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PubMed1977

Interstitial cystitis, treated by prolonged bladder distension.

25 patients with interstitial cystitis were treated by prolonged bladder distension. 16 patients are symptom-free, but 5 of these have had 1 or more previous prolonged bladder distensions. 6 patients are improved, whilst 3 remain symptomatically unchanged. Prolonged bladder distension can be repeated successfully when symptoms return. These results suggest that prolonged bladder distension has a place in the treatment of interstitial cystitis.

Adult↗
PubMed1977

Psychiatric aspects of recurrent cystitis in women.

Using both psychometric questionnaires and psychiatric interview it has been shown that women with recurrent cystitis have significantly more psychiatric symptoms (particularly those of anxiety) than the population as a whole. By comparison with the expected prevalence, the study group shows a 3-fold increase in psychiatric symptoms antedating micturition symptoms, and a 10-fold increase in psychiatric symptoms overall. Significant differences in psychometric profiles have been demonstrated between different clinical subgroups of patients (e.g. bladder instability, outlet obstruction and dyspareunia). A multifactorial approach (including an awareness of psychiatric factors) to patients complaining of recurrent cystitis can produce a treatment failure rate as low as 4.4%.

Adolescent↗
PubMed1979

Interstitial cystitis.

Twenty histologically proven cases of interstitial cystitis were investigated in an attempt to find evidence of a possible autoimmune mechanism in its aetiology. HLA tissue typing was performed, autoantibody profiles were obtained, and a questionnaire of the patients' past history completed, especially with respect to other autoimmune conditions. An experiment was designed to test the effect of sodium cromoglycate on rat bladders. The results are discussed in relation to the management of patients with interstitial cystitis.

Aged↗
PubMed1982

Mast cells in interstitial cystitis.

Specific clinical criteria have been used to diagnose interstitial cystitis in 32 patients. The distribution of mast cells in biopsies of the bladder wall from these patients has been compared with that of similar cells in control specimens. A highly significant increase (P less than 0.001) in the number of mast cells within the detrusor muscle bundles has been demonstrated in 27 of these patients. This mast cell infiltration is widespread throughout the detrusor muscle and is not confined to the ulcerative lesions seen cystoscopically. Histological estimation of mast cells is of value, therefore, in establishing the diagnosis of interstitial cystitis, and may be particularly helpful in equivocal cases. The relationship between mast cell infiltration of the detrusor muscle bundles and the aetiology of the disease remains to be determined.

Cell Count↗
PubMed1991

Lumbar nerve root compression and interstitial cystitis--response to decompressive surgery.

An identifiable lumbar nerve root compression appears to cause urological dysfunction consistent with interstitial cystitis. Ten patients (9 females, 1 male) were evaluated for chronic pelvic pain. Cystoscopic and histological appearances were consistent with a diagnosis of interstitial cystitis. Magnetic resonance studies of the lower spine consistently demonstrated a lateral compression of the L5 dorsal nerve root. Decompression of the lateral foramina of L5 resulted in immediate relief of pain in 9 patients, who have been followed up for 6 months without a recurrence. Possible mechanisms involving sympathetic dystrophy of the pelvic plexus are reviewed.

Cystitis↗
PubMed1993

Ultrastructural observations on cystitis cystica in human bladder urothelium.

Cystitis cystica, a common urothelial pathology whose aetiology, morphology and clinical significance are poorly understood, affects the human urinary bladder and trigone in both sexes. We have studied the fine structure of urothelial cysts in 11 patients diagnosed cystoscopically as suffering from cystitis cystica. Several abnormal features were observed in the adjacent urothelium, including large intracellular vacuoles (4 patients), Brunn's nest (5), lymphocyte infiltration (10) and generally disorganised urothelial architecture (10). Squamous metaplasia was observed in one case. The wall of each cyst consisted of a 2-3 layered epithelium with either tall columnar or flattened cells lining the fluid-filled lumen. Both types of lining cell possessed short microvilli, while the columnar type also contained numerous membrane-bound, electron dense secretory granules in the apical cytoplasm. Rough endoplasmic reticulum, mitochondria and Golgi membranes were plentiful in the surface cells. Junctional complexes joined adjacent lining cells. The deeper cells contained relatively fewer organelles, while a basal lamina separated the cyst wall from the underlying connective tissue.

Aged↗
PubMed1993

Lumbar epidural blockade for management of pain in interstitial cystitis.

Thirteen patients with interstitial cystitis (IC), whose predominant symptom was pelvic or urethral pain, were treated with a series of lumbar epidural local anaesthetic blocks over an 18-month period. Response was evaluated by interview and with voiding diaries and visual analogue scales (VAS) for pain. Of the 55 injections given, immediate pain relief (lasting longer than 24 h) was obtained from 41 (75%). The duration of subsequent pain relief varied considerably, ranging from 2 to 75 days (mean 15.1). Pain relief was accompanied by significant improvement in sleep habit and quality of life. A good correlation was noted between verbally expressed pain and the recorded VAS pain scores. Urinary frequency and average voided volumes were unaffected by treatment. Two patients failed to obtain any relief. Apart from minor transient backache at the injection site, there were no complications from the procedure. Lumbar sympathetic epidural blockade is an excellent means of providing pain relief in interstitial cystitis.

Adult↗
PubMed1993

Encrusted cystitis: aetiology, clinical aspects and management.

Encrusted cystitis is a rare condition characterised by the formation of calcified plaques adherent to or embedded in the bladder mucosa. Although chronic infection with urea-splitting organisms is a prerequisite, other factors seem to play an important role in its development. We report our experience of 4 such cases in which encrusted cystitis presented with various symptoms, produced different pathological abnormalities and was treated by different means in each patient.

Adult↗
PubMed1994

Treatment of interstitial cystitis with intravesical heparin.

OBJECTIVE: To control the symptoms of interstitial cystitis with chronic self-administered intravesical heparin and determine whether the drug's continued use can sustain remission. PATIENTS AND METHODS: A total of 48 patients were selected to undergo intravesical heparin therapy, 10,000 units in 10 ml sterile water, three times per week for 3 months. For patients who attained a good clinical remission, therapy was available for up to a further 9 months. RESULTS: At 3 months 27 of 48 patients (56%) attained good clinical remissions. All were offered continuous therapy and 23 elected for an additional 3 months. Twenty of the 23 continued in remission. Sixteen of these patients elected to have a further 6 months of therapy (12 months total) and 15 of 16 remained in remission. CONCLUSION: In over half of the patients studied, intravesical heparin controls the symptoms of interstitial cystitis with continued improvement even after one year of therapy.

Administration, Intravesical↗
PubMed2004

Hyperbaric oxygen does not accelerate latent in vivo prostate cancer: implications for the treatment of radiation-induced haemorrhagic cystitis.

OBJECTIVE: To assess the effects of hyperbaric oxygen (HBO2; often used to treat haemorrhagic cystitis, a known side-effect after radiation therapy for prostate cancer and with the potential to induce tumour angiogenesis and stimulate latent recurrence) on indolent in vivo prostate cancer in a murine model. MATERIALS AND METHODS: Human prostate LNCaP cells were injected into 60 severe combined-immunodeficient mice; of these 24 (40%) did not develop palpable tumours after 6 weeks. They were randomized to undergo 20 sessions of either HBO2 or normobaric air in standardized conditions, and observed for another 4 weeks before the histological assessment of any palpable tumours that developed. Analysis of developed LNCaP tumours included tumour volume, microvessel density, MIB-1, p53, p27 and racemase staining intensity. RESULTS: HBO2 was associated with less prostate tumour progression than normobaric air (P = 0.26). During HBO2 therapy, 10 mice remained free of palpable tumours, compared with seven controls (P = 0.30). On evaluation during the 4 weeks after therapy, six mice treated with HBO2 remained free of palpable tumours, vs eight of the controls (P = 0.17). There was tumour invasion and necrosis in a two of six and four of the HBO2 group during and after therapy, respectively, vs five and seven of the controls. Tumour microvessel density, proliferative index, differentiation and apoptosis markers were similar in both groups. CONCLUSIONS: HBO2 does not accelerate the growth of indolent prostate cancer in a murine model, suggesting that it does not increase the risk of residual prostate cancer reactivation when it is used to manage radiation-induced haemorrhagic cystitis in patients treated by pelvic radiotherapy for prostate cancer.

Animals↗
PubMed1997

How does cystitis affect a comparative risk profile of tiaprofenic acid with other non-steroidal antiinflammatory drugs? An international study based on spontaneous reports and drug usage data. ADR Signals Analysis Project (ASAP) Team.

Series of well-documented case reports strongly suggest a causal association between tiaprofenic acid and a form of aseptic cystitis, which can cause serious and long-term morbidity if the drug is not withdrawn promptly. These findings are supported in the Australian and UK spontaneous reporting data-bases. Using sales data as the denominator, a comparison of NSAIDs in the WHO drug monitoring data-base indicates that the reaction is specific to tiaprofenic acid and cannot be accounted for by changes in reporting patterns in certain countries or years. Delayed recognition is an important feature of this reaction and possible reasons for this are discussed. Comparison of the risk profiles of seven NSAIDs indicated that tiaprofenic acid had the poorest risk profile, compared with NSAIDs of similar efficacy, when cystitis reports were included. The results suggest that combining spontaneous reports, classified according to severity, with sales data may enhance the ability of drug monitoring data-bases to contribute to risk benefit appraisals.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1975

Use of nitroblue tetrazolium (NBT) test in the differentiation between pyelonephritis and cystitis.

NBT tests were performed on blood from 37 patients with urinary tract infections caused by coliform bacteria. The level of infections was evaluated by the clinical signs, ESR, renal concentrating capacity and titre of antibodies against the strains of E. coli isolated in their urine. Elevated proportions of NBT-positive neutrophils were found in 11 of 14 patients with pyelonephritis and in 3 of 23 patients with cystitis or asymptomatic bacteriuria (ABU). The total number of NBT-positive neutrophils was 1000 or more per mm3 blood in 11 of 13 patients considered to have pyelonephritis, while it was 800 or less in all the patients investigated, evaluated as having cystitis or asymptomatic bacteriuria. The NBT test is recommended as an adjunct in the level diagnosis or urinary tract infections in children. The utility of the test in smouldering pyelonephritis is presently being investigated.

Adolescent↗
PubMed1998

Emphysematous cystitis and bladder trigone diverticulum in a dog.

A 14-month-old, male German shepherd dog was evaluated for chronic, recurrent Escherichia coli urinary tract infection. An initial diagnosis of emphysematous cystitis was made, which resolved with appropriate antibacterial therapy. The urinary tract infection, however, did not resolve and on further investigation a bladder trigone diverticulum was evident, thought to be congenital in origin. This report describes the apparent ultrasonographic and radiological changes, and surgical repair of the diverticulum, and reviews the literature with regard to both congenital bladder trigone diverticulum and emphysematous cystitis. The former has never been documented in the dog and the latter is an unusual finding in a non-diabetic dog.

Amoxicillin-Potassium Clavulanate Combination↗
PubMedDate not supplied

The effect of experimental cystitis and iatrogenic blood contamination on the urine protein/creatine ratio in the dog.

The effect of experimentally induced cystitis and iatrogenic blood contamination on the urine protein/creatinine ratio (U P/C) was evaluated in 17 dogs. Before they were included in the study, all dogs were judged to be healthy on the basis of physical examination, serum concentrations of urea nitrogen and creatinine, complete urinalysis, and a U P/C less than 0.4. A single urine sample was contaminated with increasing quantities of canine fresh whole blood (PCV = 42%; total protein = 6.2 g/dl). When added blood was equal to or greater than 25% of the total urine sample volume, the U P/C exceeded 3.5, a finding consistent with nephrotic range proteinuria. When added blood was 10% of the total urine sample volume, the U P/C was less than 1.8. Eleven Beagles underwent routine laparotomy during which a cystotomy was done. The median U P/Cs on postoperative days 1 and 2 were significantly increased compared with preoperative values (P less than 0.05); no U P/C exceeded 2.0. Renal biopsies performed on postoperative day 3 eliminated renal proteinuria as a source of urine protein. Five dogs had bacterial cystitis experimentally induced. At 72 and 96 hours after bacterial inoculation, the median U P/Cs were significantly increased (P less than 0.05); individual values ranged from 1.5 to 40.8. Renal biopsies performed between 5 and 6 days after inoculation eliminated renal proteinuria as a source of urine protein. Cytologic evaluation of urine sediment in each group did not correlate with the magnitude of the increase in the U P/C. The U P/C significantly increased in each model of lower urinary tract inflammation.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMedDate not supplied

Polypoid cystitis in 17 dogs (1978-2001).

Polypoid cystitis is a rare disease of the urinary bladder in dogs characterized by inflammation, epithelial proliferation, and development of a polypoid mass or masses without histopathologic evidence of neoplasia. Medical records of 17 dogs with polypoid cystitis were reviewed to determine the clinical and laboratory features of this disorder and to assess treatment and outcome. Most affected dogs (15/17) were female and presented for evaluation of hematuria or recurrent urinary tract infection (UTI). Proteus spp were the most common bacterial isolates (12/52 or 23.1%) identified when all urine samples obtained for culture at any time during the course study were considered. Other commonly isolated organisms included Escherichia coli , Staphylococcus spp, and Enterococcus spp. Several dogs (7/17) also had cystic calculi at some time during the course of their disease. Most of the masses (11/14) were located cranioventrally in the bladder as opposed to transitional cell carcinoma, which has a predilection for the bladder neck or trigone area. It is unknown whether persistent or recurrent UTI predisposes to polyp formation or if polyps predispose to UTI. Surgery and removal of all polyps was the most efficacious treatment in dogs of this study. The question of whether or not polyps represent preneoplastic lesions remains unanswered and constitutes an area for future investigation.

Animals↗
PubMed1992

[Dose finding study of sparfloxacin in single-dose therapy for female acute uncomplicated cystitis].

Sparfloxacin (SPFX) is a new quinolone compound with a long half-life of 16 hours and a potent antibacterial activity (MIC90: < or = 0.025 micrograms/ml against Escherichia coli), suggesting that the agent can be effectively used in single-dose therapy for acute uncomplicated cystitis in female patients. To find the optimum dose, the present dose-finding study was conducted. A dose of either 100 mg or 200 mg of SPFX was selected by the double-blind method, and was administered only once (single dose therapy). The clinical efficacy was judged on day 3, 7 and 14 after administration. On day 3, of the 49 pts. in the 100 mg-group, the efficacy rate was 95.9% (excellent rate: 79.6%), and of the 42 pts. in the 200 mg-group, it was 100% (excellent rate: 88.1%). On day 7, of 38 pts. in the 100 mg-group, it was 94.7% (excellent rate: 78.9%), and of 28 pts. in the 200 mg-group, it was 100% (excellent rate: 92.9%). On day 14, of 27 pts. in the 100 mg-group, it was 92.6% (excellent rate: 66.7%), and of 26 in the 200 mg-group, it was 96.2% (excellent rate: 84.6%). Recurrence was observed in 4.8% (1/21) in the 200 mg-group. Therefore, there was no significant difference in the efficacy rate between the two groups, but the rate of excellent responses was higher in the 200 mg-group. Otherwise, the efficacy was estimated to be insufficient in 3 pts. and recurrent in 1 pt. they were examined the findings of detailed urological intractableness. Among 2 pts. in whom the external genitalia and urethra were closely examined, a urethral caruncle was noted in 1 pt. The results of our study indicate that 200 mg of SPFX is recommended as a single dose therapy for acute uncomplicated cystitis in females.

Acute Disease↗
PubMed2000

[Emphysematous cystitis and neuropathy; a report of the case with diabetes mellitus].

A study was made of a 55 years old male, who suffered from emphysematous cystitis with diabetes mellitus. He had multiple complications due to diabetic neuropathy such as foot ulceration, oculomotor nerve palsy, peroneal nerve palsy and a neurogenic bladder. Klebsiella pneumoniae and Pseudomonous aeruginosa were cultured from urine specimens. There have been only 19 reported cases of emphysematous cystitis since 1962. Fourteen of these cases had diabetes mellitus.

Cystitis↗
PubMed1977

Methicillin hemorrhagic cystitis.

Interstitial nephritis is a recognized complication of methicillin therapy. Hemorrhagic cystitis due to methicillin has not been emphasized. Evidence of hemorrhagic cystitis developed in six patients receiving methicillin therapy and was confirmed by cystoscopy in three of them.

Adult↗