Clinical guidelines for interstitial cystitis and hypersensitive bladder updated in 2015

Homma, Yukio; Ueda, Tomohiro; Tomoe, Hikaru; Lin, Alex Tong‐Long; Kuo, Hann Chorng; Lee, Ming Huei; Oh, Seung Won; Kim, Joon Chul; Lee, Kyu‐Sung

doi:10.1111/iju.13118

Cited by 107 publications

(129 citation statements)

References 88 publications

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“…Clinical findings suggest bladder inflammation and urothelial dysfunction [2,3]. Urothelial dysfunction, chronic inflammation, impaired bladder circulation, neurogenic hyperactivity, and systemic functional disorders have been linked to IC/BPS and presumably interact in forming IC/BPS [4]. …”

Section: Clinical Characteristics With Bladder Histopathology In Ic/bpsmentioning

confidence: 99%

Pathomechanism of Interstitial Cystitis/Bladder Pain Syndrome and Mapping the Heterogeneity of Disease

Jhang

Kuo

2016

Int Neurourol J

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Interstitial cystitis/bladder pain syndrome (IC/BPS) is a heterogeneous syndrome which is usually characterized by urinary frequency, nocturia, and bladder pain. Several pathomechanisms have been proposed, including uroepithelial dysfunction, mast cell activation, neurogenic inflammation, autoimmunity, and occult urinary tract infections. It is possible that an inflammatory process alters regulation of urothelial homeostasis and results in dysfunction of the bladder epithelium. Different phenotypes of IC/BPS have been explored including Hunner and non-Hunner type IC, hypersensitive bladder, and bladder pain both with and without functional somatic syndrome. Different gene expressions have also been found in different IC phenotypes. Abnormal expressions of uroplakin, chondroitin sulfate and adhesive protein E-cadherin, tight junction protein zonula occludens-1 in IC/BPS bladder suggest abnormal epithelial differentiation in this bladder disease. Analysis of inflammatory proteins, or cytokines in the urine or serum provides another diagnostic foundation forIC/BPS subtypes. The involvement of IC/BPS in systemic functional somatic syndrome and other pelvic organ diseases might also subdivide subtypes of IC/BPS. Chronic inflammation, increased urothelial apoptosis, and abnormal urothelial function are closely associated in IC bladders. This article reviews recent research on the pathomechanisms of IC, which might help us in mapping the heterogeneity of the disease.

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Section: Clinical Characteristics With Bladder Histopathology In Ic/bpsmentioning

confidence: 99%

Pathomechanism of Interstitial Cystitis/Bladder Pain Syndrome and Mapping the Heterogeneity of Disease

Jhang

Kuo

2016

Int Neurourol J

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“…It could be explained by the numerous pathophysiological mechanisms evoked in the BPS/IC (inflammatory, immuno-allergic, parietal lesion, overlaps with other chronic pain syndromes, etc.) [2]. The presence of hyperintense edema showed in DWMRI could become an element to help to characterize this pathology and to propose a treatment possibly adapted to the pathophysiological mechanism.…”

Section: Discussionmentioning

confidence: 99%

“…and inflammation of the bladder wall, regardless of its cause, could be one of the mechanisms leading to BPS/IC [2].…”

Section: Doi: 101159/000493507mentioning

confidence: 99%

Diffusion-Weighted Magnetic Resonance Imaging: A New Tool for the Diagnosis of Bladder Pain Syndrome/Interstitial Cystitis

et al. 2018

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Objectives: To determine whether diffusion-weighted magnetic resonance imaging (DWMRI), a noninvasive procedure, can contribute to the diagnosis of bladder pain syndrome/interstitial cystitis (BPS/IC). Methods: The pelvic DWMRI of patients with chronic pelvic pain syndrome was selected between January 2012 and June 2017. A radiologist analyzed the bladder wall signal; he was blinded to the patients’ clinical data. According to the 2008 European Society for the Study of Bladder Pain Syndrome/Interstitial Cystitis criteria, 2 groups of patients were determined: BPS/IC and no BPS/IC. The association between BPS/IC and the wall signal intensity was compared. Results: In the 106 patients included, 82 had criteria for BPS/IC and 24 did not. A significant difference in the distribution of the signal was found between the 2 groups (p = 0.01). High signal intensity of the bladder wall was related to the presence of a BPS/IC with a sensitivity of 28% and a specificity of 88%. No signal intensity of the bladder wall was related to the absence of a BPS/IC with a sensitivity of 96% and a specificity of 29%. Conclusions: In DWMRI, high bladder wall signal intensity helps to affirm a BPS/IC, whereas the absence of signal helps to exclude the diagnosis. Further studies are needed to confirm these preliminary results.

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“…Urinalysis results are usually normal in BPS/IC [32]. Numerous diagnostic biomarkers for BPS/IC have been explored, including antiproliferative factor, urinary and serum nerve growth factors, and urinary and serum proinflammatory cytokines or chemokines.…”

Section: Bladder-specific Features and Diagnosis Of Bps/icmentioning

confidence: 99%

“…Hunner lesions or mucosal/submucosal bleeding may also be observed during the office cystoscopy, although the bladder cannot be filled as much as in cystoscopy under anesthesia. It is important to examine the bladder mucosa from the early phase of filling, as Hunner lesions might be obscured soon after bladder distention [32]. The lesions are more readily recognized by a narrow-band imaging cystoscopy [34].…”

Section: Bladder-specific Features and Diagnosis Of Bps/icmentioning

confidence: 99%

Chronic Prostatitis/Chronic Pelvic Pain Syndrome and Male Bladder Pain Syndrome/Interstitial Cystitis: How Are They Related?

Lee

2017

Urogenit Tract Infect

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To date, the heterogeneous pathophysiology of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and bladder pain syndrome/interstitial cystitis (BPS/IC) has not been fully elucidated. Thus, it is difficult to make a full comparison between CP/CPPS and male BPS/IC. Controversy and confusion surrounding the terminologies and classifications of CP/CPPS and BPS/IC complicates the issue. CP/CPPS and male BPS/IC are not mutually exclusive conditions, in that they have similarities in their pathogenesis and clinical presentation. Based on the working definitions of these terms, it would be correct to say that male BPS/IC is subsumed by CP/CPPS, and that male BPS/IC can be regarded as CP/CPPS with clear bladder-specific features. Although the term CP/CPPS may be inappropriate, especially since "CP" may be misleading, the perspective that CP/CPPS and male BPS/IC are male urological chronic pain syndromes could enhance the understanding of the relationship between the two. The European Association of Urology classification for chronic pelvic pain is systematic and corresponds well with our knowledge of chronic pain. Therefore, this classification might be the solution to the problems associated with the existing terminologies and taxonomy of CP/CPPS and BPS/IC. In the management of urological chronic pelvic pain in men, clinical phenotyping systems (the UPOINT or UPOINTs system) profile patients and indicate how tailored treatment could be achieved as individualized, multimodal therapeutic regimens. It would be prudent to include bladder-specific features, such as painful filling or painful urgency, in the criteria for the organ-specific domain of the UPOINT(s) system.

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Clinical guidelines for interstitial cystitis and hypersensitive bladder updated in 2015

Cited by 107 publications

References 88 publications

Pathomechanism of Interstitial Cystitis/Bladder Pain Syndrome and Mapping the Heterogeneity of Disease

Pathomechanism of Interstitial Cystitis/Bladder Pain Syndrome and Mapping the Heterogeneity of Disease

Diffusion-Weighted Magnetic Resonance Imaging: A New Tool for the Diagnosis of Bladder Pain Syndrome/Interstitial Cystitis

Chronic Prostatitis/Chronic Pelvic Pain Syndrome and Male Bladder Pain Syndrome/Interstitial Cystitis: How Are They Related?

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