Mp29-16 Improving the Utility of Clinical Phenotyping in Interstitial Cystitis/Painful Bladder Syndrome: From Upoint to Input

Crane, Alice; Lloyd, Jessica; Shoskes, Daniel A.

doi:10.1016/j.juro.2017.02.928

Cited by 13 publications

(16 citation statements)

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“…In our institution, the UPOINT classification, which has been successfully used in clinical practice, is also widely used in the initial evaluation of the patients. Currently, Infection, Neurologic/Systemic, Psychosocial, Ulcers and Tenderness of Muscles (INPUT) classification, that incorporates Hunner's ulcers into the clinical domains, is proposed and has been validated in a wide range of patients [ 18 ]. The INPUT classification system is a promising tool which will find more use in clinical practice in the future.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Sertraline and Gabapentin in the Treatment of Urethral Pain Syndrome: Retrospective Results of Single Institutional Cohort

Cakici

Hamidi²,

Ürer

et al. 2018

CEJU

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IntroductionUrethral pain syndrome is a subgroup of chronic pelvic pain syndromes and comprises a relatively challenging patient group in urological practice. Several different treatments have been used for the management of the condition from a mostly empirical basis. In this article, we present the results of a small cohort of young male patients treated with sertraline and gabapentin therapy.Material and methodsThe data of 52 patients was retrospectively evaluated and 31 patients' data was included in this study. Clinical symptom scores, including International Prostate Symptoms Score, Hamilton Anxiety Rating Scale, Visual Analog Scale for Pain, Quality of Life due to Lower Urinary Tract Symptoms, and Urinary, Psychosocial, Organ Specific, Infection, Neurologic/Systemic, Tenderness of Skeletal Muscles (UPOINT) classifications were retrospectively analyzed from the patient records and charts.ResultsWe observed improvement in clinical scores involving anxiety, lower urinary tract symptoms, quality of life, and pain. Statistical analysis revealed significant amelioration of the symptoms with gaba- pentin and sertraline treatment in our cohort.ConclusionsGabapentin and sertraline treatment may be considered in the second step management of urethral pain syndrome. To draw an evidence-based recommendation, prospective and comparative studies should be conducted in the future.

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Section: Discussionmentioning

confidence: 99%

Efficacy of Sertraline and Gabapentin in the Treatment of Urethral Pain Syndrome: Retrospective Results of Single Institutional Cohort

Cakici

Hamidi²,

Ürer

et al. 2018

CEJU

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“…However, this system of clinical phenotyping may be less effective in patients with BPS/IC because the urological and organ-specific aspects are, by definition, present in all. Therefore, a novel clinical phenotyping system which removes these domains and adds a domain for the presence of Hunner's lesions-INPUT (infection, neurologic/systemic, psychosocial, ulcers and tenderness of muscles)-has been suggested [77]. The aim is to ensure that all aspects are evaluated for each patient with BPS/IC so that targeted treatment for all domains can be provided simultaneously, rather than offering a sequential tiered approach.…”

Section: Phenotype System: Upointmentioning

confidence: 99%

Phenotypes of BPS/IC

Malde

Sahai

2020

Curr Bladder Dysfunct Rep

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Purpose of Review The aim of this review is to summarise the latest research related to different phenotypes of BPS/IC, addressing the evidence for current well-defined phenotypes as well as identifying novel potential phenotypes and highlighting areas for future study. Recent Findings Two distinct phenotypes of BPS/IC are well-recognised: Hunner’s lesion disease and non-Hunner’s lesion BPS/IC. Recent studies have shown these phenotypes exhibit distinct clinical, pathological and cystoscopic features, and targeted treatment to Hunner’s lesions can prove effective. Recent studies have also identified new potential phenotypes based on biochemical, molecular and histological markers, pathophysiological mechanisms of disease, clinical features, cystoscopic findings, radiological features and urodynamic factors. This evidence has improved our understanding of the underlying mechanism of disease and may enable more personalised and targeted therapy in the future. Summary Novel phenotypes of BPS/IC relate to the presence of certain biomarkers, alterations in the urinary microbiome, the characteristics of pain and presence of co-existing somatic and psychosocial conditions, altered patterns of brain white matter changes and urodynamic features. Further study is required to evaluate whether these potential phenotypes are clinically useful based on their ability to guide treatment selection and predict outcome from therapy, and therefore optimise therapeutic outcomes.

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“…This has been further supported by a further study which shows women with HLs responding to fulguration or cyclosporine which further validates HLs as a differentiating phenotype. 24 Pentosan polysulfate was effective in randomised controlled trials (RCTs) from the early 1990s which focused on ulcerative disease (IC) while the randomized controlled trial by Nickel et al 25 including any BPS regardless of the presence or not of HLs ended up being a negative trial.…”

Section: S67mentioning

confidence: 99%

How can we improve the diagnosis and management of bladder pain syndrome? Part 1: ICI‐RS 2018

Khullar

Chermansky

Tarcan

et al. 2019

Neurourology and Urodynamics

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Background: This paper summarizes the discussion in a think tank at the ICI-RS 2018 about the diagnosis of bladder pain syndrome (BPS). Aims: To review the guidelines, investigations and subtypes of BPS. Materials and Methods: Review of literature in the light of the think tank discussion.Results: All guidelines recommend completing history, physical examination, urine analysis, urine culture, and urine cytology to define the BPS phenotype but there are differences on further investigations. In those guidelines which recommend cystoscopy, the identification of Hunner's lesions (HLs) is recommended as this changes the treatment plan and outcome. Conclusion: We propose that the differentiation of Hunner's ulcers is an important step in the assessment of these patients. Further suggestions for research are suggested.

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Mp29-16 Improving the Utility of Clinical Phenotyping in Interstitial Cystitis/Painful Bladder Syndrome: From Upoint to Input

Abstract: Patients with lower BC had more severe disease characterized either by clinical symptoms, cystoscopy and pathology. Our data suggest that low BC is a biomarker for a bladdercentric manifestation of IC/BPS.

Cited by 13 publications

References 0 publications

Efficacy of Sertraline and Gabapentin in the Treatment of Urethral Pain Syndrome: Retrospective Results of Single Institutional Cohort

Efficacy of Sertraline and Gabapentin in the Treatment of Urethral Pain Syndrome: Retrospective Results of Single Institutional Cohort

Phenotypes of BPS/IC

How can we improve the diagnosis and management of bladder pain syndrome? Part 1: ICI‐RS 2018

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