Evaluation of the incidence and risk factors associated with persistent frequency in interstitial cystitis/bladder pain syndrome and the efficacy of antimuscarinic treatment

Abstract

PurposeTo investigate the incidence and risk factors associated with persistent urinary frequency, and to evaluate the efficacy of antimuscarinic treatment.Materials and MethodsInterstitial cystitis/bladder pain syndrome (IC/BPS) patients complaining of persistent urinary frequency despite improved pain were evaluated. Before initial conventional treatment, each patient completed a voiding diary and symptom questionnaires. After conventional treatment, patients were divided according to the presence of pain and frequency. Improved pain was defined as lesser than 3 points in visual analogue scale, and persistent urinary frequency as >10 times/d. Risk factors for persistent frequency were identified through multivariate analysis. The efficacy of antimuscarinic treatment was assessed by the mean change of frequency.ResultsOf 171 IC/BPS patients treated with conventional therapy, 132 had improved pain after 3 months, but 72 had persistent frequency (72 of 132, 54.5%). Patients with persistent frequency had lower voided volume (p=0.008), lower maximal flow rate (p<0.001), lower maximal bladder capacity (p=0.003), and more frequent micturition (p<0.001) at baseline compared to those with improved frequency. Patients who took antimuscarinic agents showed slightly decreased urinary frequency, from 14.6 times/d to 13.5 times/d (p=0.438) after 3 months of medication. No patients showed more than a 20% decrease in frequency with antimuscarinics.ConclusionsAbout half of the patients with IC/BPS showed persistent frequency, with poor voiding function identified as a risk factor; antimuscarinic treatment was not effective in these patients.

Longitudinal intravital imaging of transplanted mesenchymal stem cells elucidates their functional integration and therapeutic potency in an animal model of interstitial cystitis/bladder pain syndrome

“…The pathogenesis of IC/BPS needs to be investigated and animal models of this disease need to be developed to identify curative treatments. Several pathophysiological features of IC/BPS were recently described, including inflammation and mast cell activation, nitric oxide or an autoimmune mechanism, and a glycosaminoglycan layer defect 33 - 36 . Stem cells may ameliorate IC/BPS by undergoing differentiation to regenerate the denuded urothelium and by secreting trophic factors to modulate chronic inflammation and immune responses 11 .…”

Longitudinal intravital imaging of transplanted mesenchymal stem cells elucidates their functional integration and therapeutic potency in an animal model of interstitial cystitis/bladder pain syndrome

“…The pathogenesis of IC/BPS needs to be investigated and animal models of this disease need to be developed to identify curative treatments. Several pathophysiological features of IC/BPS were recently described, including inflammation and mast cell activation, nitric oxide or an autoimmune mechanism, and a glycosaminoglycan layer defect [33][34][35][36]. Stem cells may ameliorate IC/BPS by undergoing differentiation to regenerate the denuded urothelium and by secreting trophic factors to modulate chronic inflammation and immune responses [11].…”

Verification of mesenchymal stem cell injection therapy for interstitial cystitis in a rat model

“…[6] Especially, even though oral medicines used in clinical practice, such as amitriptyline and pentosan polysulphate sodium, or interventional methods such as hydrodistension and intravesical instillation therapy are being widely used at present, to date, no definite standard therapeutic modalities have been established for IC. [9]…”