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Labelle O, Penninck D, Butty EM, Hahn S, Dunn M. Pseudomembranous cystitis in cats with presumed or confirmed mineralization: A retrospective study of 26 cases (2016-2021). J Vet Intern Med 2023; 37:1806-1814. [PMID: 37497780 PMCID: PMC10472995 DOI: 10.1111/jvim.16819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 07/07/2023] [Indexed: 07/28/2023] Open
Abstract
BACKGROUND Pseudomembranous cystitis (PMC) in cats is a recognized disease, but concurrent mineralization is reported rarely and its outcome is poorly described. HYPOTHESIS AND OBJECTIVES Describe a population of cats with PMC and the prevalence of concurrent mineralization. ANIMALS Twenty-six cats with PMC. METHODS Medical records were retrospectively reviewed (January 2016 to December 2021). Cats with an ultrasound diagnosis of PMC were included. Clinicopathologic results, imaging, treatment, and outcome were reviewed. RESULTS All cats were male and 21 (80%) were diagnosed with urethral obstruction (UO). Five cats (23.8%) had positive urine culture (Staphylococcus felis, 3/5; Proteus mirabilis, 2/5) with a median urine pH of 8 (range, 6-9). All cats had ultrasonographic changes suggestive of mineralization. On ultrasound examination, 10 cats (38.5%) had pseudomembranes with acoustic shadowing suggestive of mineralization, 15 (57.7%) had changes indicative of ulceration, and 8 (31%) had changes compatible with of a urachal anomaly. Twenty-two cats received medical treatment, 4 underwent surgery (3 percutaneous cystolithotomy, 1 cystotomy). Twenty cats (77%) survived to discharge. Follow-up ultrasound examination indicated resolution of PMC in 6/7 cats, 4 had persistent hyperechoic bladder lining. Five of 12 cats with follow-up had a relapse of lower urinary tract signs. CONCLUSIONS AND CLINICAL IMPORTANCE Pseudomembranous cystitis was diagnosed mainly in male cats with UO and imaging findings suggestive of mineralization were present in all cases. Frequent negative urine culture suggests a different etiology than encrusting cystitis related to urease-positive bacteria. Good outcomes can be achieved with medical management.
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Affiliation(s)
- Olivier Labelle
- Veterinary Teaching Hospital of the University of Montreal (CHUV)St. HyacintheQuebecCanada
| | - Dominique Penninck
- Tufts Cummings School of Veterinary MedicineNorth GraftonMassachusettsUSA
| | | | | | - Marilyn Dunn
- Veterinary Teaching Hospital of the University of Montreal (CHUV)St. HyacintheQuebecCanada
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2
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Peng L, Wang W, Gao XS, Luo DY. Perioperative Safety of Bladder Hydrodistention in Patients on Antithrombotic Therapy. UROGYNECOLOGY (PHILADELPHIA, PA.) 2022; 29:489-496. [PMID: 36944055 PMCID: PMC10144279 DOI: 10.1097/spv.0000000000001300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
IMPORTANCE Bladder hydrodistention (BH) is commonly used to diagnose and treat patients with interstitial cystitis/bladder pain syndrome (IC/BPS), but the overall assessment of bleeding complications for patients taking antithrombotics is lacking. OBJECTIVES The study aimed to investigate if perioperative complications were more common in patients with IC/BPS receiving antithrombotic therapy after BH. STUDY DESIGN We retrospectively reviewed patients with IC/BPS who underwent hydrodistention during January 2010 and May 2021. Patients with and without antithrombotic drugs were identified and grouped, and their medical records were reviewed. Perioperative data and symptom scores were assessed. The rates of complications in the 2 groups were recorded at 3 months and at the last visit postoperatively. RESULTS A total of 387 patients were eventually included. Among them, 29 (7.5%) patients were receiving systemic antithrombotic therapy and 358 (92.5%) were not. Compared with the non-antithrombotic group, patients receiving antithrombotic therapy demonstrated a longer hospital stay (P = 0.033) and a longer catheterization time (P = 0.034). Moreover, the patients with antithrombotic drugs had increased odds of bladder tamponade (odds ratio, 6.76; P = 0.019) and urinary retention (odds ratio, 5.79; P = 0.033) both 3 months postoperatively and last follow-up, but this is not statistically different between patients with and without Hunner lesions. No thromboembolic events were identified during the study period. CONCLUSIONS Although a small number of patients with IC/BPS needed anticoagulants, longer hospital stays, longer catheterization time, and increased odds of bladder tamponade and urinary retention were observed in patients receiving antithrombotic therapy. Still, a comprehensive management scheme to balance bleeding complications and antithrombotic agents is needed for individuals.
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Affiliation(s)
- Liao Peng
- From the Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, Sichuan, PR China
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3
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Lew LJ, Berent AC, Kirsch MS, Weisse CW. Bladder wall adhesion causing a vesicular septum in a dog following surgical cystotomy. J Am Vet Med Assoc 2022; 260:1-8. [PMID: 35175927 DOI: 10.2460/javma.21.01.0021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
CASE DESCRIPTION An 8-year-old spayed female Yorkshire Terrier-Poodle dog was evaluated for persistent pollakiuria and stranguria following routine cystotomy for calcium oxalate cystoliths. CLINICAL FINDINGS The dog presented for a cystotomy with intermittent hematuria. Postoperative radiographs revealed no remaining cystoliths. Urine, cystolith, and bladder mucosal aerobic cultures were negative. Pollakiuria, stranguria, and hematuria developed immediately after surgery and persisted despite antibiotics. Ultrasound revealed suspected fibrous adhesions within the urinary bladder lumen connecting the dorsal and ventral bladder wall creating a septum. This was confirmed cystoscopically 4 weeks after surgery. TREATMENT AND OUTCOME Cystoscopic-guided laser ablation was performed to incise abnormal tissue connecting the ventral and dorsal bladder wall using a holmium:yttrium-aluminum-garnet laser. Three weeks later, ultrasound revealed adhesion resolution though mild pollakiuria and stranguria persisted. Oxybutynin was prescribed and clinical signs resolved. At 27 months after ablation, hematuria occurred with recurrent cystoliths. These cystoliths were removed by percutaneous cystolithotomy, documenting a cystoscopically normal bladder wall. The patient had normal urination for 55.5 months after ablation, with normal bladder wall thickness on ultrasound repeated at 27 and 36 months after ablation. CLINICAL RELEVANCE To the authors' knowledge, an adhesion creating a septum between the dorsal and ventral bladder wall has not been previously reported as a complication after cystotomy in any species and should be considered as a cause of persistent lower urinary signs after surgery. Ultrasound identified the lesion in this dog. Because bladder abnormalities can develop quickly after surgery, ultrasound might be considered if urine testing is not supportive of infection. Cystoscopic-guided laser ablation was a successful minimally invasive treatment in this case.
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4
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Bschleipfer T, Kaftan B. [Interstitial cystitis: interventions and surgery - more than a last resort?]. Aktuelle Urol 2021; 52:561-568. [PMID: 34847608 DOI: 10.1055/a-1668-2975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Interstitial cystitis is an underdiagnosed chronic-relapsing to chronic-progressive urinary bladder disease, whose pathogenesis and aetiology has not been fully elucidated. The disease itself cannot be cured and treatment is symptomatic. Treatment options comprise conservative and medicinal approaches as well as a large number of interventional/surgical procedures. These include intravesical instillation, transurethral procedures such as injections of botulinum toxin A, corticosteroids and local anaesthetics, hydrodistension and neuromodulation as well as (laser) fulguration, resection and cystectomy. Although surgical procedures are considered a late option and are often referred to as last-resort therapy, these interventional options often show good to very good response rates, manageable complications and a favourable risk-benefit evaluation. An overall generalisation of surgery as a last-resort treatment option should therefore be avoided and its use should be discussed based on the individual needs of each patient.
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Affiliation(s)
- Thomas Bschleipfer
- Klinik für Urologie, Andrologie und Kinderurologie, Interdisziplinäres Kontinenz- und Beckenbodenzentrum, Zentrum für Interstitielle Zystitis (IC) und Beckenschmerz, Klinikum Weiden/Klinken Nordoberpfalz AG, Weiden, Germany
| | - Björn Kaftan
- Klinik für Urologe, Interdisziplinäres Kontinenz- und Beckenbodenzentrum, Zentrum für Interstitielle Zystitis (IC) und Beckenschmerz, Städtisches Klinikum Lüneburg gGmbH, Lüneburg, Germany
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5
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Valsangkar R, Kashypi B, Date J, Shivde S. Subtotal vesical necrosis as a result of infected traumatic bladder hematoma: A rare case with a literature review of bladder necrosis due to hematoma. Urol Ann 2021; 13:301-304. [PMID: 34421269 PMCID: PMC8343294 DOI: 10.4103/ua.ua_101_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 01/25/2021] [Indexed: 12/01/2022] Open
Abstract
Subtotal bladder necrosis following bladder hematoma is rare. We report such a case following blunt abdominal injury. The urologic presentation was delayed hematuria which settled with conservative management but was followed by the development of urosepsis. Computed tomography scan showed full bladder due to long-standing liquified bladder hematoma. Suprapubic exploration revealed a bladder wall abscess which was drained (secondarily infected hematoma). Excision of the subtotal necrotic bladder and ileal conduit with left ureteroileal anastomosis was done later. The patient also had a simultaneous right renal and ureteric injury as an independent simultaneous event which required initial nephrostomy placement. It later healed with complete obliteration of the right renal pelvis which was managed by right nephrectomy later. A literature review of cases of vesical necrosis caused by hematomas (of different locations and etiology) is discussed.
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Affiliation(s)
- Rohan Valsangkar
- Department of Urology, Deenanth Mangeshkar Hospital, Pune, Maharashtra, India
| | - Bhalchandra Kashypi
- Department of Urology, Deenanth Mangeshkar Hospital, Pune, Maharashtra, India
| | - Jaydeep Date
- Department of Urology, Deenanth Mangeshkar Hospital, Pune, Maharashtra, India
| | - Subodh Shivde
- Department of Urology, Deenanth Mangeshkar Hospital, Pune, Maharashtra, India
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Painful Bladder Syndrome/Interstitial Cystitis and High Tone Pelvic Floor Dysfunction. Obstet Gynecol Clin North Am 2021; 48:585-597. [PMID: 34416939 DOI: 10.1016/j.ogc.2021.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
This article provides an overview of 2 conditions that defy straightforward characterization and treatment: interstitial cystitis/painful bladder syndrome often coexists with high tone pelvic floor dysfunction. These conditions are common in gynecologic patients who present with chronic pelvic pain and are often misdiagnosed due to their syndromic nature and amorphous definitions. Clinicians should maintain a high level of suspicion for these processes in patients with chronic pelvic pain or recurrent urinary tract infection symptoms. Optimal treatment uses a multimodal approach to alleviate symptoms.
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7
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Pseudomembranous Cystitis: An Uncommon Ultrasound Appearance of Cystitis in Cats and Dogs. Vet Sci 2021; 8:vetsci8070125. [PMID: 34357917 PMCID: PMC8310035 DOI: 10.3390/vetsci8070125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 06/28/2021] [Accepted: 06/30/2021] [Indexed: 11/17/2022] Open
Abstract
In veterinary medicine, pseudomembranous cystitis (PC) is a rare condition described only in cats. The purposes of this retrospective study were to describe ultrasound features of PC in cats and dogs, predisposing factors, comorbidities and outcomes. Cats and dogs with an ultrasonographic diagnosis of PC were included in the study. The bladder ultrasound findings that were recorded were: pseudomembranes' characteristics, abnormalities of the bladder's wall and content and anomalies of the pericystic peritoneal space. Ten cats and four dogs met the inclusion criteria. Four pseudomembrane adhesion patterns were described. The presence of pseudomembrane acoustic shadowing was observed in the 60% of cats. A total of 80% of the cats included were presented for urethral obstruction (UO) and/or had at least one episode of UO in the previous 2 months. Thirteen patients out of fourteen received only medical therapy, and all of them survived. PC is a rare disorder in cats and dogs and there are some ultrasonographic differences between the two species, suggesting a greater severity of the pathology in cats. Chronic cystitis and UO may have a potential role in the development of feline PC. Finally, the medical approach can be a non-invasive and effective approach for PC.
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8
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Homma Y, Akiyama Y, Tomoe H, Furuta A, Ueda T, Maeda D, Lin ATL, Kuo H, Lee M, Oh S, Kim JC, Lee K. Clinical guidelines for interstitial cystitis/bladder pain syndrome. Int J Urol 2020; 27:578-589. [DOI: 10.1111/iju.14234] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 02/27/2020] [Indexed: 12/19/2022]
Affiliation(s)
- Yukio Homma
- Department of Urology Japanese Red Cross Medical Center Tokyo Japan
| | - Yoshiyuki Akiyama
- Department of Urology Graduate School of Medicine The University of Tokyo Tokyo Japan
| | - Hikaru Tomoe
- Department of Urology Tokyo Women’s Medical University Medical Center East Tokyo Japan
| | - Akira Furuta
- Department of Urology Jikei University School of Medicine Tokyo Japan
| | | | - Daichi Maeda
- Department of Clinical Genomics Graduate School of Medicine Osaka University Osaka Japan
| | - Alex TL Lin
- Department of Urology Taipei Veterans General Hospital National Yang Ming University Taipei Taiwan
| | - Hann‐Chorng Kuo
- Department of Urology School of Medicine Buddhist Tzu Chi General Hospital Tzu Chi University Hualien Taiwan
| | - Ming‐Huei Lee
- Department of Urology Feng‐Yuan Hospital Taichung Taiwan
| | - Seung‐June Oh
- Department of Urology Seoul National University Seoul Korea
| | - Joon Chul Kim
- Department of Urology The Catholic University of Korea Seoul Korea
| | - Kyu‐Sung Lee
- Department of Urology Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Korea
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9
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Garzon S, Laganà AS, Casarin J, Raffaelli R, Cromi A, Sturla D, Franchi M, Ghezzi F. An update on treatment options for interstitial cystitis. PRZEGLAD MENOPAUZALNY = MENOPAUSE REVIEW 2020; 19:35-43. [PMID: 32699542 PMCID: PMC7258371 DOI: 10.5114/pm.2020.95334] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 03/18/2020] [Indexed: 12/22/2022]
Abstract
Interstitial cystitis or bladder pain syndrome (IC/BPS) is a chronic pelvic pain syndrome related to the urinary bladder. The ideal treatment should match as much as possible with the pathophysiologic causes of the IC/BPS, but the scarcely available evidence limits this approach, with the majority of available treatments that are primarily targeted to the control of symptoms. The treatment strategies have traditionally focused on the bladder, which is considered the primary end-organ and source of pain. Nevertheless, the growing body of evidence suggests a multifaceted nature of the disease with systemic components. In general, guidelines recommend the personalized and progressive approach, that starts from the more conservative options and then advances toward more invasive and combined treatments. The behavioral changes represent the first and most conservative steps. They can be combined with oral medications or progressively with intravesical instillation of drugs, up to more invasive techniques in a combined way. Despite the multiple available options, the optimal treatment is not easy to be found. Only further investigation on the etiopathogenetic mechanisms, taking into account the differences among subgroups, and the interaction between central and peripherical factors may allow providing a real improvement in the treatment and management of these patients.
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Affiliation(s)
- Simone Garzon
- Department of Obstetrics and Gynecology, “Filippo Del Ponte” Hospital, University of Insubria, Varese, Italy
| | - Antonio Simone Laganà
- Department of Obstetrics and Gynecology, “Filippo Del Ponte” Hospital, University of Insubria, Varese, Italy
| | - Jvan Casarin
- Department of Obstetrics and Gynecology, “Filippo Del Ponte” Hospital, University of Insubria, Varese, Italy
| | - Ricciarda Raffaelli
- Department of Obstetrics and Gynecology, AOUI Verona, University of Verona, Verona, Italy
| | - Antonella Cromi
- Department of Obstetrics and Gynecology, “Filippo Del Ponte” Hospital, University of Insubria, Varese, Italy
| | - Davide Sturla
- Department of Obstetrics and Gynecology, “Filippo Del Ponte” Hospital, University of Insubria, Varese, Italy
| | - Massimo Franchi
- Department of Obstetrics and Gynecology, AOUI Verona, University of Verona, Verona, Italy
| | - Fabio Ghezzi
- Department of Obstetrics and Gynecology, “Filippo Del Ponte” Hospital, University of Insubria, Varese, Italy
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10
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Gülpınar Ö, Esen B, Akpınar Ç, Baklacı U, Gökce Mİ, Süer E, Bedük Y. Potassium sensitivity test predicts hydrodistention efficacy in patients with bladder pain syndrome/interstitial cystitis. Turk J Urol 2019; 46:231-235. [PMID: 31747364 DOI: 10.5152/tud.2019.19084] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 09/25/2019] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To determine the possible role of potassium sensitivity test (PST) in predicting the success of hydrodistention (HD) in patients with bladder pain syndrome/interstitial cystitis (BPS/IC). MATERIAL AND METHODS Patients who underwent PST before diagnostic cystoscopy and HD were evaluated to collect data regarding the visual analog score (VAS) to assess pain, the voiding diary for frequency of urination/nocturia, mean urine volume per void, interstitial cystitis symptom index, and problem index before HD. Patients were requested to provide the VAS of pain at 1 month and 6 months post-HD. A reduction 2 or more on the VAS of pain was considered as a response adequate to be noted. RESULTS The median age of the patients was 46 years. The PST was positive for 27 patients (27/39; 69.2%). At 1 month post-HD, out of the 27 patients with positive PST, 23 (85.2%) were found to have been responsive to HD and 4 (14.8%) were non-responsive. Of the 12 (12/39; 30.8%) patients who showed a negative PST, 7 (58.3%) were non-responsive and 5 (41.7%) were responsive to HD. A logistic regression analysis revealed that PST (p=0.009) was the only parameter that was able to predict HD efficacy at 1 month post-HD. CONCLUSION PST was found to be a predictive factor for the short-term efficacy of HD. BPS/IC patients with positive PST are likely to be more susceptible to the damage of mucosal afferent nerve endings, which results in them benefiting from HD to a greater degree.
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Affiliation(s)
- Ömer Gülpınar
- Department of Urology, Ankara University School of Medicine, Ankara, Turkey.,Department of Urology, Ankara University School of Medicine, Ankara, Turkey
| | - Barış Esen
- Department of Urology, Ankara University School of Medicine, Ankara, Turkey.,Department of Urology, Ankara University School of Medicine, Ankara, Turkey
| | - Çağrı Akpınar
- Department of Urology, Ankara University School of Medicine, Ankara, Turkey.,Department of Urology, Ankara University School of Medicine, Ankara, Turkey
| | - Utku Baklacı
- Department of Urology, Ankara University School of Medicine, Ankara, Turkey.,Department of Urology, Ankara University School of Medicine, Ankara, Turkey
| | - Mehmet İlker Gökce
- Department of Urology, Ankara University School of Medicine, Ankara, Turkey.,Department of Urology, Ankara University School of Medicine, Ankara, Turkey
| | - Evren Süer
- Department of Urology, Ankara University School of Medicine, Ankara, Turkey.,Department of Urology, Ankara University School of Medicine, Ankara, Turkey
| | - Yaşar Bedük
- Department of Urology, Ankara University School of Medicine, Ankara, Turkey.,Department of Urology, Ankara University School of Medicine, Ankara, Turkey
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11
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Bosschieter J, Oudshoorn FHK, Meuleman EJH, Nieuwenhuijzen JA. Bladder necrosis: 'A man without a bladder'. BMJ Case Rep 2018; 2018:bcr-2016-217769. [PMID: 29455174 DOI: 10.1136/bcr-2016-217769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Since the use of antibiotics, bladder necrosis has become a rare condition. We report a case of bladder necrosis in a 90-year-old man following urinary retention. After insertion of a transurethral catheter (TUC), 2 L of urine was evacuated. In the following days, the TUC became intermittently blocked. Adequate bladder drainage could not be obtained despite intensive rinsing and placement of a suprapubic catheter. On surgical exploration necrosis of almost the entire bladder wall, except for the trigone, was encountered. Surgical debridement of the non-viable bladder wall without opening the abdominal cavity was conducted, and a TUC was placed in the Retzius cavity to ensure evacuation of urine. Since the patient was haemodynamically unstable, construction of a urinary diversion was waived and urinary drainage of the Retzius cavity by the TUC was accepted, resulting in adequate urinary drainage without compromising renal function.
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Affiliation(s)
- Judith Bosschieter
- Department of Urology, VU University Medical Center, Amsterdam, The Netherlands
| | | | - Eric J H Meuleman
- Department of Urology, VU University Medical Center, Amsterdam, The Netherlands
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12
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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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13
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Winter BJ, O'Connell HE, Bowden S, Carey M, Eisen DP. A Case Control Study Reveals that Polyomaviruria Is Significantly Associated with Interstitial Cystitis and Vesical Ulceration. PLoS One 2015; 10:e0137310. [PMID: 26325074 PMCID: PMC4556646 DOI: 10.1371/journal.pone.0137310] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2015] [Accepted: 08/14/2015] [Indexed: 11/19/2022] Open
Abstract
Objectives To investigate whether polyomaviruses contribute to interstitial cystitis pathogenesis. Subjects and Methods A prospective study was performed with 50 interstitial cystitis cases compared with 50 age-matched, disease-free controls for the frequency of polyomaviruria. Associations between polyomaviruria and disease characteristics were analysed in cases. Polyomavirus in urine and bladder tissue was detected with species (JC virus vs. BK virus) specific, real-time PCR. Results Case patients were reflective of interstitial cystitis epidemiology with age range from 26–88 years (median 58) and female predominance (41/50 F). There was a significant increase in the frequency of polyomavirus shedding between cases and controls (p<0.02). Polyomavirus shedding, in particular BK viruria, was associated with vesical ulceration, a marker of disease severity, among interstitial cystitis cases after adjustment for age and sex (OR 6.8, 95% CI 1.89–24.4). There was a significant association among cases between the presence of BK viruria and response to intravesical Clorpactin therapy (OR 4.50, 95% CI 1.17–17.4). Conclusion The presence of polyomaviruria was found to be associated with the ulcerative form of interstitial cystitis. Clorpactin, which has anti-DNA virus activity, was more likely to improve symptoms in the presence of BK viruria. These data from this pilot study suggest associations between polyomaviruria and interstitial cystitis warranting further investigation.
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Affiliation(s)
- Benjamin J. Winter
- Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Helen E. O'Connell
- Department of Surgery, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Scott Bowden
- Victorian Infectious Diseases Reference Laboratory, Wreckyn St, North Melbourne, Victoria, Australia
| | - Marcus Carey
- Department of Urogynaecology, Royal Women’s Hospital, Flemington Rd, Parkville, Victoria, Australia
| | - Damon P. Eisen
- Victorian Infectious Diseases Service at the Doherty Institute, Royal Melbourne Hospital, Melbourne, Victoria, Australia
- Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia
- * E-mail:
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14
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Russell T, Pollock PJ. Local anesthesia and hydro-distension to facilitate cystic calculus removal in horses. Vet Surg 2012; 41:638-42. [PMID: 22463467 DOI: 10.1111/j.1532-950x.2012.00986.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To report a technique for improving surgical access to the bladder for removal of cystic calculi in male horses. STUDY DESIGN Retrospective case series. ANIMALS OR SAMPLE POPULATION Geldings (8) with cystic calculi. METHODS After catheterization of the bladder through the penis, 100 mL 2% lidocaine hydrochloride solution was instilled. After 10 minutes, the bladder was distended with sterile, warmed Hartmann's solution to a pressure of ≈ 40 cm H(2) O, using gravity feed. This was left in place until abdominal access was gained at surgery, then the fluid siphoned off via the catheter. RESULTS Calculi were 3-11 cm in diameter (median, 6 cm). Bladder capacity ranged from 1.4 to 2.5 L (median, 1.8 L). Exteriorization time from placing a hand in the abdomen to having the bladder in a surgically accessible position was <5 minutes. CONCLUSION The described technique facilitates exteriorization of the bladder for removal of cystic calculi.
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Affiliation(s)
- Tom Russell
- Goulburn Valley Equine Hospital, Congupna, Victoria, Australia.
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15
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Le Boedec K, Pastor ML, Lavoué R, Reynolds BS. Pseudomembranous cystitis, an unusual condition associated with feline urine outflow obstruction: Four cases. J Feline Med Surg 2011; 13:588-93. [PMID: 21524928 PMCID: PMC10822408 DOI: 10.1016/j.jfms.2011.02.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2010] [Revised: 02/18/2011] [Accepted: 02/23/2011] [Indexed: 10/18/2022]
Abstract
The clinical follow-up of four cats presumptively diagnosed with pseudomembranous cystitis is described. All presented with acute urine outflow obstruction and acute renal failure. Urethral catheterisation was performed without difficulty but ultrasonography and contrast radiography consistently revealed abnormal bladder wall and content. One cat was euthanased, the remaining three underwent an exploratory cystotomy. Abundant inflammatory and necrotic tissue covering an ulcerated bladder mucosa was removed. All cats recovered uneventfully. No definitive cause was identified but the clinical course of the disease was not typical of idiopathic cystitis.
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Affiliation(s)
- Kevin Le Boedec
- Department of Clinical Sciences, National Veterinary School of Toulouse, 23, chemin des Capelles, BP 87614, 31076 Toulouse Cedex 03, France
| | - Mélanie L. Pastor
- Department of Clinical Sciences, National Veterinary School of Toulouse, 23, chemin des Capelles, BP 87614, 31076 Toulouse Cedex 03, France
| | - Rachel Lavoué
- Department of Clinical Sciences, National Veterinary School of Toulouse, 23, chemin des Capelles, BP 87614, 31076 Toulouse Cedex 03, France
| | - Brice S. Reynolds
- Department of Clinical Sciences, National Veterinary School of Toulouse, 23, chemin des Capelles, BP 87614, 31076 Toulouse Cedex 03, France
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L’hydrodistension vésicale dans la prise en charge thérapeutique du syndrome douloureux vésical. Prog Urol 2010; 20:1054-9. [DOI: 10.1016/j.purol.2010.08.049] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2010] [Accepted: 08/16/2010] [Indexed: 11/20/2022]
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17
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Homma Y, Ueda T, Tomoe H, Lin ATL, Kuo HC, Lee MH, Lee JG, Kim DY, Lee KS. Clinical guidelines for interstitial cystitis and hypersensitive bladder syndrome. Int J Urol 2009; 16:597-615. [DOI: 10.1111/j.1442-2042.2009.02326.x] [Citation(s) in RCA: 165] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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18
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Fall M, Oberpenning F, Peeker R. Treatment of Bladder Pain Syndrome/Interstitial Cystitis 2008: Can We Make Evidence-Based Decisions? Eur Urol 2008; 54:65-75. [PMID: 18403099 DOI: 10.1016/j.eururo.2008.03.086] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2007] [Accepted: 03/20/2008] [Indexed: 10/22/2022]
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19
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Hsieh CH, Chang ST, Hsieh CJ, Hsu CS, Kuo TC, Chang HC, Lin YH. Treatment of interstitial cystitis with hydrodistention and bladder training. Int Urogynecol J 2008; 19:1379-84. [DOI: 10.1007/s00192-008-0640-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2008] [Accepted: 04/06/2008] [Indexed: 01/22/2023]
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20
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Necrotic mass after transurethral resection of a bladder tumor: novel management with robotic partial cystectomy. J Robot Surg 2008; 1:257-61. [PMID: 25484974 PMCID: PMC4247438 DOI: 10.1007/s11701-007-0041-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2007] [Accepted: 09/04/2007] [Indexed: 11/25/2022]
Abstract
A 76-year-old female with a history of high-grade transitional cell carcinoma (TCC) of the bladder presented with persistent nocturia and urge incontinence and was diagnosed with a necrotic bladder lesion. Cystoscopy revealed a 4 cm area of necrosis, ulceration, calcification, and fat. Transurethral biopsy confirmed the lesion to be benign, and two attempts to re-epithelialize the area of necrosis with cold scraping of exudate failed. Decision was then made to proceed with removal of necrotic lesion with bladder preservation. With the aid of concomitant cystoscopic visualization of the necrotic lesion, a robotic partial cystectomy with bladder reconstruction was performed. The patient tolerated the procedure, had an uneventful post-operative course, and remains asymptomatic and disease-free at last follow-up of 6 months. To our knowledge, this case represents the first report of a necrotic lesion as a complication of transurethral resection of a bladder tumor (TURBT) and the first description of a robotic partial cystectomy for the management of either benign or malignant bladder disease.
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Abstract
Chronic pelvic pain syndrome (CPPS) is a common condition that is encountered by a variety of healthcare professionals. Unfortunately, physicians often misdiagnose this problem or recommend inappropriate and sometimes dangerous treatments that offer little hope of successful outcome. In addition, CPPS is typically a multifaceted disorder, simultaneously compromising psychological, peripheral nerve, autonomic, central nervous, visceral, connective tissue, hormonal and other systems. Thus, solo practitioners who may correctly diagnose CPSS are often ill-equipped to provide adequate comprehensive, multidisciplinary treatment. This article is intended as an overview of the most recent literature in support of various treatment modalities for chronic pelvic pain in men and women. We advocate a team-oriented approach in the treatment of CPPS, which employs the coordinated efforts of multiple practitioners, ideally in a subspecialty care setting.
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Affiliation(s)
- Gaetan Moise
- Department of Neurological Surgery, NY 10032, USA
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