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PubMed2002

Similarities between interstitial cystitis and male chronic pelvic pain syndrome.

Few clinical conditions encountered by the urologist cause more patient and clinician frustration than interstitial cystitis and male chronic pelvic pain syndrome, also know as nonbacterial prostatitis. This frustration is fueled by the chronicity of often disabling urogenital (and often associated systemic) symptoms coupled with delayed care, misdiagnosis, and suboptimal clinical responses. Basic research and therapeutic trials for these syndromes have historically taken two separate paths. However, mounting evidence suggests that significant overlap may exist between them in epidemiology, pathophysiology, and even therapy. This discussion reviews some of the common features of these clinical problems and makes a case that they might in fact represent different manifestations of the same disease process.

Autoimmunity↗
PubMed2003

Interstitial cystitis: modern tools for an accurate diagnosis.

Interstitial cystitis (IC) is a disease defined by a constellation of signs and symptoms; its etiology is not well understood. There are multiple theories regarding the cause of IC; however, no one cause has been proven conclusively. In the meantime, physicians are trying to accurately diagnose a disease that has no identified definitive cause. There have been multiple tests designed to aid in the diagnosis of IC and there are new tests on the horizon that appear promising. However, the diagnosis of IC still is one of exclusion and based primarily on clinical findings. The most useful tests are described in this article, which may make diagnosis a more accurate, less arduous process.

Adult↗
PubMed2006

Urinary and Serologic Markers forInterstitial Cystitis: An Update.

This update reviews the published literature from the past 2 years pertaining to urinary and serum markers for interstitial cystitis (IC). Literature on markers described before 2004 also is included when needed to provide background information for the current literature. The markers that have been the focus of the most research in the recent literature are antiproliferative factor, epidermal growth factor, heparin-binding epidermal growth factor-like growth factor, glycosaminoglycans, and bladder nitric oxide. These markers are discussed in consideration of their three different possible roles: 1) as diagnostic markers of IC; 2) distinguishing relevant subsets of IC patients; and 3) measuring disease activity and objectively following treatment response.

Biomarkers↗
PubMed2006

Dysfunction of bladder urothelium and bladder urothelial cells in interstitial cystitis.

The human bladder urothelium (BU) and bladder urothelial cells (BUCs) play an important role in the normal functioning of bladder including bladder storage. Current evidence in interstitial cystitis (IC) supports multiple abnormalities in bladder urothelial physiology. These data have come primarily from human studies. The discovery of a novel protein termed the antiproliferative factor (APF) uniquely expressed by IC BUCs is extremely important. APF induces increased permeability of normal BUCs grown in culture. Furthermore, APF regulates expression of other cytokines, including upregulating heparin-binding epidermal growth factor-like growth factor and downregulating epidermal growth factor by BUCs. These cytokine abnormalities were also related to increases in purinergic (adenosine triphosphate) signaling, which could mediate increased bladder sensation. Recent studies of uroplakins, which are specialized proteins expressed only in the apical urothelial cells, suggest that uroplakins play a role in the barrier function of the BU. It is also conceivable that alterations in uroplakins may result in bladder symptoms related to increased permeability or decreased protective function. As the body of knowledge about BU and BUC function increases, novel therapies targeting urothelial cells should become clinically feasible.

Cell Communication↗
PubMed1992

Eosinophilic cystitis during pregnancy.

The first report of a case of eosinophilic cystitis during pregnancy is presented. Premature cervical dilatation was associated with onset of the disease at 19 weeks' gestation.

Adult↗
PubMed1984

Immunoglobulin deposits in bladder epithelium and vessels in interstitial cystitis: possible relationship to circulating anti-intermediate filament autoantibodies.

Sera from patients suffering from interstitial cystitis (IC) reacted with bright staining of the bladder epithelium and vascular endothelium when tested for autoantibodies by indirect immunofluorescence using normal bladder tissue as target antigen. When tested for autoantibodies using cultured cells as antigen the antibodies were found to be directed against cytoskeletal intermediate filaments (IMF). Sera from 43 IC patients had a high incidence and high titers of anti-IMF autoantibodies as compared to both healthy individuals and patients suffering from other urological or surgical diseases. The results suggest that anti-IMF autoantibodies may be involved in the perpetuating chronic type of tissue injury seen in these patients. The antibodies were of the IgM class. In vivo deposits of IgM in patient bladder biopsies localized similarly to the autoantibodies; epithelial tissue showed deposits in 19% and vascular tissue, deposits in more than 50% of the patients, often together with complement components Clq,C3, or C4. In addition, subendothelial deposits associated with fibrillar structures could be observed. The results suggest a possible relationship between the in vivo IgM deposits in the bladder epithelium and vascular endothelium, on one hand, and the presence of anti-IMF antibodies capable of reacting with these cell structures, on the other hand. However, as the autoantibodies have to gain access to intracellular structures in order to cause in vivo deposits, primary tissue injury has to be postulated.

Adult↗
PubMed1987

In vivo binding of immunoglobulin and complement to elastic structures in urinary bladder vascular walls in interstitial cystitis: demonstration by immunoelectron microscopy.

An ultrastructural immunoperoxidase staining technique was used to identify and localize immune deposits in the urinary bladder vessel walls of patients with interstitial cystitis. Deposition of immunoglobulin together with the C3 component of complement was found in the subendothelial space and in endothelial basement membranes. More peripherally, deposits were often found associated with elastic fibers between smooth muscle cells. In these fibers the staining was confined to the microfibrillar coat. The findings suggest that elastic microfibrils act as target sites for the immunologic reaction occurring in vivo. Following binding of autoantibodies to antigens in bladder mucosa, activation of complement could be involved in the production of tissue injury and in the chronic self-perpetuating inflammation typical of this disease.

Basement Membrane↗
PubMed1975

Observations on interstitial cystitis.

Interstitial cystitis is more common in young women than previously believed. Findings typical of the disease are a history of diurnal and nocturnal pollakiuria, pelvic discomfort increases with bladder distention, marked bladder tenderness on gentle palpation of the anterior later vaginal fornices, less than normal bladder capacity, and a negative urinalysis except for many epithelial cells.

Cystitis↗
PubMed1976

Ureteritis cystica after treatment of cyclophosphamide-induced hemorrhagic cystitis.

A case is presented in which ureteritis cystica developed following formalin instillation for treatment of cyclophosphamide-induced hemorrhagic cystitis. It is not known whether this complication, not previously reported, is a result of the cyclophosphamide, the formalin, or a combination of both. Patients being considered for formalin instillation should be studied by cystography for evaluation of vesicoureteral reflux. Alternative methods to formalin instillation should be considered in patients with reflux.

Child↗
PubMed1977

Intestinocystoplasty in treatment of interstitial cystitis.

Nine cases of interstitial cystitis treated by intestinocystoplasty are reviewed. The longest follow-up is seventy-eight months. Two patients have since died of unrelated causes. The results reveal seven symptomatic cures and two failures. Long-term renal and vesical function have been well maintained.

Adult↗
PubMed1978

Fatal complication of intravesical formalin during control of intractable hemorrhage from radiation cystitis.

Fatal acute tubular necrosis occurred in 1 patient in whom intravesical formalin was used to control massive persistent hemorrhage from radiation cystitis. A suggestion is made to monitor blood formic acid levels and institute prompt dialysis whenever these exceed 80 mg. per 100 ml. to avert such a catastrophe. Intravenous sodium bicarbonate appears to be indicated prophylactically in combating the associated metabolic acidosis due to absorbed formic acid.

Acute Kidney Injury↗
PubMed1978

Ether cystitis.

Two children are reported in whom chemical cystitis developed when ether was used to dissolve a Foley catheter balloon that would not deflate. The irritative effects of ether and preventive measures are discussed.

Child↗
PubMed1978

Emphysematous cystitis presenting with subcutaneous emphysema.

A case is reported of subcutaneous emphysema of the neck in association with emphysematous cystitis and uncontrolled diabetes. Problems in its management are discussed. Anatomic pathway for the spread of the gas from the bladder to the subcutaneous tissues of the neck and the back is speculated.

Aged↗
PubMed1979

Complication of Clorpactin WCS90 therapy for interstitial cystitis.

A case of ureteral fibrosis complicating Clorpactin WCS90 treatment for interstitial cystitis in a patient with vesicoureteral reflux is presented. The results of a laboratory experiment designed to study the effects of Clorpactin WCS90 on refluxing ureters are discussed.

Animals↗
PubMed1979

Simple innocuous treatment of massive cyclophosphamide hemorrhagic cystitis.

A rare complication of cyclophosphamide therapy is severe, protracted, and often life-threatening hemorrhagic cystitis. Many reports on the management of this problem have advocated invasive and in themselves dangerous methods. It is proposed that this condition can be managed by suprapubic cystotomy with the fulguration of obvious bleeding points and the placement of two suprapubic tubes. High-flow continuous bladder irrigation can then be instituted using cooled saline. In addition, the patient should be sedated and constipation avoided.

Cyclophosphamide↗
PubMed1981

Prevention of ifosfamide-induced hemorrhagic cystitis by continuous bladder irrigation.

To prevent hemorrhagic cystitis induced by ifosfamide, continuous bladder irrigation with 3,000 ml. of saline per day was performed in 8 patients. Ifosfamide was given by an intravenous infusion one to two hours at a dose of either 1,600 to 1,950 mg./m2 daily for three days, or 1,430 to 1,480 mg./m2 daily for five days. Gross hematuria was induced in none and microscopic hematuria in one during 24 courses of treatment. There was no complication associated with catheter placement, other than urethral discomfort in 1 patient. Thus this appears to be a useful and effective method.

Adult↗
PubMed1984

Successful treatment of lupus erythematosus cystitis with DMSO.

Systemic lupus erythematosus patients sometimes present with pathologically confirmed lupus interstitial cystitis. Treatment with prednisone has not been observed to be successful. Two patients are presented who were successfully treated with intravesical dimethyl sulfoxide (DMSO).

Adult↗