Stratification of Patients With Interstitial Cystitis/Bladder Pain Syndrome According to the Anatomical Bladder Capacity

Mazeaud, Charles; Rigaud, J.; Levesque, Amélie; Madec, F.-X.; Clerc, Q. Le; Wack, Maxime; Normand, L. Le; Riant, T.; Verbe, M. Perrouin

doi:10.1016/j.urology.2018.07.046

Cited by 6 publications

(4 citation statements)

References 21 publications

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“…It is a matter of debate what is the underlying mechanism of the extremely low‐volume FS in IBS without DO, and whether this has a different pathophysiology from DO. Reported underlying pathologies of IBS without DO have included mild interstitial cystitis, depression/anxiety and neurologic diseases that affect the sensory pathway or the basal ganglia . Among neurologic diseases, myelopathies are reported to be the most common cause of IBS without DO .…”

Section: Discussionmentioning

confidence: 99%

“…The underlying pathology of IBS without DO may include alteration of the bladder afferent, alteration of the urethra, or both . The underlying pathology of IBS without DO is also a matter of debate, but appears to include mild interstitial cystitis, depression/anxiety and neurologic diseases that affect the sensory pathway or the basal ganglia, and so on. Among these, we present our data focusing on the urodynamic nature of IBS without DO, applying our five‐grade sensory measure during urodynamics …”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Increased bladder sensation without detrusor overactivity revisited: Use of a five‐grade sensory measure

Tateno

Sakakibara

Aiba

et al. 2019

LUTS

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Aims: Increased bladder sensation (IBS) without detrusor overactivity (DO) is still a matter of debate, regarding its clinical relevance, urodynamic nature, underlying pathology, and management. Among these, we present our data focusing on the urodynamic nature of IBS without DO, by applying our five-grade sensory measure during urodynamics. Methods:We enrolled 400 individuals who visited our laboratory for screening of lower urinary tract function, mostly with neurogenic etiologies. They included 74 control, 87 DO (irrespective of IBS), and 239 IBS (defined as first sensation <100 mL) without DO. During slow bladder filling, we instructed individuals to indicate their sensation in five grades: 1, first sensation to 5, strong desire to void. We also instructed individuals to report other sensations such as pain.Results: The five-grade measure could be performed in all participants without difficulty. None of the participants reported pain or any qualitatively different sensations.Although we defined DO irrespective of IBS, the sensation interval 0 (start) to 1 (first sensation) of subjects with IBS but without DO was significantly less than that of subjects with DO (P < 0.05). Conclusions:The present study results showed that first sensation of subjects with IBS without DO was significantly less than that of subjects with DO (P < 0.05), while the bladder capacities of the two groups were the same. An extremely low-volume first sensation may suggest the possibility of IBS without DO. K E Y W O R D S bladder filling phase, increased bladder sensation without detrusor overactivity, overactive bladder syndrome, urodynamics

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Increased bladder sensation without detrusor overactivity revisited: Use of a five‐grade sensory measure

Tateno

Sakakibara

Aiba

et al. 2019

LUTS

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“…These molecular and clinical data supported the framework for differing phenotypes of IC/BPS: a low bladder capacity subtype with bladder-centric disease and a nonlow bladder capacity subtype with generalized pain and psychosomatic disease. Furthermore, previous studies have shown that IC/BPS patients with low bladder capacity were older and had higher levels of frequency and nocturia, higher levels of acute and chronic bladder inflammation, earlier onset of painful urge during bladder filling, and poorer compliance [ 107 , 108 ].…”

Section: Clinical Diagnosis For Ic/bpsmentioning

confidence: 99%

Urinary Biomarkers in Interstitial Cystitis/Bladder Pain Syndrome and Its Impact on Therapeutic Outcome

Lin

Chuang

et al. 2021

Diagnostics

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Interstitial cystitis/bladder pain syndrome (IC/BPS) is defined as a chronic bladder disorder with suprapubic pain (pelvic pain) and pressure and/or discomfort related to bladder filling accompanied by lower urinary tract symptoms, such as urinary frequency and urgency without urinary tract infection (UTI) lasting for at least 6 weeks. IC/BPS presents significant bladder pain and frequency urgency symptoms with unknown etiology, and it is without a widely accepted standard in diagnosis. Patients’ pathological features through cystoscopy and histologic features of bladder biopsy determine the presence or absence of Hunner lesions. IC/PBS is categorized into Hunner (ulcerative) type IC/BPS (HIC/BPS) or non-Hunner (nonulcerative) type IC/BPS (NHIC/BPS). The pathophysiology of IC/BPS is composed of multiple possible factors, such as chronic inflammation, autoimmune disorders, neurogenic hyperactivity, urothelial defects, abnormal angiogenesis, oxidative stress, and exogenous urine substances, which play a crucial role in the pathophysiology of IC/BPS. Abnormal expressions of several urine and serum specimens, including growth factor, methylhistamine, glycoprotein, chemokine and cytokines, might be useful as biomarkers for IC/BPS diagnosis. Further studies to identify the key molecules in IC/BPS will help to improve the efficacy of treatment and identify biomarkers of the disease. In this review, we discuss the potential medical therapy and assessment of therapeutic outcome with urinary biomarkers for IC/BPS.

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“…The bladder-centric Hunner's lesion phenotype is associated with a low anatomical bladder capacity under anaesthesia-an indication of the destructive inflammatory nature of Hunner's lesion disease which ultimately results in bladder contracture [66•]. Recent studies have shown that low anaesthetic bladder capacity is associated with more severe symptoms, but a lower likelihood of psychosocial complaints or other systemic pain syndromes [67,68]. Furthermore, patients with an anaesthetic bladder capacity of < 400 ml are more likely to have Hunner's lesions and have histological evidence of significantly more acute and chronic inflammation compared with patients with a bladder capacity > 400 ml [69].…”

Section: Phenotype: Low Bladder Capacitymentioning

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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Stratification of Patients With Interstitial Cystitis/Bladder Pain Syndrome According to the Anatomical Bladder Capacity

Cited by 6 publications

References 21 publications

Increased bladder sensation without detrusor overactivity revisited: Use of a five‐grade sensory measure

Increased bladder sensation without detrusor overactivity revisited: Use of a five‐grade sensory measure

Urinary Biomarkers in Interstitial Cystitis/Bladder Pain Syndrome and Its Impact on Therapeutic Outcome

Phenotypes of BPS/IC

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