Trigone as a diagnostic and therapeutic target for bladder-centric interstitial cystitis/bladder pain syndrome

Dobberfuhl, Amy D.; Uem, Stefanie van; Versi, Eboo

doi:10.1007/s00192-021-04878-9

Cited by 9 publications

(5 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…IC/BPS with and without Hunner lesions is characterized by pelvic/suprapubic pain, bladder discomfort or pressure and increased frequency of urination, and associated with peripheral and central nerve sensitization [118,119]. Migration of bone marrow-derived macrophages to the bladder tissue has been reported in different animal models for IC/BPS [43,120,121].…”

Section: Visceral Painmentioning

confidence: 99%

Macrophage as a Peripheral Pain Regulator

Domoto

Sekiguchi

Tsubota

et al. 2021

Cells

View full text Add to dashboard Cite

A neuroimmune crosstalk is involved in somatic and visceral pathological pain including inflammatory and neuropathic components. Apart from microglia essential for spinal and supraspinal pain processing, the interaction of bone marrow-derived infiltrating macrophages and/or tissue-resident macrophages with the primary afferent neurons regulates pain signals in the peripheral tissue. Recent studies have uncovered previously unknown characteristics of tissue-resident macrophages, such as their origins and association with regulation of pain signals. Peripheral nerve macrophages and intestinal resident macrophages, in addition to adult monocyte-derived infiltrating macrophages, secrete a variety of mediators, such as tumor necrosis factor-α, interleukin (IL)-1β, IL-6, high mobility group box 1 and bone morphogenic protein 2 (BMP2), that regulate the excitability of the primary afferents. Neuron-derived mediators including neuropeptides, ATP and macrophage-colony stimulating factor regulate the activity or polarization of diverse macrophages. Thus, macrophages have multitasks in homeostatic conditions and participate in somatic and visceral pathological pain by interacting with neurons.

show abstract

Section: Visceral Painmentioning

confidence: 99%

Macrophage as a Peripheral Pain Regulator

Domoto

Sekiguchi

Tsubota

et al. 2021

Cells

View full text Add to dashboard Cite

show abstract

“…There has been debate regarding the effectiveness of Botox on IC/BPS between different sites of injection. The trigone has been considered to be rich in unmyelinated nociceptive C-fibers, and it may be a potential target for chemodenervation in patients with IC/BPS [ 81 ]. Giannantoni et al injected Botox at the trigone and lateral bladder wall and reported symptomatic improvement in 86.6% of patients [ 70 ].…”

Section: Clinical Application Of Botox On Interstitial Cystitis/bladd...mentioning

confidence: 99%

Clinical Application of Botulinum Neurotoxin in Lower-Urinary-Tract Diseases and Dysfunctions: Where Are We Now and What More Can We Do?

Kuo

2022

Toxins

View full text Add to dashboard Cite

Botulinum toxin A (Botox) had been considered a promising drug that has an effect on functional disorders of the lower urinary tract. Because Botox exhibits anti-inflammatory and antispasmodic effects, Botox injection into the bladder can decrease detrusor contractility, reduce bladder hypersensitivity, and eliminate painful sensations. Injecting Botox into the bladder outlet can relax the hyperactivity of the bladder neck, and of the urethral smooth and striated muscles. Based on these therapeutic effects, Botox has been widely applied to treat lower-urinary-tract dysfunctions (LUTDs) such as overactive bladder and neurogenic detrusor overactivity. However, this treatment has not been licensed for use in other LUTDs such as interstitial cystitis, voiding dysfunction due to benign prostatic hyperplasia in men, and dysfunctional voiding in women. Botox has also not been approved for the treatment of children with overactive bladder and dysfunctional voiding; in patients with spinal cord injuries with detrusor sphincter dyssynergia and autonomic dysreflexia; or for poorly relaxed external sphincter in non-neurogenic patients. This article reviews the current knowledge regarding Botox treatment for LUTDs and discusses the potential clinical applications of Botox, as well as work that can be conducted in the future.

show abstract

“…Despite numerous guideline treatments, only intravesical dimethyl sulfoxide and oral pentosan polysulfate sodium have been approved by the United States Food and Drug Administration (FDA) for the IC/ BPS indication. 14 In contrast to IC/BPS, the FDA has Global response assessment (GRA) approved many therapies for OAB, including antimuscarinics, beta-3 agonists, intradetrusor BTA, sacral neuromodulation, and percutaneous tibial nerve stimulation.…”

Section: Multimodal Therapies With Dual Effects On Both Ic/bps and Oabmentioning

confidence: 99%

“…Similarly for OAB, the AUA has published guidelines 6 which include: (1) behavioral therapies; (2) pharmacotherapy; (3) BTA and neuromodulation; and (4) augmentation cystoplasty or urinary diversion. Despite numerous guideline treatments, only intravesical dimethyl sulfoxide and oral pentosan polysulfate sodium have been approved by the United States Food and Drug Administration (FDA) for the IC/BPS indication 14 . In contrast to IC/BPS, the FDA has approved many therapies for OAB, including antimuscarinics, beta‐3 agonists, intradetrusor BTA, sacral neuromodulation, and percutaneous tibial nerve stimulation.…”

Section: Multimodal Therapies With Dual Effects On Both Ic/bps and Oabmentioning

confidence: 99%

Pathophysiology, assessment, and treatment of overactive bladder symptoms in patients with interstitial cystitis/bladder pain syndrome

Dobberfuhl

2022

Neurourology and Urodynamics

View full text Add to dashboard Cite

Introduction Interstitial cystitis/bladder pain syndrome (IC/BPS) is prevalent, difficult to treat, and has close symptom overlap with overactive bladder (OAB). A review of the pathophysiology, assessment, and treatment of IC/BPS patients with overlapping OAB symptoms has not been summarized recently in the published literature. Methods A review of the published literature on the overlap of IC/BPS and OAB was conducted using MeSH terminology (1992–2022). Results The pathophysiology of IC/BPS is not fully understood. Animal research has found the bladder trigone and base are richly populated by afferent fibers, including many small unmyelinated C‐fibers that may be upregulated in IC/BPS. Successful therapies with multimodal effects on OAB symptoms in patients with IC/BPS are likely to exert beneficial effects on both pain and lower urinary tract symptoms. Potentially efficacious therapies for the treatment of OAB in IC/BPS include pelvic floor physical therapy, oral pharmacotherapy (antimuscarinics and beta‐3 agonists), sacral neuromodulation, percutaneous tibial nerve stimulation, and botulinum toxin A (BTA). Antimuscarinics and beta‐3 agonists have yielded partial efficacy in IC/BPS, although may help differentiate symptoms of OAB from those associated with IC/BPS. The transvaginal trigone treatment (T3) intradetrusor injection approach allows for delivery of therapeutics to the bladder without the need for a cystoscope and appears to be feasible. Conclusions Further research is needed to understand the pathophysiology of IC/BPS and symptom overlap with OAB, which in turn should enable the development of more personalized therapeutics.

show abstract

Trigone as a diagnostic and therapeutic target for bladder-centric interstitial cystitis/bladder pain syndrome

Cited by 9 publications

References 24 publications

Macrophage as a Peripheral Pain Regulator

Macrophage as a Peripheral Pain Regulator

Clinical Application of Botulinum Neurotoxin in Lower-Urinary-Tract Diseases and Dysfunctions: Where Are We Now and What More Can We Do?

Pathophysiology, assessment, and treatment of overactive bladder symptoms in patients with interstitial cystitis/bladder pain syndrome

Contact Info

Product

Resources

About