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At least 1,081 records · Page 60Linked to original sources
PubMed1995

Absence of neuropathic pelvic pain and favorable psychological profile in the surgical selection of patients with disabling interstitial cystitis.

PURPOSE: We evaluated the results among patients with disabling interstitial cystitis treated by cystectomy, urethrectomy and creation of a continent colonic urinary reservoir (the Florida pouch). The value of psychological evaluation and pain localization techniques, as well as the use of a team approach in the evaluation of these patients were assessed. MATERIALS AND METHODS: The 20 women and 2 men who underwent surgery for disabling interstitial cystitis ranged from 31 to 75 years old (mean age 48). The duration of symptoms ranged from 2 to 14 years (mean 7). All patients had undergone multiple prior therapies, including vesical hydrodistension, instillations, laser treatments, and use of tranquilizers and a variety of pain medications. Patients underwent a clinical, cystoscopic (with bladder biopsies) and urodynamic evaluation as well as examination by a gynecologist with expertise in vaginal ultrasonography. The last 5 patients underwent psychological evaluation and pain localization techniques. RESULTS: Among the clinical parameters, the presence of a small capacity bladder with the patient under anesthesia (less than 400 cc) was associated with the best surgical results. Among 11 patients evaluated only clinically success was achieved in 64%, while all 5 (100%) who also underwent pain localization techniques and psychological evaluation had a successful outcome postoperatively. The overall surgical success rate in the 22 patients was 73%. Two patients undergoing psychological evaluation and pain localization techniques were not considered to be surgical candidates. Among 7 surgical failures 4 patients underwent postoperative psychological evaluation and pain localization techniques, and they would not have been considered candidates for surgery with the new parameters. CONCLUSIONS: A team approach is essential in the evaluation of these patients. Following the initial selection of patients who had a small bladder capacity while under anesthesia, psychological evaluation and pain localizing techniques may assist surgeons in selecting those who would benefit from a radical operation.

Adult↗
PubMed1995

[Prostaglandin E1 bladder instillations for late-onset hemorrhagic cystitis following allogeneic bone marrow transplantation].

Between July, 1990 and March, 1994, 31 patients with hematological malignancies or severe aplastic anemia underwent allogeneic bone marrow transplantation (BMT) at the Second Department of Internal medicine, Chiba University Hospital. Among the 29 evaluable patients who survived over 100 days after transplant, 11 patients (37.9%) developed late-onset hemorrhagic cystitis with a median time of onset of 57 days (range 11-205) from BMT. Adenovirus type 11 was isolated from the urine of 4 patients. Five patients recovered with fluid hydration and forced diuresis, while 6 patients had persistent gross hematuria with clot formation, 5 of whom also developed hydronephrosis. Seven-day courses of 500 micrograms prostaglandin E1 (PGE1) bladder instillations was initiated to control hematuria in these 6 patients. Complete resolution of gross hematuria was achieved in 4, and partial response with decreased clot formation and partial clearing of the urine was observed after 4 of 9 courses of the treatment. Although all patients experienced bladder spasm or lower abdominal pain during the PGE1 instillations, these symptoms were manageable with sedative drugs and morphine. No systemic side effect was apparent. PGE1 bladder instillations is a safe and useful treatment for severe, life-threatening late-onset hemorrhagic cystitis after allogeneic BMT.

Administration, Intravesical↗
PubMed1995

Suprapubic cystotomy as treatment for severe hemorrhagic cystitis after bone marrow transplantation.

We analyzed the success of suprapubic cystotomy in patients with severe hemorrhagic cystitis after bone marrow transplantation. Seventy-three out of 963 patients developed severe hemorrhagic cystitis which resulted in urinary tract obstruction after high-dose cytoreductive therapy. Eleven patients (15%) failed medical treatment and required emergency suprapubic cystotomy. Three of these patients died of other complications prior to resolution of HC. Of the remaining 8 patients who underwent surgery, 4 are alive. The mortality rate was significantly higher in patients who required surgery than in those who responded to medical therapy. Patients whose HC required surgery also had a greater transfusion requirement than those who responded to medical therapy. We conclude that surgical treatment of severe HC should be undertaken only after failure of medical therapy.

Adolescent↗
PubMed1993

[Eosinophilic cystitis].

Nine cases were diagnosed to be eosinophilic cystitis on the basis of histological criteria and clinical observations were made on these cases. In all cases, a past history of allergic or collagen diseases were revealed. Eosinophils in urine were present in 8 out of 9 cases and allergic tests were then performed. Histamine release from biopsied bladder tissue, incubated with anti-IgE, were first examined and a higher level than control was found. Next, intravesical provocation test (IgE RAST positive allergen was introduced into vesical cavity) revealed the appearance of bladder irritabilities within 30 minutes and release of urinary histamine within 3 hours. In 3 cases, provocation tests by eating food were performed and 2 out of 3 cases showed a positive reaction. These results show that allergy may be related to the development of eosinophilic cystitis in part.

Adolescent↗
PubMed1994

[Evaluation of clinical efficacy and safety of cefpodoxime proxetil (CPDX-PR) in acute uncomplicated cystitis].

One hundred and fifty female patients with acute uncomplicated cystitis were given 200 mg of CPDX-PR twice daily for 3-7 days to evaluate both its overall clinical efficacy and its adverse effects. In 82 cases (Group I) in which it was administered for 3 days, the overall clinical efficacy, evaluated by the criteria proposed by the Japanese UTI committee, was excellent in 64 cases, moderate in 17 and poor in one, with the effective rate being 98.8%. In 35 cases (Group II) in which it was administered for 4-7 days, the overall clinical efficacy was excellent in 18 cases, moderate in 15 and poor in 2, with the effective rate being 94.3%. The overall clinical evaluation was not performed in another 33 cases because they were given CPDX-PR for more than 8 days or 300 mg/day. Subjective adverse effects such as hoarseness and lingual inflammation were observed in only one of the 150 cases, but they disappeared spontaneously after the cessation of administration of CPDX-PR. These findings suggest that CPDX-PR is one of the most effective and safe antibiotic in the treatment of acute uncomplicated cystitis.

Acute Disease↗
PubMed1994

Lupus cystitis. report of a case.

A 42-year-old female with a history of systemic lupus erythematosus (SLE) visited the Department of Internal Medicine at our hospital complaining of anorexia. Hydronephrosis was diagnosed, and she was referred to our department for further evaluation. Intravenous pyelography (IVP) revealed bilateral hydronephrosis and hydroureters. Computerized tomography (CT) showed retention of ascitic fluid and thickening of the intestinal and bladder walls with contrast effects in the serosa and mucosa. Lasix-loaded renography showed that both kidneys were normal. Examination of a biopsy specimen revealed interstitial edema, fibrosis, and infiltration of inflammatory cells. Cystometry showed normal intravesical pressure. A diagnosis of lupus cystitis was made and administration of 40mg of prednisolone was started. The anemia was ameliorated, and thickening of the bladder and intestinal walls was no longer seen on CT. Hydronephrosis of the left kidney was less prominent. However, aggravation of the right ureteral stenosis was noted, and a stent was inserted in the stenosed ureter. Stenosis was successfully relieved by the stent, and internal drainage was established. The patient is still receiving steroids and is being followed at our department. Twenty-two reported cases of lupus cystitis in Japan are reviewed.

Adult↗
PubMed1994

[Emphysematous cystitis].

The presence of gas in the bladder wall and/or lumen (emphysematous cystitis) is an uncommon disease entity that may be caused by infectious organisms. Diabetes and chronic urinary infection are predisposing factors. Its clinical features are unspecific and the prognosis depends on the degree of aggressiveness at presentation. Early diagnosis and treatment (bladder drainage + antibiotics) are very important in order to resolve the condition before severe sequelae are caused. We report on 75-year-old diabetic female with mild emphysematous cystitis caused by Clostridium perfringens which resolved with bladder drainage and antibiotics. The incidence, forms of presentation, pathogenesis, diagnosis and treatment of this condition are discussed.

Aged↗
PubMed1994

[Eosinophilic cystitis. Study of the clinical course in 6 new cases and review of the recent literature].

Presentation of a series of 6 cases of eosinophilic cystitis diagnosed in our hospital and recorded in 1988-1993, with an average follow-up of 2 years from time of diagnosis. The actual trend with regard to this particular form of chronic cystitis is to abandon the idea of considering it a "benign" disease, basically due to its increasingly less uncommon association to bladder and/or prostate tumoral pathology (in the recent literature and most particular in the present series). Also, a relative increase in the frequency of occurrence of this disease is noted, because of chemoprophylaxis of surface bladder tumour with Mitomycin-C, an association which is increasingly frequent. Based on these 6 cases, a review of the most recent literature on this topic is made.

Aged↗
PubMedDate not supplied

[Frequency of adherent colibacillus in a population with acute pyelonephritis and a population with acute cystitis].

Urothelial adhesion of Escherichia coli is one of the principal factors of colonisation and infection of the upper urinary tract. We compared 3 measurements of bacterial adhesion: 1) Mannose-Resistant Haemagglutination (MRHA), é) Adhesion to urothelial cells, 3) Latex particle agglutination, to test 85 strains of Escherichia coli in 42 cases of acute pyelonephritis and 43 cases of acute cystitis. These tests were positive in 73.8% to 85.7% of the acute pyelonephritis population and in 4% to 2.3% of the acute cystitis population (statistically significant difference). This study confirms the major role of strains carrying type PAP adhesion in the pathogenesis of acute pyelonephritis.

Acute Disease↗
PubMed1975

Attempted reversal of oxytetracycline resistance of Proteus mirabilis by EDTA-tromethamine lavage in experimentally induced canine and feline cystitis.

An attempt was made to reverse the antibiotic resistance of Proteus mirabilis used to induce experimental cystitis in cats and dogs. Results of in vitro studies on an oxytetracycline-resistant strain of P mirabilis, utilizing standard plate counts, indicated the organism became susceptible to oxytetracycline when it was treated with a solution of EDTA-tromethamine. In vivo experiments were conducted with cats and dogs in which 50% of the experimentally infected animals were treated with bladder lavage twice daily with EDTA-tromethamine solution and 50% with tromethamine buffer alone; all were given standard doses of oxytetracycline. Results of bacteriologic cultural examinations of urinary samples and urinalyses done each day, at the end of the experiments, indicated all animals had cystitis. Thus, although the organism's resistance to oxytetracycline was changed by EDTA-tromethamine in vitro, change in bacterial resistance did not occur in vivo in cats and dogs during clinical treatment.

Animals↗
PubMedDate not supplied

[Recurrent cystitis in children: do predisposing factors exist for its onset?].

It is known that a great number of subjects, mainly little girls, frequently go to pediatric's observation for recurrent episodes of pollakiuria, dysuria or burning miction. They often complain enuresis, sometimes tenesmus so intense that they arrive at the incontinence (urge incontinence). Many of these cases, quickly defined as cystitis, really revealed that they weren't. Repetitively negative bacteriologic examinations allow us to classify them as "sham syndromes", as Stephens called them. According to what we said above, we wondered whether any recurrent cystitis are not favoured by missed observation of definite rules.

Anti-Bacterial Agents↗
PubMed1994

Interstitial cystitis. A patient's perspective.

Interstitial cystitis is a debilitating bladder disorder that affects up to 450,000 people in the United States, 90% of whom are women. Confusion in defining and understanding interstitial cystitis has resulted in the failure to diagnose and treat thousands of afflicted patients, committing them to a life of intractable pain. Even with diagnosis, there are no uniformly effective treatments. It is extremely important that these patients have the understanding and support of the medical community, and they should develop a constructive and effective relationship with their physician and other urologic caregivers.

Cystitis↗
PubMed1994

Calcium channel antagonists in the treatment of interstitial cystitis.

The calcium channel antagonist nifedipine has shown efficacy in the treatment of interstitial cystitis and the urethral syndrome. The optimal daily dose of nifedipine can be determined with the use of a nifedipine titration test. To complete the repair of damaged bladder and/or urethral mucosa, nifedipine therapy should be used for a minimum of 3 months. Patients who do not respond well to nifedipine are those with the pelvic floor muscle spasm syndrome variant of interstitial cystitis.

Cystitis↗
PubMed1994

Self-care regimens for patients with interstitial cystitis.

For those who suffer from interstitial cystitis, living with the condition is a challenge that requires creativity, patience, determination, and a sound set of coping mechanisms. Because of the high percentage of gynecologic and systemic manifestations of interstitial cystitis, a customized treatment regimen is often necessary to achieve the therapeutic goal of a remission in symptoms. Treatment philosophies should be based on the proposed causative mechanisms, and a multimodality approach to therapy is usually successful. Self-care regimens give the patient a sense of control by active participation in treatment, which often improves coping mechanisms. Treatment of the sequelae of chronic pain (anxiety and depression) often improves response to overall therapy. Remission is the goal, coping is the key, and creativity opens the door to treating this most perplexing of conditions.

Cystitis↗
PubMed1994

Surgical management of interstitial cystitis.

For most urologists the decision to operate on a patient with interstitial cystitis is made with extreme caution. The knowledge that this is a nonmalignant disease, that it poses little risk to overall health (although most patients would differ with this assertion), and that surgical intervention may be accompanied by additional complications has relegated open surgical procedures to last on the list of treatments for interstitial cystitis. This reluctance to operate until late in the course of the disease is clearly unsatisfactory. If a successful surgical procedure can performed, it ought to be employed early in the course of the patient's management and not withheld after the unfortunate patient has been subjected to a host of unsatisfactory conservative treatments. There is a need for balance between timidity and surgical aggression in the management of this dreadful condition. There is a need to identify the appropriate patients for surgical treatment and to select the most successful procedure. We should not expect to have to move through a series of different procedures for each patient, but rather select the right one the first time. There is an obvious need for a better understanding of the precise cause and pathogenesis of the condition so that alternative forms of treatment may be investigated. Surgery can provide significant relief for many patients with incapacitating symptoms. Cystectomy, either supratrigonal or total, is best reserved for those patients with markedly reduced bladder capacities.

Cystectomy↗
PubMed1994

Interstitial cystitis. Current and future approaches to diagnosis and treatment.

Both the patient and physician must understand that there is no single cure for interstitial cystitis, nor is there a single treatment that is effective in reducing symptoms for every patient. Most patients, however, can benefit from one treatment or another, or from a combination of treatments. The author's general philosophy about the treatment of interstitial cystitis is described, and other theoretical modalities of treatment are discussed.

Clinical Trials as Topic↗