Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Cystitis, Interstitial”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 253 records · Page 14Linked to original sources
PubMed1992

Interstitial cystitis: increased sympathetic innervation and related neuropeptide synthesis.

To investigate the possibility of a neural deterioration of the bladder wall in interstitial cystitis, bladder tissue from 10 patients with interstitial cystitis was compared with that from 10 control subjects by means of immunohistochemistry. An enhanced innervation of the bladder in the submucosa and detrusor muscle was found to represent an increase of sympathetic but not cholinergic neurons. In interstitial cystitis the number of neurons positive for vasoactive intestinal polypeptide and neuropeptide Y was higher and carried a larger number of axonal varicosities, whereas the number of neurons positive for substance P and calcitonin-gene-related peptide was not significantly different in both groups. We conclude that interstitial cystitis is associated with increased sympathetic outflow into the bladder and altered metabolism of vasoactive intestinal polypeptide and neuropeptide Y. Since similar changes have been observed in other inflammatory diseases of a presumably autoimmune nature, such as rheumatoid arthritis, Crohn's disease and colitis ulcerosa, the pathophysiology of interstitial cystitis may share common pathways with the latter. Experience in these diseases may facilitate a better understanding of the pathophysiology of interstitial cystitis and suggest new therapeutic concepts.

Adrenergic Fibers↗
PubMedDate not supplied

[Enterocystoplasty in the treatment of interstitial cystitis].

OBJECTIVE: To evaluate supratrigonal cystectomy and enterocystoplasty in patients with interstitial cystitis. METHODS: We reviewed four women with interstitial cystitis with infructuos conservative treatment and performed supratrigonal cystectomy and enterocystoplasty. All the patients fulfilled the NHI criteria with increased voiding frequency by night (mean 7.3 times). In 3 cases urodynamic study was available. We used is the four patients ileon as segment for the enterocystoplasty. RESULTS: Mean postoperative follow up was 60 months. In all cases the suprapubic pain disappeared and night voiding frequency reduced (mean 2.2 times). We don't have mayor complications. One patient needs self catheterism 3 years after surgery. CONCLUSION: In patients with interstitial cystitis to be operated supratrigonal cystectomy and enterocystoplasty is the most effective method.

Aged↗
PubMed2005

Risk of irritable bowel syndrome and depression in women with interstitial cystitis: a case-control study.

PURPOSE: We determined the risk of irritable bowel syndrome and depression in women with interstitial cystitis. MATERIALS AND METHODS: Cases consisted of 46 women with newly diagnosed interstitial cystitis. The control group consisted of 46 women presenting for an annual gynecologic examination. Data were collected using standardized, validated questionnaires. RESULTS: The 2 groups were similar with respect to age, race, parity, previous pelvic surgery and postmenopausal hormone use. Compared with controls patients with interstitial cystitis were more likely to be diagnosed with irritable bowel syndrome (OR 11, 95% CI 2.7 to 52, p <0.001) and depression (OR 3.97, 95% CI 1.17 to 14.1, p <0.05). In the interstitial cystitis group when we compared women with and without depression, we noted that women with depression were significantly more likely to complain of bladder pain, nocturia, abdominal pain and other bowel symptoms. CONCLUSIONS: The association of irritable bowel syndrome and depression appears to be greater in women with interstitial cystitis than in controls. Additionally, it appears that pain of bladder or bowel origin is a significant cause of depression in women with interstitial cystitis.

Adult↗
PubMed1997

Effect of long-term oral L-arginine on the nitric oxide synthase pathway in the urine from patients with interstitial cystitis.

PURPOSE: We attempted to determine whether oral L-arginine, the substrate for nitric oxide synthase, increases nitric oxide synthase activity and cyclic guanosine monophosphate (cGMP) levels in the urine from interstitial cystitis patients. Nitric oxide and cGMP are decreased in urine from interstitial cystitis patients and both induce smooth muscle relaxation and immunological responses. Increasing urinary nitric oxide and cGMP may ameliorate interstitial cystitis symptoms. MATERIALS AND METHODS: Eight patients with interstitial cystitis were given L-arginine (1,500 mg. a day) orally for 6 months. Before and during treatment nitric oxide synthase activity and inducible nitric oxide synthase protein, cGMP, nitrate plus nitrite and interleukin 8 (IL-8) levels were measured in urine. RESULTS: After 2 weeks to 1 month of oral L-arginine treatment, urinary levels of nitric oxide synthase related enzymes and products increased significantly, while levels of the cytokine IL-8 were not changed significantly. IL-8 was significantly elevated in interstitial cystitis patients with leukocyte esterase positive urine. CONCLUSIONS: Long-term oral administration of L-arginine increases nitric oxide related enzymes and metabolites in the urine of patients with interstitial cystitis, which is associated with a decrease in interstitial cystitis related symptoms.

Administration, Oral↗
PubMed1996

Mast cell counts are not useful in the diagnosis of nonulcerative interstitial cystitis.

PURPOSE: Mast cell counts have been advocated as useful in the pathological diagnosis of interstitial cystitis. To determine the clinical significance of mucosal and detrusor muscle mast cells we quantified mast cells within the lamina propria and detrusor muscle in nonulcerative interstitial cystitis, and various inflammatory and neoplastic bladder diseases. MATERIALS AND METHODS: Mast cells from Giemsa stained sections were enumerated from 8 cases of clinically diagnosed nonulcerated interstitial cystitis and 32 control cases having inflammatory or neoplastic bladder disease. Cystectomy specimens from controls also included sections from normal (5) and inflamed transitional mucosa (4) distant from the invasive tumor. RESULTS: There was no significant difference in mast cell counts when considered absolutely or relative to the muscle-to-mucosa ratio in cases of nonulcerative interstitial cystitis and controls. CONCLUSIONS: Our findings indicate that mast cell counts are not useful in the evaluation of nonulcerative interstitial cystitis and do not represent a diagnostic criterion for inclusion or exclusion of the disease.

Adult↗
PubMed2002

Diurnal cortisol variations and symptoms in patients with interstitial cystitis.

PURPOSE: Little attention has focused on systemic factors that may allow a state of chronic bladder inflammation to be established and maintained in interstitial cystitis cases. Abnormalities of the hypothalamic-pituitary-adrenal feedback system result in poorer regulation of the inflammatory response and are present in many chronic inflammatory and pain conditions, of which some have high co-morbidity with interstitial cystitis. MATERIALS AND METHODS: A total of 48 patients with interstitial cystitis and 35 healthy, age matched controls collected 24-hour urine samples and 3 days of salivary samples at 7 to 8 a.m., 4 to 5 p.m. and 8 to 9 p.m. for cortisol analysis. In addition, they completed a concurrent symptom questionnaire. Prospective symptom diaries also were completed in the month before sampling. RESULTS: Mean urinary or salivary cortisol did not differ in patients and controls. However, patients with interstitial cystitis and higher morning cortisol had significantly less pain and urgency, while those with higher urinary free cortisol reported less overall symptomatology (p <0.05). Relationships with morning cortisol were also observed when controlling for co-morbid conditions known to be affected by the hypothalamic-pituitary-adrenal axis, such as fibromyalgia, chronic fatigue and rheumatoid arthritis. Patients with morning cortisol less than 12.5 nmol./l. were 12.8 times more likely to report high urinary urgency than those with values above this cutoff. CONCLUSIONS: These findings imply that regulation of the hypothalamic-pituitary-adrenal axis may be associated with interstitial cystitis symptomatology and there may be different diurnal hypothalamic-pituitary-adrenal patterns in patients with interstitial cystitis who do and do not have co-morbid conditions. These findings may have treatment implications for patients with interstitial cystitis who have early morning cortisol deficiencies.

Adult↗
PubMed2000

Interstitial cystitis. Etiology, diagnosis, and treatment.

OBJECTIVE: To review current knowledge about the epidemiology, etiology, diagnosis, and treatment of interstitial cystitis, with special emphasis on management of this condition by family physicians. QUALITY OF EVIDENCE: Articles were identified through MEDLINE and review of abstracts presented at Urology and Interstitial Cystitis meetings during the last decade. Recent reviews were further searched for additional studies and trials. Data were summarized from large epidemiologic studies. Etiologic theories were extracted from current concepts and reviews of scientific studies. Diagnostic criteria described in this review are based on clinical interpretation of National Institutes of Health (NIH) research guidelines, interpretation of data from the NIH Interstitial Cystitis Cohort Study, and recent evidence on use of the potassium sensitivity test. Treatment suggestions are based on six randomized placebo-controlled clinical treatment trials and best available clinical data. MAIN MESSAGE: Interstitial cystitis affects about 0.01% to 0.5% of women. Its etiology is unknown, but might involve microbiologic, immunologic, mucosal, neurogenic, and other yet undefined agents. The diagnosis of interstitial cystitis is a diagnosis of exclusion. It is impossible to provide a purely evidence-based treatment strategy, but review of available evidence suggests that conservative supportive therapy (including diet modification); oral treatment with pentosan polysulfate, amitriptyline, or hydroxyzine; and intravesical treatments with heparinlike medications, dimethyl sulfoxide, or BCG vaccine could benefit some patients. CONCLUSION: Family physicians should have an understanding of interstitial cystitis and be able to make a diagnosis and formulate an evidence-based treatment strategy for their patients.

Administration, Intravesical↗
PubMed2006

Safety and efficacy of hyperbaric oxygen therapy for the treatment of interstitial cystitis: a randomized, sham controlled, double-blind trial.

PURPOSE: We conducted a double-blind, sham controlled study to evaluate the safety, efficacy and feasibility of hyperbaric oxygenation for interstitial cystitis. MATERIALS AND METHODS: A total of 21 patients with interstitial cystitis were randomized to 90 minutes treatment in a hyperbaric chamber pressurized with 100% O2 to 2.4 atmosphere absolute for 30 treatments sessions or 1.3 atmosphere absolute, breathing normal air in the control group. Moderate or marked improvement in a global response assessment questionnaire was defined as treatment response (primary outcomes). Secondary measurements included changes of pain and urgency evaluated by visual analog scales, functional bladder capacity and frequency. Changes in the O'Leary-Sant Interstitial Cystitis Index and rating of overall satisfaction with the therapeutic outcome were also reported. RESULTS: There were 3 of 14 patients on verum and no control patients who were identified as responders (p < 0.52) [corrected] At 12-month followup 3 patients (21.4%) still reported treatment response. Hyperbaric oxygenation resulted in a decrease of baseline urgency intensity from 60.2 +/- 15.0 to 49.9 +/- 35.2 mm at 3 months and decrease of pain intensity from 43.1 +/- 20.5 to 31.2 +/- 19.8 mm, respectively (p < 0.05). The Interstitial Cystitis Symptom Index score sum decreased from 25.7 to 19.9 points in patients on verum. Sham treatment did not result in improvement of the baseline parameters. CONCLUSIONS: A total of 30 treatment sessions of hyperbaric oxygenation appear to be a safe, effective and feasible therapeutic approach to interstitial cystitis. In the treatment responders application of hyperbaric oxygenation resulted in a sustained decrease of interstitial cystitis symptoms with a discordant profile regarding the peak amelioration of the various interstitial cystitis symptoms compared with a normobaric, normoxic sham treatment.

Adult↗
PubMed2003

Interstitial cystitis.

PURPOSE: To describe the pathophysiology, assessment, diagnosis, and management of interstitial cystitis. DATA SOURCES: Selected professional publications and presentations. CONCLUSIONS: Interstitial cystitis (IC) is a chronic and disabling condition. Symptoms include urinary frequency and urgency, pain, dyspareunia, and nocturia. It occurs primarily in women. Onset is predominately in adulthood although IC does occur in childhood. Bladder wall defects, auto-immune disorder, viral and/or bacterial infection, toxin exposure, pelvic floor dysfunction and inflammatory response are possible causes. Diagnosis is by history, physical examination, laboratory tests, and cystoscopic examination. The management of interstitial cystitis includes dietary changes, antihistamines, tricyclic antidepressants, oral and intravesicle glucosaminoglycans, hydrodistention, pain management and emotional support. IMPLICATIONS FOR PRACTICE: Nurse practitioners need to be knowledgeable about the occurrence and debilitating effect of IC. Inclusion of IC into the differential diagnoses related to urgency, frequency, and abdominal pain will help assure the timely and effective diagnosis and management of this unusual disease.

Cystitis, Interstitial↗
PubMed1993

Effect of repeated instillation of interstitial cystitis urine on the rabbit urinary bladder.

One theory for the etiology of interstitial cystitis (IC) proposes toxic substances in the urine. This hypothesis was tested in our laboratory by infusing urine into the bladders of rabbits twice weekly for six weeks. For the first study rabbits were treated by one-hour biweekly intravesical exposure to urine from a symptomatic interstitial cystitis patient, a normal volunteer, or physiologic saline. For the second study, animals were exposed to both a high and a low molecular weight fraction of urine pooled from 7 interstitial cystitis patients, 7 normal female volunteers, and physiologic saline. At the end of six weeks the animals were cystoscoped and the bladder was removed the following day for histologic and contractile studies. Post-distention glomerulations were observed in 3 of the 4 whole IC urine-treated animals and an ulcer identical to the classic "Hunner's ulcer" was seen in one of these animals. Post-distention petechial hemorrhages were also noted in all 5 of the high molecular weight IC urine-treated animals but in none of the others, suggesting a difference between IC and normal urine. These IC urine-treated groups also showed the greatest degree of histologic changes including edema and plasma cell infiltrates in the lamina propria, submucosa and perivascular tissue. However, there was no statistically significant difference in bladder capacity, micturition patterns, or contractile response of bladder strips. These results indicate that there are substances with nominal molecular weight greater than 10 kD in interstitial cystitis urine that induce changes in the rabbit bladder that resemble bladders of interstitial cystitis patients.

Administration, Intravesical↗
PubMed2001

Interstitial cystitis: a chronic inflammatory bladder condition.

Interstitial cystitis (IC) is a chronic inflammatory condition of the bladder wall, characterized by urinary frequency and urgency, and severe suprapubic and/or pelvic pain. Symptoms of IC resemble those of ordinary urinary tract infections. However, standard urine cultures are negative and antibiotic therapy offers no relief. Recent research indicates that IC may be much more common than was previously thought, affecting over 700,000 people in the US. More than 90% of those affected are women, many of whose lives are thoroughly disrupted by severe pain. Long overlooked and misdiagnosed, IC is only now beginning to be understood. Although there is no specific diagnostic test or marker for IC and no uniformly effective treatment, little more than a decade of research has yielded promising results. New diagnostic tests are currently being developed and new therapeutic modalities are in clinical trials. While science searches for answers to this devastating disease, patients living with pain deserve relief.

Cystitis, Interstitial↗
PubMed2004

Interstitial cystitis: a chronic pelvic pain syndrome.

Interstitial cystitis, an enigmatic chronic pelvic pain syndrome that occurs primarily in women, is much more common than originally believed. Its etiology is unknown, its evaluation and diagnosis remain controversial, and its treatment is largely empiric. Recent basic and clinical research is unlocking some of the mystery surrounding this clinical syndrome. Diagnostic awareness, willingness to consider recently studied therapies, and reasonable therapeutic expectations on the part of both the physician and the patient seem to be the key to successful management of this condition.

Chronic Disease↗
PubMed2001

Interstitial cystitis: a chronic visceral pain syndrome.

Interstitial cystitis (IC) has remained an unresolved problem in clinical urology. The etiology and pathophysiologic mechanisms of IC are still undetermined, and to date the diagnosis is based on the clinical characteristics of the disease and the exclusion of other diseases and pathology that can mimic the symptoms of IC. In clinical practice, much emphasis has been placed on finding a specific etiology and specific pathologic markers for the disease and on identifying specific events that precipitate IC; however, those have not been identified with certainty. In this review, an additional approach is proposed, taking into account the observation that IC shares many features with other chronic nonmalignant visceral pain syndromes. This approach is based on the conceptualization of 3 hypotheses: (1) a spectrum of different insults can lead to chronic visceral pain in patients with IC; (2) different underlying pathogenic pain mechanisms may require different pain treatment strategies for patients diagnosed with IC; and (3) multiple different pathogenic pain mechanisms may coexist in the same patient requiring several different pain treatment strategies (perhaps concomitantly) to successfully treat chronic visceral pain associated with IC. This concept is likely to lead to new insights into the pathophysiologic mechanisms of IC and to novel treatment avenues for patients with IC and-in a broader view-also for patients with other chronic visceral pain syndromes.

Chronic Disease↗
PubMed1997

Intravesical hyaluronic acid in the treatment of refractory interstitial cystitis.

OBJECTIVES: On the assumption that interstitial cystitis (IC) is the result of a defective mucous lining of the bladder epithelium, a study was carried out to investigate the activity of hyaluronic acid (HA) in the treatment of IC. HA is an important glycosaminoglycan (GAG) present in all connective tissues, including the GAG layer of the vesical mucosa. It exhibits a variety of pharmacologic properties that enhance its appeal for the therapy of IC. METHODS: A total of 25 patients, with the characteristic picture of IC and refractory to other medical treatments, participated in a trial of HA. Patients received 40 mg of HA intravesically on a weekly basis for 4 weeks, then monthly. Response to therapy was evaluated by symptom score, voiding diaries, and visual analog scales. RESULTS: An initial positive (complete+partial) response of 56% at week 4 increased to 71% by week 12. This response was maintained until week 20; beyond week 24 there appears to be a moderate decrease in the effectiveness of the medication. There was no significant toxicity attributable to the presence of HA in the bladder. CONCLUSIONS: The response of refractory IC patients to the intravesical administration of HA was gratifying. In the past, many therapies for IC that were initially considered promising failed the test of a controlled study. Further studies will establish the effectiveness of this particular preparation of HA in the treatment of IC.

Administration, Intravesical↗
PubMed2003

Research criteria versus clinical criteria for interstitial cystitis.

In March 2003 experts on interstitial cystitis (IC) from around the world met in Kyoto, Japan for a series of workshops intended to define areas of agreement and difference in the approach to this disease. This workshop explored the diagnostic criteria IC in the clinical and research settings. The NIDDK criteria are used almost universally for research but there is tremendous disparity in the clinics and no consensus at all as to the best practice in diagnosing IC for clinical purposes. Throughout the world many physicians use the NIDDK research criteria for clinical diagnosis; in some countries this is standard. Undoubtedly, this mandates under-diagnosis and denies treatment to many patients. Still, a majority feel that one diagnostic system is mandatory to promote clarity in communication. The group called for two initiatives to help advance this area of controversy: (1) a large-scale, prospective study critically examining the role of cystoscopy, bladder distention, and biopsy in the diagnosis of IC; (2) a concerted effort to develop a single evidence-based guideline or algorithm that would be flexible enough to meet the needs of clinicians, researchers, and patients.

Biomedical Research↗
PubMed2005

Abnormal urinary potassium metabolism in patients with interstitial cystitis.

PURPOSE: If most patients with interstitial cystitis (IC) have epithelial leakage allowing urinary K to penetrate the interstitium and provoke symptoms, urinary K should be lower in untreated patients than in healthy subjects and it should increase with successful heparinoid treatment. This study tested these hypotheses. MATERIALS AND METHODS: Na, K and creatinine (Cr) were determined in spot urine samples from new, symptomatic, untreated patients with IC meeting all National Institute of Diabetes and Digestive and Kidney Diseases clinical diagnostic criteria, returning patients with IC reporting 50% or greater symptom improvement after 4 or greater months of oral heparinoid therapy and control subjects, and in 24-hour urine samples from new untreated patients and controls. RESULTS: In spot urine specimens of 37 new patients with IC K-to-Cr ratios were significantly lower than in 18 controls (0.51 vs 0.88 mg/mg Cr, p = 0.001). A total of 50 successfully treated patients with IC had significantly higher K-to-Cr ratios than those in 37 new patients (0.66 vs 0.51 mg/mg Cr, p = 0.025). Na-to-Cr ratios in the 3 groups were not significantly different. In 24-hour urine specimens 30 new patients had lower average K (31.0 vs 46.2 mEq/l, p = 0.01) and lower K-to-Cr ratios (0.43 vs 0.52 mg K/mg Cr, p = 0.01) than in 47 controls, while Na was not significantly different. CONCLUSIONS: Our finding of lower urinary K in new, untreated patients supports the concept of abnormal epithelial permeability and K absorption in IC. Higher urinary K in successfully treated vs untreated patients may reflect decreasing urinary K absorption due to mucosal repair and a resulting decrease in epithelial permeability. K/mg Cr appears accurate for normalizing urinary K.

Absorption↗
PubMed2005

[Clinical evaluation of 30 patients with interstitial cystitis complicated by fibromyalgia].

PURPOSE: Although interstitial cystitis (IC) complicated by fibromyalgia (FM) is yet unreported in Japan, we encountered patients with the complications almost as frequently as in the USA. We report the present status of such patients and the significance of this complication. PATIENTS AND METHODS: We evaluated the clinical findings of 30 patients with IC complicated by FM in the last four years. RESULTS: Average IC symptom index and problem index was 14.9 and 14.6, respectively. Average numbers of tender points for the criteria for FM was 16 locations. Both diseases have some similarities in the decrease in pain threshold, extensive pain, factors exacerbating symptoms and treatment methods. CONCLUSION: Approximately 11% of patients with IC have a complication of FM. They feel isolated due to the lack of understanding of the disease and endure generalized intolerable pain.

Cystitis, Interstitial↗
PubMed2001

Treatment of interstitial cystitis with a quercetin supplement.

PURPOSE: Interstitial cystitis (IC) is a disorder of unknown etiology with few effective therapies. Oral bioflavonoid therapy utilizing quercetin recently proved to be clinically effective in men with chronic pelvic pain syndrome, a disorder with similarities to IC. We therefore tested in an open-label trial a quercetin-based supplement in patients with clinically proven IC. MATERIALS AND METHODS: Twenty-two patients (5 men and 17 women; average age 53.1 years) with classically documented IC received one capsule of Cysta-Q complex (equivalent to 500 mg of quercetin) twice a day for 4 weeks. Symptoms were assessed before and after therapy by the IC problem and symptom indices as well as by global assessment of pain (range 0-10). RESULTS: Two patients did not complete the study. In the remaining 20 patients, improvement was seen in all three parameters tested. After 4 weeks of treatment, the mean (+/- SEM) problem index improved from 11.3 +/- 0.6 to 5.1 +/- 0.7 (p = .000001), the mean symptom index improved from 11.9 +/- 0.9 to 4.5 +/- 0.5 (p = .000001), and the mean global assessment score improved from 8.2 +/- 0.4 to 3.5 +/- 0.4 (p = .000001). None of the patients experienced any negative side effects, and all but one patient had at least some improvement in every outcome measure. CONCLUSION: Oral therapy with the quercetin supplement Cysta-Q was well tolerated and provided significant symptomatic improvement in patients with IC. Larger, randomized, placebo-controlled trials appear warranted based on these preliminary open-label results.

Adult↗