepted: 08/14/2013] [Indexed: 12/29/2022]
Affiliation(s)
- Jia-Fong Jhang
- Department of Urology; Buddhist Tzu Chi General Hospital and Tzu Chi University; Hualien Taiwan
| | - Yuan-Hong Jiang
- Department of Urology; Buddhist Tzu Chi General Hospital and Tzu Chi University; Hualien Taiwan
| | - Hann-Chorng Kuo
- Department of Urology; Buddhist Tzu Chi General Hospital and Tzu Chi University; Hualien Taiwan
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106
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Fan YH, Lin ATL, Lu SH, Chuang YC, Chen KK. Non-bladder conditions in female Taiwanese patients with interstitial cystitis/hypersensitive bladder syndrome. Int J Urol 2014; 21:805-9. [DOI: 10.1111/iju.12456] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2013] [Accepted: 03/07/2014] [Indexed: 12/30/2022]
Affiliation(s)
- Yu-Hua Fan
- Department of Urology; Taipei Veterans General Hospital; Taipei Taiwan
- School of Medicine; National Yang-Ming University; Taipei Taiwan
- Shu-Tien Urological Science Research Center; Taipei Taiwan
| | - Alex TL Lin
- Department of Urology; Taipei Veterans General Hospital; Taipei Taiwan
- School of Medicine; National Yang-Ming University; Taipei Taiwan
- Shu-Tien Urological Science Research Center; Taipei Taiwan
| | - Shing-Hwa Lu
- School of Medicine; National Yang-Ming University; Taipei Taiwan
- Department of Urology; Taipei City Hospital; Taipei Taiwan
| | - Yao-Chi Chuang
- Department of Urology; Kaohsiung Chang Gung Memorial Hospital; Kaohsiung Taiwan
- Chang Gung University College of Medicine; Kaohsiung Taiwan
| | - Kuang-Kuo Chen
- Department of Urology; Taipei Veterans General Hospital; Taipei Taiwan
- School of Medicine; National Yang-Ming University; Taipei Taiwan
- Shu-Tien Urological Science Research Center; Taipei Taiwan
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Oliveira PD. Editorial Comment from Professor Dinis to Potential therapeutic effect of intravesical botulinum toxin type A on bladder pain syndrome/interstitial cystitis. Int J Urol 2014; 21 Suppl 1:56. [DOI: 10.1111/iju.12319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Paulo Dinis Oliveira
- Urology Department; Faculty of Medicine of Porto Portugal; Hospital Sao Joao; Porto Portugal
- Department of Urology; Hospital Sao Joao; Porto Portugal
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108
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Jiang YH, Liu HT, Kuo HC. Decrease of urinary nerve growth factor but not brain-derived neurotrophic factor in patients with interstitial cystitis/bladder pain syndrome treated with hyaluronic acid. PLoS One 2014; 9:e91609. [PMID: 24614892 PMCID: PMC3948883 DOI: 10.1371/journal.pone.0091609] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Accepted: 02/12/2014] [Indexed: 01/07/2023] Open
Abstract
Aims To investigate urinary nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF) levels in interstitial cystitis/bladder pain syndrome (IC/BPS) patients after hyaluronic acid (HA) therapy. Methods Thirty-three patients with IC/BPS were prospectively studied; a group of 45 age-matched healthy subjects served as controls. All IC/BPS patients received nine intravesical HA instillations during the 6-month treatment regimen. Urine samples were collected for measuring urinary NGF and BDNF levels at baseline and 2 weeks after the last HA treatment. The clinical parameters including visual analog scale (VAS) of pain, daily frequency nocturia episodes, functional bladder capacity (FBC) and global response assessment (GRA) were recorded. Urinary NGF and BDNF levels were compared between IC/BPS patients and controls at baseline and after HA treatment. Results Urinary NGF, NGF/Cr, BDNF, and BDNF/Cr levels were significantly higher in IC/BPS patients compared to controls. Both NGF and NGF/Cr levels significantly decreased after HA treatment. Urinary NGF and NGF/Cr levels significantly decreased in the responders with a VAS pain reduction by 2 (both p < 0.05) and the GRA improved by 2 (both p < 0.05), but not in non-responders. Urinary BDNF and BDNF/Cr did not decrease in responders or non-responders after HA therapy. Conclusions Urinary NGF, but not BDNF, levels decreased significantly after HA therapy; both of these factors remained higher than in controls even after HA treatment. HA had a beneficial effect on IC/BPS, but it was limited. The reduction of urinary NGF levels was significant in responders, with a reduction of pain and improved GRA.
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Affiliation(s)
- Yuan-Hong Jiang
- Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan
| | - Hsin-Tzu Liu
- Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan
- Institute of Pharmacology and Toxicology, Tzu Chi University, Hualien, Taiwan
| | - Hann-Chorng Kuo
- Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan
- * E-mail:
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Malykhina A, Hanno P. How are we going to make progress treating bladder pain syndrome? ICI-RS 2013. Neurourol Urodyn 2014; 33:625-9. [PMID: 24615847 DOI: 10.1002/nau.22575] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2013] [Accepted: 01/27/2014] [Indexed: 12/24/2022]
Abstract
AIMS To look at the current state of knowledge in bladder pain syndrome and ascertain how we can make advances in the near term. METHODS A compendium of the ideas presented at the International Consultation on Incontinence Research Society 2013 meeting of clinicians and basic scientists. RESULTS The meeting included the following topics: potential connection between defined and undefined IC/BPS; association between psychiatric disorders and IC/BPS; rationale for multimodal therapy approach in IC/BPS; and issues of a placebo control in human studies. CONCLUSIONS Translational research studies are still in need of improved animal models to study IC/BPS mechanisms and development of novel methods to objectively measure bladder pain in rodents. The need to try and develop better clinical therapies will best be met by proper phenotyping of this heterogeneous population and avoiding premature publication of clinical trials that are anecdotal and do not include randomized placebo control populations. Patients with Hunner's lesions should be identified prior to or in the course of clinical trials so that results in this subgroup can be evaluated.
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Affiliation(s)
- Anna Malykhina
- Division of Urology, Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
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110
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Peng CH, Jhang JF, Shie JH, Kuo HC. Down Regulation of Vascular Endothelial Growth Factor Is Associated With Decreased Inflammation After Intravesical OnabotulinumtoxinA Injections Combined With Hydrodistention for Patients With Interstitial Cystitis—Clinical Results and Immunohistochemistry Analysis. Urology 2013; 82:1452.e1-6. [DOI: 10.1016/j.urology.2013.09.003] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Revised: 08/20/2013] [Accepted: 09/04/2013] [Indexed: 11/29/2022]
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Ueda T, Yoshida T, Tanoue H, Ito M, Tamaki M, Ito Y, Yoshimura N. Urine alkalization improves the problems of pain and sleep in hypersensitive bladder syndrome. Int J Urol 2013; 21:512-7. [PMID: 24224617 DOI: 10.1111/iju.12324] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Accepted: 09/23/2013] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To investigate the efficacy of urine alkalization therapy using citrates in patients with hypersensitive bladder syndrome. METHODS A total of 76 patients with urinary frequency were assessed for their symptoms using a 2-day voiding diary as well as the urine pH at each voiding during the screening period. Their symptoms were also assessed by pain score, King's health questionnaire, and O'Leary-Sant symptom and problem index scores. Finally, 50 patients were evaluated for changes in symptoms after oral treatment with citrates for 2-4 weeks after the screening period. RESULTS After the treatment, significant increases in the urine pH (from 5.8 ± 0.4 to 6.3 ± 0.4; increment of 0.5 ± 0.4; P < 0.01), and significant decreases in the number of micturitions per day (from 14.5 ± 6.5 to 13.5 ± 5.9; P = 0.02) and the number of episodes of pain/discomfort per day (from 7.8 ± 6.8 to 6.1 ± 7.1; P = 0.02) were observed. In the King's health questionnaire, the sleep/energy domain score was significantly improved (from 60.0 ± 25.0 to 50.3 ± 29.6; P < 0.01). In a subgroup analysis based on urine pH (urine pH <6.2 and ≥6.2), significant improvements in the voiding symptoms, the sleep/energy domain score and the O'Leary-Sant problem index were observed in the group with urine pH of ≥6.2. There were statistically significant differences between the subgroups in the volume per voiding, maximum volume per voiding and the problem index. In addition, the subgroup, in which patients had pain in the screening period, showed statistically significant improvements in the number of micturitions per day, episodes of pain/discomfort per day, the sleep/energy domain score and the problem index. CONCLUSIONS Urine alkalization therapy is likely to be effective in the treatment for hypersensitive bladder syndrome.
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Boudry G, Labat JJ, Riant T, Le Normand L, Manunta A, Bensalah K, Rigaud J. Validation of voiding diary for stratification of bladder pain syndrome according to the presence/absence of cystoscopic abnormalities: a two-centre prospective study. BJU Int 2013; 112:E164-8. [PMID: 23795793 DOI: 10.1111/bju.12165] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To assess the value of the voiding diary in the management of patients with bladder pain syndrome for predicting the presence or absence of cystoscopic abnormalities. PATIENTS AND METHODS From November 2009 to March 2011, 54 consecutive patients (39 women and 15 men) with bladder pain syndrome, as defined by the European Society for the Study of Interstitial Cystitis/Bladder Pain Syndrome (ESSIC) criteria, were prospectively enrolled in this two-centre study. All patients completed a home voiding diary on 3 consecutive days, which included analysis of voiding frequency, voided volume and severity of pre- and post-voiding pain. The variables were evaluated on a numeric pain scale (NPS). All patients then underwent standardized cystoscopy under anaesthesia. Patients were stratified into two groups: a group with or a group without cystoscopic abnormalities. Voiding diary variables were compared using Student's t-test. RESULTS Cystoscopic abnormalities were found in 33 patients. The group of patients with cystoscopic abnormalities had significantly more severe frequency (P = 0.034), especially nocturnal frequency (P = 0.009), a significantly lower mean voiding volume and lower sd from the mean (P = 0.011 and P = 0.014), and a significantly lower mean post-voiding NPS score (P = 0.039). CONCLUSION On analysis of the voiding diaries, we found that different patient profiles were associated with the cystoscopic appearance of the bladder. A clinical voiding score was proposed to predict the cystoscopic appearance of the bladder on the basis of the voiding diary in bladder pain syndrome but needs to be validated on an independent population.
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113
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Kuo YC, Kuo HC. The urodynamic characteristics and prognostic factors of patients with interstitial cystitis/bladder pain syndrome. Int J Clin Pract 2013; 67:863-9. [PMID: 23952465 DOI: 10.1111/ijcp.12116] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2012] [Accepted: 12/19/2012] [Indexed: 11/27/2022] Open
Abstract
AIMS The role of urodynamic study (UDS) in diagnosis of interstitial cystitis/bladder pain syndrome (IC/BPS) remains inconclusive, nor has the predictor for a treatment success been elucidated. We evaluated the diagnostic and prognostic values of UDS in patients with IC/BPS. MATERIALS AND METHODS IC/BPS patients with complete data of a symptom assessment, video UDS, potassium chloride (KCl) test, cystoscopic hydrodistention and treatment records were reviewed retrospectively. O'Leary-Sant symptom index and problem index (ICSI, ICPI) were available in part of the patients. The associations between UDS parameters with symptom scores, KCl test result, cystoscopy findings and treatment outcome were analysed. The UDS parameters, including first sensation of filling (FSF), first desire to void (FD), strong desire to void (SD), cystometric bladder capacity (CBC), maximum flow rate (Q(max)), detrusor pressure at Q(max) (Pdet), voided volume (VV) and postvoid residual (PVR). Univariate and multivariate logistic regression analyses were used to identify the variable predicting treatment success. RESULTS A total of 214 IC/BPS patients were enrolled in this study. The mean volumes at FSF, FD, SD, CBC and VV were inversely correlated with ICSI and ICPI (all p < 0.05). The patients with a positive KCl test had significantly lower mean volumes at SD, CBC, VV and lower Q(max) (all p < 0.05). Significantly lower mean volumes for FSF, FD, SD, CBC and VV were found in patients with higher grade of glomerulation under cystoscopy (all p < 0.01). The anaesthetic maximal bladder capacity (MBC) was positively correlated with FSF, FD, SD, CBC, Q(max) and VV (all p < 0.01). Female gender and the volume at SD were found to be the independent predictors for treatment outcome. CONCLUSIONS Our study demonstrated that there might be a role of UDS to help in diagnosis and prognostication for IC/BPS. Future prospective investigations are warranted.
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Affiliation(s)
- Y-C Kuo
- Department of Urology, Yangming Branch of Taipei City Hospital, Taipei, Taiwan
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114
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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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Lee CL, Jiang YH, Kuo HC. Increased apoptosis and suburothelial inflammation in patients with ketamine-related cystitis: a comparison with non-ulcerative interstitial cystitis and controls. BJU Int 2013; 112:1156-62. [PMID: 23937072 DOI: 10.1111/bju.12256] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To investigate the suburothelial inflammation and urothelial dysfunction that occurs with ketamine-related cystitis (KC) and interstitial cystitis/bladder pain syndrome (IC/BPS). PATIENTS AND METHODS Bladder tissues from 16 patients with KC, 17 patients with IC/BPS and 10 control subjects were analysed. Immunofluorescence staining of the junction protein E-cadherin was carried out, and tryptase levels and a TUNEL assay were used to assess mast-cell activation and urothelial apoptosis, respectively. The fluorescence intensity of E-cadherin was measured using the ImageJ method. The percentages of activated mast cells and apoptotic cells were calculated as positive cells per unit area (4 μm(2) ). RESULTS The mean (sd) ages of the patients in the KC, IC/BPS and control groups were 25.0 (3.8), 41.3 (13.7) and 50.5 (9.6) years, respectively (P < 0.05). The mean (sd) distributions of E-cadherin in KC (10.1 [11.2]) and IC/BPS (25.1 [16.3]) tissues were significantly lower than in the control tissues (42.4 [16.7]; both P < 0.05). The mean (sd) number of activated mast cells, measured by tryptase signals in the KC (6.5 [3.7]) and IC/BPS (4.6 [3.0]) tissues, were significantly higher than in the control tissues (1.3 [1.12]; both P < 0.05). TUNEL staining showed a significantly higher mean (sd) number of apoptotic cells in KC (4.4 [2.5]) and IC/BPS (2.4 [1.7]) tissues than in control tissues (0.1 [0.3]; both P < 0.05). Tissues from the KC bladders had significantly lower expression of E-cadherin (P = 0.024) and significantly higher numbers of apoptotic cells (P = 0.02) compared with the IC/BPS bladder tissues. Greater numbers of apoptotic cells and lower expression levels of E-cadherin significantly correlated with maximum bladder capacity in the overall patient samples (P < 0.05). CONCLUSIONS KC and IC/BPS tissues both showed defective junction protein, increased suburothelial inflammation and increased urothelial cell apoptosis. Decreased expression of E-cadherin and increased apoptosis were more severe in KC than in IC/BPS bladder tissues and these findings were associated with the clinical symptoms of KC and IC/BPS.
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Affiliation(s)
- Cheng-Ling Lee
- Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan
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Homma Y, Nomiya A, Tagaya M, Oyama T, Takagaki K, Nishimatsu H, Igawa Y. Increased mRNA expression of genes involved in pronociceptive inflammatory reactions in bladder tissue of interstitial cystitis. J Urol 2013; 190:1925-31. [PMID: 23727186 DOI: 10.1016/j.juro.2013.05.049] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2013] [Indexed: 12/22/2022]
Abstract
PURPOSE We assayed mRNA expression of the TRP family of channels and ASIC1 in bladder tissue from patients with interstitial cystitis. MATERIALS AND METHODS Bladder biopsies of 1) nonclassic interstitial cystitis, 2) nonulcerative portions of classic interstitial cystitis, 3) ulcerative portions of classic interstitial cystitis and 4) noncancerous portions of bladder cancer as the control were placed immediately in ice-cold RNAlater® and subjected to real-time reverse transcriptase-polymerase chain reaction. We compared the mRNA expression of TRP channels, ASIC1, NGF, CXCL9 and UPK3A with that of controls, and correlated expression with symptom severity. RESULTS We analyzed specimens from 17 patients with nonclassic interstitial cystitis, 22 with classic interstitial cystitis and 11 controls. In nonclassic interstitial cystitis samples TRPV2 and NGF showed significantly increased expression. In classic interstitial cystitis samples nonulcerative portions demonstrated a significant increase in the expression of TRPA1, TRPM2 and 8, TRPV1 and 2, ASIC1, NGF and CXCL9, and a significant decrease in UPK3A and TRPV4. Ulcerative portions showed similar changes for TRPM2, TRPV1, 2 and 4, CXCL9 and UPK3A. Increased expression of TRPM2, first noted in interstitial cystitis tissue, was the most pronounced one of the TRP family. All symptom measures correlated with TRPM2 and TRPV2 expression, and partially with that of the other genes. CONCLUSIONS This study showed increased expression of the genes involved in pronociceptive inflammatory reactions in interstitial cystitis, including TRPV1, 2 and 4, ASIC1, NGF and CXCL9, and to our knowledge TRPM2 for the first time. The different expression patterns suggest distinct pathophysiologies for classic and nonclassic interstitial cystitis. The genes and their products are potential candidates for use as biomarkers or novel therapy targets.
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Affiliation(s)
- Yukio Homma
- Department of Urology, University of Tokyo, Tokyo, Japan.
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TOBU S, NOGUCHI M, HATADA T, MORI KI, MATSUO M, SAKAI H. Upregulation of Angiotensin II Receptor and Connexin 43 in Increased Suburothelial Myofibroblasts in the Rat Inflammatory Bladder. Low Urin Tract Symptoms 2013; 5:90-5. [DOI: 10.1111/j.1757-5672.2012.00167.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Matsumoto S, Ueda T, Kakizaki H. Effect of supplementation with hydrogen-rich water in patients with interstitial cystitis/painful bladder syndrome. Urology 2013; 81:226-30. [PMID: 23374763 DOI: 10.1016/j.urology.2012.10.026] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2012] [Revised: 10/14/2012] [Accepted: 10/15/2012] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To investigate the efficacy of hydrogen-rich water for the treatment of patients with interstitial cystitis/painful bladder syndrome (IC/PBS). METHODS We conducted a prospective, randomized, double-blind, placebo-controlled clinical trial of hydrogen-rich water in patients with IC/PBS. Inclusion criteria were stable symptoms of IC/PBS for ≥ 12 weeks after bladder hydrodistension, Interstitial Cystitis Symptom Index score of ≥ 7 and bladder pain (question 4 on Interstitial Cystitis Symptom Index) of ≥ 4. They were randomized by a 2:1 ratio to receive hydrogen-rich water or placebo water for 8 weeks. The symptoms were assessed using the Interstitial Cystitis Symptom Index, Interstitial Cystitis Problem Index, Parsons' Pelvic Pain and Urgency/Frequency Patient Symptom Scale, visual analog scale bladder pain scores, and a standard 3-day voiding diary. The primary outcome was improvement of patient-reported symptoms evaluated after treatment. RESULTS A total of 30 participants (29 women and 1 man, age 64.0 ± 14.8 years) were enrolled in the present study, and 2 patients (both women) were withdrawn from the study. The score of bladder pain was significantly reduced in both groups. However, the effect of hydrogen-rich water on symptoms was not significantly different from that of placebo, although supplementation with hydrogen-rich water was extremely effective in improving the bladder pain score in 11% of the patients. CONCLUSION The results of the present study do not support the use of supplementation with hydrogen-rich water for treating patients with IC/PBS.
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Affiliation(s)
- Seiji Matsumoto
- Department of Renal and Urologic Surgery, Asahikawa Medical University, Hokkaido, Japan.
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Homan T, Tsuzuki T, Dogishi K, Shirakawa H, Oyama T, Nakagawa T, Kaneko S. Novel mouse model of chronic inflammatory and overactive bladder by a single intravesical injection of hydrogen peroxide. J Pharmacol Sci 2013; 121:327-37. [PMID: 23545478 DOI: 10.1254/jphs.12265fp] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
There is so far no generally accepted animal model of chronic cystitis by which potential therapies can be evaluated. In this study, we aimed to establish a new mouse model of cystitis based on the proinflammatory effects of reactive oxygen species. A single intravesical injection of 1.5% hydrogen peroxide (H2O2) significantly increased the numbers of voids by 1 day after injection in female mice, which lasted up to 7 days. The H2O2 injection rapidly increased the bladder weight by 3 h in parallel with the histological damage and hyperpermeability of urothelial barrier. Although the urothelial dysfunction was recovered to normal by 7 days, increase in bladder weight, edematous thickening of the submucosa, and vascular hyperpermeability were apparent even 7 days after injection. During the time course, massive infiltration of neutrophils and increased expression of inflammatory cytokines were observed in the bladder. An intraperitoneal administration of oxybutynin, amitriptyline, indomethacin, or morphine attenuated the H2O2-induced frequent urination. These findings suggest that an intravesical injection of H2O2 induces relatively long-lasting inflammatory and overactive bladder, compared with existing cystitis models. The intravesical H2O2 injection model may be a simple and useful tool in the pathological study and drug discovery for chronic cystitis.
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Affiliation(s)
- Takashi Homan
- Department of Molecular Pharmacology, Graduate School of Pharmaceutical Sciences, Kyoto University, Japan
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Homma Y. Hypersensitive bladder: towards clear taxonomy surrounding interstitial cystitis. Int J Urol 2013; 20:742-3. [PMID: 23521051 DOI: 10.1111/iju.12143] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2013] [Accepted: 02/18/2013] [Indexed: 01/22/2023]
Affiliation(s)
- Yukio Homma
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
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121
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[The care situation of patients with interstitial cystitis in Germany: results of a survey of 270 patients]. Urologe A 2013; 52:691-702. [PMID: 23459923 DOI: 10.1007/s00120-013-3130-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Using a comprehensive questionnaire the care situation of 270 patients with interstitial cystitis (IC) and bladder pain syndrome in Germany was recorded. Despite comprehensive literature on IC (62,000 citations in PubMed) almost nothing is known of the everyday care and quality of patient care in Germany. RESULTS In total 94% of the patients were women and 6% men, the average age of women was 53.5 years and that of men 67 years and 47.77% of the patients felt that they were well or very well informed about the disease whereby the internet was the source of information in many cases. The exchange of information among patients will increase further through social networks. The diagnosis of IC was made most frequently (62.22%) by biopsy and histological examination followed by urodynamics, potassium test, hydrodistension and cystoscopy. The average duration of the diagnosis was 9 years, 46.67% of the patients consulted a doctor more than 20 times before the diagnosis was made and 51.84% had to pass water more than 14 times per day. Frequency, nocturia and pain were the leading symptoms and 25% of the patients complained of urge incontinence. Among oral medications, analgesics were taken most frequently (61.7%) followed by pentosan polysulphate, antidepressants, antiepileptic drugs, antispasmodics and remedies for urinary urgency. In the self-assessment of the success of treatment with oral medications (helped very well and well), pentosan polysulphate, analgesics, antidepressants and antiepileptic drugs were considered to be the best. Medications that restore the glucosamine lining of the bladder were used predominantly for instillation into the bladder included hyaluronic acid, chondroitin sulphate and a combination of both and pentosan polysulphate. In the self-assessment of the success of treatment with instillation therapy (helped very well or well) the order was: chondroitin sulphate (62.69%), hyaluronic acid (55.77%), a combination of both (53.66%) and pentosan polysulphate (46.30%). The electromotive drug administration (EMDA) procedure with the use of direct current to introduce medications into the bladder wall was mentioned surprisingly often, namely, in 119 patients. In the self-assessment success (helped very well or well) was considered the best for intravesical procedures with 61.34%. CONCLUSIONS Compared with all drug procedures instillation of medications into the bladder was mentioned 368 times and was assessed by the patients as having helped very well and noticeably by 53.53%, followed by special invasive procedures at 50.56%/271 mentions, alternative therapies at 41.11%/287 mentions and oral medication at 39.75%/1,024 mentions. Hyaluronic acid and chondroitin sulphate products, the combination of both and pentosan polysulphate (oral and intravesical) are not reimbursed by the statutory health insurance. Over 40% of patients treated with these therefore discontinued the treatment for reasons of cost.
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Long-term treatment outcomes in patients with interstitial cystitis/painful bladder syndrome: 10-year experience in NCKUH. UROLOGICAL SCIENCE 2013. [DOI: 10.1016/j.urols.2013.01.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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123
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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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Shie JH, Liu HT, Kuo HC. Protein expression profiling in interstitial cystitis/painful bladder syndrome: A pilot study of proteins associated with inflammation, apoptosis, and angiogenesis. UROLOGICAL SCIENCE 2012. [DOI: 10.1016/j.urols.2012.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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125
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Shie JH, Kuo HC. Pathologic mechanism of the therapeutic effect of botulinum toxin A on interstitial cystitis and painful bladder syndrome. Tzu Chi Med J 2012. [DOI: 10.1016/j.tcmj.2012.05.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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126
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Liu HT, Kuo HC. Increased urine and serum nerve growth factor levels in interstitial cystitis suggest chronic inflammation is involved in the pathogenesis of disease. PLoS One 2012; 7:e44687. [PMID: 23028581 PMCID: PMC3444462 DOI: 10.1371/journal.pone.0044687] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2012] [Accepted: 08/07/2012] [Indexed: 12/30/2022] Open
Abstract
Objective Interstitial cystitis/bladder pain syndrome (IC/BPS) is considered a bladder disorder due to localized chronic inflammation. This study investigated the nerve growth factor (NGF) levels in serum and urine in patients with IC/BPS. Materials and Methods Thirty patients with IC/BPS and 28 normal subjects without lower urinary tract symptoms were recruited from an outpatient clinic. IC/BPS was diagnosed by frequency, bladder pain, and the presence of glomerulations during cystoscopic hydrodistention. Serum and urine were collected before any treatment was given. Serum NGF and urinary NGF/Cr levels were compared between IC/BPS and the controls. Results Urinary NGF levels were significantly higher in patients with IC/PBS (26.3±11.2 pg/ml) than in controls (1.40±0.63 pg) (p = 0.014). After normalization, the urinary NGF/Cr levels were significantly greater in IC/BPS (0.69±0.38 pg/mg) than controls (0.20±0.01, p = 0.011). Relative to the levels in control subjects (1.90±0.38 pg/mL), the mean serum NGF levels were higher in patients IC/BPS patients (3.48±0.55 pg/mL) (p = 0.015). No significant correlation was found between the serum and urinary NGF levels in IC/BPS patients. However, the clinical characteristics and medical co-morbidities did not show significant difference between IC/BPS patients with a higher and lower serum NGF level. Conclusions Increased urinary NGF levels in IC/BPS patients suggest that chronic inflammation is involved in this bladder disorder. Increased circulating serum NGF levels were noted in over half of patients with IC/BPS, however, the urinary and serum NGF were not inter-correlated and elevated serum NGF did not relate with clinical features.
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Affiliation(s)
- Hsin-Tzu Liu
- Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualin, Taiwan
- Institute of Pharmacology and Toxicology, Tzu Chi University, Hualien, Taiwan
- * E-mail: (HTL); (HCK)
| | - Hann-Chorng Kuo
- Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualin, Taiwan
- * E-mail: (HTL); (HCK)
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Shie JH, Liu HT, Wang YS, Kuo HC. Immunohistochemical evidence suggests repeated intravesical application of botulinum toxin A injections may improve treatment efficacy of interstitial cystitis/bladder pain syndrome. BJU Int 2012; 111:638-46. [DOI: 10.1111/j.1464-410x.2012.11466.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Jia-Heng Shie
- Department of Urology; Buddhist Tzu Chi General Hospital and Tzu Chi University
| | | | - Yu-Syuan Wang
- Department of Urology; Buddhist Tzu Chi General Hospital and Tzu Chi University
| | - Hann-Chorng Kuo
- Department of Urology; Buddhist Tzu Chi General Hospital and Tzu Chi University
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128
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Fall M, Peeker R. Methods and incentives for the early diagnosis of bladder pain syndrome/interstitial cystitis. ACTA ACUST UNITED AC 2012; 7:17-24. [PMID: 23530841 DOI: 10.1517/17530059.2012.717069] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
INTRODUCTION The concept of interstitial cystitis (IC) has changed dramatically during the last decades, eventually representing a symptom complex with varying contents. To include all patients with bladder pain, the umbrella term 'bladder pain syndrome' (BPS) has been suggested, incorporating the classic presentation of IC as a separate phenotype. This change of concepts has not been uncontroversial. Bladder pain syndrome often has a profound effect on the patients' quality of life. Generally, recognition of this problem complex is hampered by insufficient familiarity in the medical community. The correct diagnosis is often delayed by several years and may be preceded by multiple medical consultations and treatment attempts. There is no doubt that an early and correct diagnosis is of great significance for the patient. AREAS COVERED In this article, a critical review of methods and means to approach the diagnosis is presented including some notes of current controversies. EXPERT OPINION The key to an early diagnosis is symptom recognition. We are dealing with a heterogeneous concept including various phenotypes. The successful treatment requires understanding and expedient use of objective means, such as cystoscopy, biopsy and input from the multidisciplinary team. In the literature, limited evidence exists for the management of BPS/IC, due to heterogeneity in methodology and description of the syndrome(s). A more consequent use of available methods is desirable. For the immediate future, better understanding of the aetiology, pathogenesis and presentation of various BPS/IC phenotypes is indispensable.
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Affiliation(s)
- Magnus Fall
- University of Gothenburg, Sahlgrens University Hospital, Department of Urology, Göteborg, Sweden.
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129
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Lai MC, Kuo YC, Kuo HC. Intravesical hyaluronic acid for interstitial cystitis/painful bladder syndrome: a comparative randomized assessment of different regimens. Int J Urol 2012; 20:203-7. [PMID: 22925498 DOI: 10.1111/j.1442-2042.2012.03135.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To compare the clinical effectiveness of different regimens of intravesical hyaluronic acid instillation for patients with interstitial cystitis/painful bladder syndrome. METHODS A total of 60 patients (age 16-77 years) diagnosed with interstitial cystitis/painful bladder syndrome were enrolled in this prospective, randomized study. A total of 30 patients were assigned to receive four weekly intravesical instillations of 40 mg of hyaluronic acid followed by five monthly instillations (hyaluronic acid-9 group). Another 30 patients received 12 intravesical instillations of 40 mg hyaluronic acid every 2 weeks (hyaluronic acid-12 group). Symptomatic changes after hyaluronic acid treatments were assessed using Interstitial Cystitis Symptom and Problem Indexes, pain visual analog scale, functional bladder capacity, frequency and nocturia in voiding diary, maximum flow rate, voided volume, postvoid residual volume, and Quality of Life Index at 1, 3 and 6 months. RESULTS Of the 60 patients, 59 were evaluable at the end of the study. The Interstitial Cystitis Symptom Index, Interstitial Cystitis Problem Index and total score, pain visual analog scale, functional bladder capacity, maximum flow rate, and Quality of Life Index improved significantly after 6 months in both groups. The frequency and voided volume improved significantly only in the hyaluronic acid-12 group. However, patients with moderate and marked improvement were clinically similar in both groups. The measured variables did not differ between the two groups over the course of the study. CONCLUSION No significant difference was noted in the therapeutic effect between two hyaluronic acid instillation regimens for treatment of interstitial cystitis/painful bladder syndrome patients. Both groups showed significant improvement in symptom scores and Quality of Life Index.
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Affiliation(s)
- Ming-Chih Lai
- Department of Urology, Taipei City Hospital, Taipei, Taiwan
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130
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Giannantoni A, Bini V, Dmochowski R, Hanno P, Nickel JC, Proietti S, Wyndaele JJ. Reply to Claus Riedl’s Letter to the Editor re: Antonella Giannantoni, Vittorio Bini, Roger Dmochowski, et al. Contemporary Management of the Painful Bladder: A Systematic Review. Eur Urol 2012;61:29–53. Eur Urol 2012. [DOI: 10.1016/j.eururo.2012.02.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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131
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Hanno P, Andersson KE, Birder L, Elneil S, Kanai A, Pontari M. Chronic pelvic pain syndrome/bladder pain syndrome: Taking stock, looking ahead: ICI-RS 2011. Neurourol Urodyn 2012; 31:375-83. [DOI: 10.1002/nau.22202] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2011] [Accepted: 12/23/2011] [Indexed: 12/21/2022]
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Furuta A, Suzuki Y, Hayashi N, Egawa S, Yoshimura N. Transient receptor potential A1 receptor-mediated neural cross-talk and afferent sensitization induced by oxidative stress: Implication for the pathogenesis of interstitial cystitis/bladder pain syndrome. Int J Urol 2012; 19:429-36. [DOI: 10.1111/j.1442-2042.2012.02966.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Kuo YC, Kuo HC. Potential factors that can be used to differentiate between interstitial cystitis/painful bladder syndrome and bladder oversensitivity in women. Int J Clin Pract 2012; 66:146-51. [PMID: 21951755 DOI: 10.1111/j.1742-1241.2011.02767.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
AIM There is considerable overlap between symptoms of interstitial cystitis/painful bladder syndrome (IC/PBS) and bladder oversensitivity, thereby making it difficult to differentiate between the two based on symptoms alone. We investigated factors that could potentially be used to differentiate between IC/PBS and bladder oversensitivity in women. MATERIALS AND METHODS Video-urodynamic study (VUDS) results in women with lower urinary tract symptoms (LUTS) were retrospectively analysed. Patients classified as having increased bladder sensation (IBS) were selected for analysis. A potassium chloride (KCl) test was performed and pain or urgency elicited was considered positive response. Cystoscopic hydrodistention demonstrating glomerulation was considered diagnosis of IC/PBS; otherwise bladder oversensitivity was diagnosed. LUTS, urodynamic variables and results of the KCl test were used to predict IC/PBS in these women. RESULTS A total of 405 women with IBS and 272 symptomatic controls with normal VUDS findings were included. Among 227 IBS patients undergoing KCl test, a positive result was found in 190 and a negative test result was found in 37. Characteristic glomerulation was noted in 170 patients, including 165 with a positive and five with a negative KCl test. We found that storage symptoms and pain had a positive predictive value of 45.3% for IC/PBS. When a CBC ≤ 350 ml was added the positive predictive value was 65% for IC/PBS. A combination of storage symptoms, a CBC ≤ 350 ml, a positive KCl test result with an increase of ≥ 2 on the visual analogue pain scale (VAS) provided 100% predictive of IC/PBS. CONCLUSION A diagnosis of IC/PBS can be made without cystoscopic hydrodistention in women with increased bladder sensation, having storage symptoms, a CBC ≤ 350 ml, a positive KCl test result and a VAS score ≥ 2.
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Affiliation(s)
- Y-C Kuo
- Department of Urology, Taipei City Hospital, Yangming Branch, Taipei, Taiwan
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134
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Increased Cell Apoptosis of Urothelium Mediated by Inflammation in Interstitial Cystitis/Painful Bladder Syndrome. Urology 2012; 79:484.e7-13. [DOI: 10.1016/j.urology.2011.09.049] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2011] [Revised: 07/27/2011] [Accepted: 09/07/2011] [Indexed: 11/20/2022]
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135
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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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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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137
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Fujimura T, Kume H, Nishimatsu H, Sugihara T, Nomiya A, Tsurumaki Y, Miyazaki H, Suzuki M, Fukuhara H, Enomoto Y, Homma Y. Assessment of lower urinary tract symptoms in men by international prostate symptom score and core lower urinary tract symptom score. BJU Int 2011; 109:1512-6. [DOI: 10.1111/j.1464-410x.2011.10445.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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138
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Nomiya A, Nishimatsu H, Homma Y. Interstitial cystitis symptoms associated with ketamine abuse: the first Japanese case. Int J Urol 2011; 18:735. [PMID: 21848631 DOI: 10.1111/j.1442-2042.2011.02829.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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139
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Bladder Pain Syndrome, Interstitial Cystitis, Painful Bladder Syndrome, and Hypersensitive Bladder Syndrome: New Nomenclature/New Guidelines. CURRENT BLADDER DYSFUNCTION REPORTS 2011. [DOI: 10.1007/s11884-011-0098-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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140
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Abstract
Bladder pain syndrome is a deceptively intricate symptom complex that is diagnosed on the basis of chronic pelvic pain, pressure, or discomfort perceived to be related to the urinary bladder, accompanied by at least one other urinary symptom. It is a diagnosis of exclusion in a patient who has experienced the symptoms for at least 6 weeks in the absence of any confusable diseases that may give rise to the symptoms. Symptoms compatible with the diagnosis are now thought to affect up to 3% of the female population in the United States with a 5:1 female-to-male preponderance. Diagnosis and treatment can be challenging, and misdiagnosis as a psychological problem, overactive bladder, or chronic urinary infection has plagued patients with the problem.
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Affiliation(s)
- Philip Hanno
- Perelman Center for Advanced Medicine, Hospital of the University of Pennsylvania, West Pavilion 3rd Floor, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA.
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141
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Shie JH, Kuo HC. Higher levels of cell apoptosis and abnormal E-cadherin expression in the urothelium are associated with inflammation in patients with interstitial cystitis/painful bladder syndrome. BJU Int 2010; 108:E136-41. [DOI: 10.1111/j.1464-410x.2010.09911.x] [Citation(s) in RCA: 108] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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142
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Galosi AB, Montironi R, Mazzucchelli R, Lacetera V, Muzzonigro G. Interstitial Cystitis: Minimal Diagnostic Criteria. Urologia 2010. [DOI: 10.1177/039156031007700302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Any article reporting on Interstitial Cystitis (IC) will list numerous investigations. This paper presents a review of the minimum investigations needed and their significance for the initial evaluation and diagnosis of patients with Interstitial Cystitis. To optimize patient's early diagnosis and disease monitoring, a comprehensive algorithm for the diagnosis of IC has been proposed. The paper defines interstitial cystitis (IC) as a disease of the urinary bladder diagnosed by at least one of the following 3 requirements: 1) endoscopic criteria (cystoscopy findings); 2) pathologic criteria of bladder biopsy; and 3) clinical criteria including pain and lower urinary tract symptoms evaluation. Furthermore, the exclusion of confusable diseases is mandatory in all cases. These are recommendations, mostly based on expert opinions and literature review. Where possible, a level of recommendation was developed according to a 3–grade scale: mandatory (grade 1), recommended (grade 2), and optional (grade 3). By using a stepwise approach and an evidence-based thought process, the diagnosis of IC is made easier and reliable.
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Affiliation(s)
- Andrea Benedetto Galosi
- Gruppo Lavoro del Centro di Riferimento per le Malattie Rare, Università Politecnica delle Marche, Azienda Ospedaliero-Universitaria Ospedali Riuniti, Ancona
- Clinica Urologica, Università Politecnica delle Marche, Azienda Ospedaliero-Universitaria Ospedali Riuniti, Ancona
| | - Rodolfo Montironi
- Anatomia Patologica, Università Politecnica delle Marche, Azienda Ospedaliero-Universitaria Ospedali Riuniti, Ancona
| | - Roberta Mazzucchelli
- Anatomia Patologica, Università Politecnica delle Marche, Azienda Ospedaliero-Universitaria Ospedali Riuniti, Ancona
| | - Vito Lacetera
- Clinica Urologica, Università Politecnica delle Marche, Azienda Ospedaliero-Universitaria Ospedali Riuniti, Ancona
| | - Giovanni Muzzonigro
- Clinica Urologica, Università Politecnica delle Marche, Azienda Ospedaliero-Universitaria Ospedali Riuniti, Ancona
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Bibliography: Current world literature. Female urology. Curr Opin Urol 2010; 20:343-6. [PMID: 20531093 DOI: 10.1097/mou.0b013e32833bd73a] [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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145
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Clemens JQ, Calhoun EA, Litwin MS, Walker-Corkery E, Markossian T, Kusek JW, McNaughton-Collins M. A survey of primary care physician practices in the diagnosis and management of women with interstitial cystitis/painful bladder syndrome. Urology 2010; 76:323-8. [PMID: 20303575 DOI: 10.1016/j.urology.2009.12.047] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2009] [Revised: 12/14/2009] [Accepted: 12/15/2009] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To describe the practice patterns among primary care physicians' (PCPs) managing patients with symptoms suggestive of interstitial cystitis/painful bladder syndrome (IC/PBS). METHODS We developed a clinical vignette describing a woman with typical IC/PBS symptoms to elicit questions about etiology, management strategies, and familiarity with this syndrome. We mailed the questionnaire to 556 PCPs, including academicians and community physicians, in Boston, Los Angeles, and Chicago. RESULTS We received 290 completed questionnaires (response rate, 52%). Nineteen percent of respondents reported they had "never" seen a patient like the one described in the vignette. Two-thirds of respondents correctly identified the hallmark symptom of IC/PBS (bladder pain/pressure). Regarding etiology, 90% correctly indicated that IC/PBS was a noninfectious disease, 76% correctly reported that it was not caused by a sexually transmitted infection, and 61% correctly indicated that it was not caused by a psychiatric illness. Common treatments included antibiotics and nonsteroidal anti-inflammatory agents. Referrals were often made to a specialist. CONCLUSIONS Although most PCPs indicate familiarity with IC/PBS, they manage the condition infrequently. They also appear to have significant knowledge deficits about the clinical characteristics of IC/PBS, and they indicate variable practice patterns in the diagnosis and treatment of the condition. Educational efforts directed at PCPs will likely improve the care of patients with IC/PBS.
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Affiliation(s)
- J Quentin Clemens
- Department of Urology, University of Michigan Medical Center, Ann Arbor, Michigan, USA.
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Aihara K, Hirayama A, Tanaka N, Fujimoto K, Yoshida K, Hirao Y. Hydrodistension under local anesthesia for patients with suspected painful bladder syndrome/interstitial cystitis: safety, diagnostic potential and therapeutic efficacy. Int J Urol 2010; 16:947-52. [PMID: 19817916 DOI: 10.1111/j.1442-2042.2009.02396.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To evaluate the safety, diagnostic potential and therapeutic efficacy of cystoscopy with hydrodistension under local anesthesia in patients with suspected painful bladder syndrome/interstitial cystitis (PBS/IC). METHODS Thirty-six patients with frequency, urgency or bladder pain for > or = 6 months and an average voided volume of <200 mL were enrolled in the study. Hydrodistension was carried out 10 min after instillation of 10 mL of 4% lidocaine. The instilled saline volume for hydrodistension was determined based on each patient's level of tolerance of urinary sensation and symptoms. RESULTS Overall, 30 patients (median age 54 years, range 25-76) were evaluated. The median instilled saline volume was 450 mL (250 to 580 mL). No patients were admitted to hospital due to adverse events associated with hydrodistension. Glomerulation was found in 23 patients and two had Hunner's ulcers. Therapeutic efficacy at one month after hydrodistension was shown in 21/30 patients (71%). A median efficacy period of 20 + or = 3.7 weeks was determined by Kaplan-Meier analysis. Factors with an independent influence on therapeutic efficacy of hydrodistension were not identified, but patients with an instilled volume greater than the median volume had significantly longer efficacy periods (P < 0.022). CONCLUSIONS Cystoscopy with hydrodistension under local anesthesia provides a simple and safe method for differential diagnosis and has some therapeutic efficacy in patients with suspected PBS/IC.
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Affiliation(s)
- Kinue Aihara
- Osaka Kaisei Hospital, Department of Urology, Osaka, Japan
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147
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Ogawa T, Homma T, Igawa Y, Seki S, Ishizuka O, Imamura T, Akahane S, Homma Y, Nishizawa O. CXCR3 Binding Chemokine and TNFSF14 Over Expression in Bladder Urothelium of Patients With Ulcerative Interstitial Cystitis. J Urol 2010; 183:1206-12. [DOI: 10.1016/j.juro.2009.11.007] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2009] [Indexed: 11/25/2022]
Affiliation(s)
- Teruyuki Ogawa
- Department of Urology, Shinshu University School of Medicine, Matsumoto, Japan
- Department of Clinical Urologic and Pharmacological Research, Shinshu University School of Medicine, Matsumoto, Japan
| | - Toshiki Homma
- Discovery Research, R & D, Kissei Pharmaceutical Co., Ltd., Nagano, Japan
| | - Yasuhiko Igawa
- Department of Urology, Shinshu University School of Medicine, Matsumoto, Japan
- Department of Clinical Urologic and Pharmacological Research, Shinshu University School of Medicine, Matsumoto, Japan
| | - Satoshi Seki
- Department of Clinical Urologic and Pharmacological Research, Shinshu University School of Medicine, Matsumoto, Japan
| | - Osamu Ishizuka
- Department of Urology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Tetsuya Imamura
- Department of Urology, Shinshu University School of Medicine, Matsumoto, Japan
- Department of Clinical Urologic and Pharmacological Research, Shinshu University School of Medicine, Matsumoto, Japan
| | - Satoshi Akahane
- Discovery Research, R & D, Kissei Pharmaceutical Co., Ltd., Nagano, Japan
| | - Yukio Homma
- Department of Urology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Osamu Nishizawa
- Department of Urology, Shinshu University School of Medicine, Matsumoto, Japan
- Department of Clinical Urologic and Pharmacological Research, Shinshu University School of Medicine, Matsumoto, Japan
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148
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Guo YJ, Ho CH, Chen SC, Yang SS, Chiu HM, Huang KH. Lower urinary tract symptoms in women with irritable bowel syndrome. Int J Urol 2010; 17:175-81. [DOI: 10.1111/j.1442-2042.2009.02442.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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149
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Wright LJ, Noonan C, Ahumada S, Rodríguez MÁB, Buchwald D, Afari N. Psychological distress in twins with urological symptoms. Gen Hosp Psychiatry 2010; 32:262-7. [PMID: 20430229 PMCID: PMC2862233 DOI: 10.1016/j.genhosppsych.2010.01.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2009] [Revised: 01/16/2010] [Accepted: 01/19/2010] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Interstitial cystitis/painful bladder syndrome (IC/PBS) is a chronic pain condition with unclear underlying etiology. Our objectives were to determine whether psychological distress was higher in twins with urological symptoms commonly found in IC/PBS than in twins without, and if so, did familial influences contribute to this association. METHOD Data from 1165 female twins in a community-based sample were used. Urological symptoms, symptoms of posttraumatic stress disorder (PTSD), depression, anxiety and perceived stress were assessed with standardized questionnaires. Generalized estimating equation (GEE) regression models were used to examine the relationship between psychological distress and urological symptoms. RESULTS Compared to unaffected twins, twins with urological symptoms were more likely to report PTSD symptoms (OR=3.9; 95% CI=2.6-5.8), depression (OR=3.1; 95% CI=2.0-5.0), anxiety (OR=3.4; 95% CI=2.3-5.2) and perceived stress (OR=3.2; 95% CI=2.1-4.9). After adjusting for familial influences, the within-pair effects remained significant for PTSD symptoms (OR=2.2; 95% CI=1.2-3.8) and perceived stress (OR=2.2; 95% CI=1.2-3.8). CONCLUSION Familial influences partially explained the relationship between indicators of psychological distress and urological symptoms. Future research should examine shared environmental and genetic mechanisms that may further explain this relationship and improve diagnosis and treatment of this unexplained clinical condition.
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Affiliation(s)
| | - Carolyn Noonan
- Department of Medicine, University of Washington, Seattle, WA
| | - Sandra Ahumada
- Department of Psychiatry, University of California, San Diego, La Jolla, CA
| | | | - Dedra Buchwald
- Department of Medicine, University of Washington, Seattle, WA
| | - Niloofar Afari
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, Veterans Affairs San Diego Healthcare System & Veterans Affairs Center of Excellence for Stress and Mental Health, San Diego, CA
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150
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Mahendru AA, Al-Taher H. Cystodistension: certainly no standards and possibly no benefits—survey of UK practice. Int Urogynecol J 2009; 21:135-9. [DOI: 10.1007/s00192-009-1026-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2009] [Accepted: 10/11/2009] [Indexed: 11/28/2022]
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