Actinic cystitis: causes, treatment and experience of a single centre in the last five years

Mangano, M.; Gobbi, Alberto De; Ciaccia, Matteo; Lamon, Claudio; Beniamin, Francesco; Maccatrozzo, L.

doi:10.5301/uj.5000273

Cited by 8 publications

(9 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Fibrosis results from the pathological accumulation of ECM proteins due to chronic inflammation, resulting in scarring and thickening of tissue and, finally, in organ failure 15 . We used X-ray irradiation to establish an animal model of actinic cystitis, in order to characterize the mechanical fingerprints of fibrotic bladder tissue.…”

Section: Discussionmentioning

confidence: 99%

“…This study has focused on two pathological conditions of the bladder: actinic cystitis and urothelial bladder cancer. Actinic cystitis is a pathological condition, which may be caused as a sequelae of pelvic radiotherapy, commonly used to treat prostate and rectum cancer 15,16 . Actinic cystitis is caused by the accumulation of ECM proteins due to chronic inflammation, resulting in scarring and tissue thickening and potentially in end-stage organ failure, with clinically relevant impact toward patients 4 .…”

mentioning

confidence: 99%

“…Moreover, this knowledge can contribute to the development of novel therapies based on the modification of the micromechanical drivers of carcinogenesis 6 . In addition, a deep understanding of the mechanical features of a healthy bladder may be crucial for any bladder reconstruction purpose, with the goal of developing artificial and mechanically compliant bladders 15,23 .…”

mentioning

confidence: 99%

See 2 more Smart Citations

Micro-mechanical fingerprints of the rat bladder change in actinic cystitis and tumor presence

et al. 2023

View full text Add to dashboard Cite

Tissue mechanics determines tissue homeostasis, disease development and progression. Bladder strongly relies on its mechanical properties to perform its physiological function, but these are poorly unveiled under normal and pathological conditions. Here we characterize the mechanical fingerprints at the micro-scale level of the three tissue layers which compose the healthy bladder wall, and identify modifications associated with the onset and progression of pathological conditions (i.e., actinic cystitis and bladder cancer). We use two indentation-based instruments (an Atomic Force Microscope and a nanoindenter) and compare the micromechanical maps with a comprehensive histological analysis. We find that the healthy bladder wall is a mechanically inhomogeneous tissue, with a gradient of increasing stiffness from the urothelium to the lamina propria, which gradually decreases when reaching the muscle outer layer. Stiffening in fibrotic tissues correlate with increased deposition of dense extracellular matrix in the lamina propria. An increase in tissue compliance is observed before the onset and invasion of the tumor. By providing high resolution micromechanical investigation of each tissue layer of the bladder, we depict the intrinsic mechanical heterogeneity of the layers of a healthy bladder as compared with the mechanical properties alterations associated with either actinic cystitis or bladder tumor.

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Micro-mechanical fingerprints of the rat bladder change in actinic cystitis and tumor presence

et al. 2023

View full text Add to dashboard Cite

show abstract

“…In case of failure, third line options proposed include hyperbaric oxygen (HBO) or arterial embolization. In extreme cases a radical cystectomy with urinary derivation might be indicated (6)(7)(8)(9)(10). Despite the variety of treatments available there is not a consensus about the best treatment to use in these cases (11).…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of intravesical fibrin glue instillation for management of patients with refractory hemorrhagic cystitis: 12-months results. A promising therapy for hemorrhagic cystitis

Cassani

Marchioni

Silletta

et al. 2021

Arch Ital Urol Androl

View full text Add to dashboard Cite

Objectives: Fibrin glue (FG) endo-vesical application seems to be a promising therapy for hemorrhagic cystitis (HC). We aimed to evaluate efficacy and safety of FG instillation in patients with HC. Methods: Patients with HC not responsive to conventional treatments (bladder irrigation, catheterization, blood transfusions, hyperhydration and endoscopic coagulation) were treated with FG endo-vesical instillation (April 2017- December 2018). FG was prepared from 120 mL of patient blood with the Vivostat® system. After standard cystoscopy, bladder was insufflated with carbon dioxide (CO2) according to bladder compliance and autologous FG was applied to bladder wall and bleeding sites. Results: Ten patients included with grade 2 or higher HC secondary to bone marrow graft for hematological diseases (30%) or to actinic cystitis caused by prostate cancer radiotherapy (RT) (70%). The median HC onset time after RT was 4.8 (IQR 3.9- 6.3) years and 35 (IQR 27.5-62.5) days after hematopoietic stem cell transplantation (HSCT). Five patients had a complete response after one treatment, three patients had clinical response (grade < 2 hematuria, amelioration of symptoms), one of them required catheterization and bladder irrigation. One patient required a second instillation of FG achieving a clinical response. No adverse events related to the procedure were recorded, however one patient died for causes not related to the procedure. Median Interstitial Cystitis Symptoms Index was 13.0 (IQR 11.0-15.0) pre-operatively and 4.0 (IQR 2.0-5.0) post-operatively. Conclusions: Our study showed that, even in hematological patients, autologous FG instillation maybe a safe, repeatable and effective treatment modality in patients with refractory HC.

show abstract

“…It is estimated that the average time between the onset of symptoms and diagnosis is around five and a half years 1.2 . The causes can be mechanical trauma of any etiology, immunological processes, infections, and/or inflammatory processes 2,3 , so actinic cystitis is one of the causes of CPP 4 . Other causes include vulvodynia, psychosomatic disorders, prostatitis, urinary tract infection, pelvic inflammatory disease, and sexually transmitted infections 5 .…”

Section: Introductionmentioning

confidence: 99%

Actinic cystitis associated with urinary tract infection by Candida glabrata as a differential diagnosis of pudendal neuralgia. Case report

Hoffmann¹,

Daronco²,

Seyboth³

2020

Brazilian Journal of Pain

View full text Add to dashboard Cite

BACKGROUND AND OBJECTIVES: Chronic pelvic pain is still a little-known syndrome with different etiological agents, high morbidity rate, with little information about its etiopathogenesis, which makes its treatment difficult, with symptoms that significantly impact the patient's quality of life. Among the conditions that lead to chronic pelvic pain, actinic cystitis stands out, a complication of pelvic radiotherapy. This pathology presents signs, symptoms, and complications similar to pudendal neuralgia. The objective of this report is to present one of the etiologies of chronic pelvic pain and its treatment. CASE REPORT: Sixty-three-year-old male patient who sought medical care with a history of chronic pelvic pain attributed to pudendal neuralgia. The diagnosis was actinic cystitis, resulting from pelvic radiotherapy for prostate adenocarcinoma and urinary tract infection by Candida glabrata, an opportunistic fungal agent. The patient was treated with fluconazole with total control of the painful symptoms and significant improvement in the quality of life. CONCLUSION: A case report with total pain control in a patient with an initial diagnosis of pudendal neuralgia, who after the clinical evaluation, imaging tests, cystoscopy, and lab tests was diagnosed with actinic cystitis associated to the urinary tract infection by Candida glabrata.

show abstract

Actinic cystitis: causes, treatment and experience of a single centre in the last five years

Abstract: The first approach to patients with AC is often supportive care. Surgery remains the most invasive treatment in the management of those patients who are not responsive to conservative treatments.

Cited by 8 publications

References 25 publications

Micro-mechanical fingerprints of the rat bladder change in actinic cystitis and tumor presence

Micro-mechanical fingerprints of the rat bladder change in actinic cystitis and tumor presence

Efficacy and safety of intravesical fibrin glue instillation for management of patients with refractory hemorrhagic cystitis: 12-months results. A promising therapy for hemorrhagic cystitis

Actinic cystitis associated with urinary tract infection by Candida glabrata as a differential diagnosis of pudendal neuralgia. Case report

Contact Info

Product

Resources

About