Electron Microscopic Investigation of the Bladder Urothelium and Glycocalyx in Patients with Interstitial Cystitis

Dixon, J. S.; Holm-Bentzen, M.; Gilpin, Christopher J.; Gosling, J. A.; Bostofte, Erik; Hald, T; Larsen, Svend

doi:10.1016/s0022-5347(17)45763-6

Cited by 83 publications

(29 citation statements)

References 10 publications

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“…6 Some reports, however, did not find a difference in the GAG layer between BPS and control patients. [7][8] Oral pentosan polysulphate sodium (PPS) is approved by Health Canada and the FDA for symptoms associated with BPS. The widely accepted theory for the mechanism of action PPS is that it substitutes the deficiency in the GAG layer.…”

Section: Introductionmentioning

confidence: 99%

Long-term efficacy and tolerability of pentosan polysulphate sodium in the treatment of bladder pain syndrome

Al-Zahrani¹,

Gajewski²

2011

CUAJ

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Section: Introductionmentioning

confidence: 99%

Long-term efficacy and tolerability of pentosan polysulphate sodium in the treatment of bladder pain syndrome

Al-Zahrani¹,

Gajewski²

2011

CUAJ

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Section: Introductionmentioning

confidence: 99%

Long-term efficacy and tolerability of pentosan polysulphate sodium in the treatment of bladder pain syndrome

Al-Zahrani¹,

Gajewski²

2013

CUAJ

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Objective: The primary objective of this study is to report on thelong-term efficacy and tolerability of pentosan polysulphate sodium(PPS) in patients with bladder pain syndrome (BPS). The secondaryobjective is to find the predictors of the long-term outcome.Methods: This is a single institution, retrospective study. The studyperiod was from 1994 to 2008. All patients fulfilled the clinicalcriteria of BPS, as suggested by European Society for the Study ofInterstitial Cystitis. We included only patients with de novo BPSdiagnosis and no previous PPS or other treatment. The efficacyof PPS was measured with the global response assessment scale(GRA). Patients were stratified into 2 groups based on the durationof the treatment. Group 1 took the drug for less than 12 months.Group 2 took the drug for more than 12 months.Results: There were 271 patients eligible for the study. Most of thepatients were female (90%), with the mean age at presentation of45.5 years. The average duration of symptoms was 28.5 months.The mean follow-up was 22 months (range 3-130). Out of all thepatients, 147 patients (54.2%) reported over 50% improvementusing the GRA. The reported efficacy was higher in Group 2 (60%).Ninety-three patients (34.3%) decided to stop taking the medicationfor various reasons. The most common reasons to stop themedication were poor outcome (16.6% of patients) and side effects(11.1% of patients). Poor outcome was associated with nocturia,smoking and detrusor overactivity. Good outcome was associatedwith longer PPS intake (>12 months) and severe cystoscopic findingsof glomerulation.Conclusion: Pentosan polysulphate sodium is an effective oraltherapy to control the symptoms of BPS with good long-term efficacyand tolerability.

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“…Light-microscopic and electron-microscopic ex aminations of the detrusor layer of the bladder in pa tients with IC have shown patch degeneration of smooth muscle cells with decreased myofibrillar mass, as well as severe endothelial injury [15][16][17][18]. Simmons and Bunce were the first to observe mast cells in the bladder wall and the first to present evi dence that histamine release in the bladder wall of IC patients may be responsible for the pathophysiology of the disease [5,6], The involvement of mast cells in the bladder of IC patients has also been reported by various other authors [19][20][21][22][23].…”

Section: Discussionmentioning

confidence: 99%

Mast Cell Activation in Sterile Bladder and Prostate Inflammation

Theoharides

Flaris²,

Cronin³

et al. 1990

Int Arch Allergy Immunol

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Sterile inflammation of the bladder has often been associated with interstitial cystitis (IC), a urologic condition of unknown etiology, predominantly affecting young and middle-aged females, for which no effective therapy is known. Recent reports have indicated that IC is associated with an increased number of bladder mast cells. Here we report the case of a middle-aged man with chronic sterile hematuria, dysuria and lower abdominal pain associated with a high number of bladder and prostate mast cells. Following therapeutic transurethral resection of the trigone area, bladder neck and prostate, samples of bladder and prostate were examined with light and electron microscopy and contained many mast cells (about 150 cells/mm²) which were not degranulated. Nevertheless, mast cells contained many altered granules and urinary levels of histamine were elevated, implying secretion without exocytosis. These findings are discussed in the context of the pathophysiology of IC and possible therapeutic interventions.

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Electron Microscopic Investigation of the Bladder Urothelium and Glycocalyx in Patients with Interstitial Cystitis

Cited by 83 publications

References 10 publications

Long-term efficacy and tolerability of pentosan polysulphate sodium in the treatment of bladder pain syndrome

Long-term efficacy and tolerability of pentosan polysulphate sodium in the treatment of bladder pain syndrome

Long-term efficacy and tolerability of pentosan polysulphate sodium in the treatment of bladder pain syndrome

Mast Cell Activation in Sterile Bladder and Prostate Inflammation

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