Clinical and histological findings in bladder pain syndrome/interstitial cystitis: The implication of time of symptoms

2018 ◽  
Vol 11 (4) ◽  
pp. 248-253
Author(s):  
Daniele Porru ◽  
Valentina Bobbi ◽  
Carmelo Di Franco ◽  
Alessandra Viglio ◽  
Mattia Novario ◽  
...  
Keyword(s):  
Interstitial Cystitis ◽  
Symptom Onset ◽  
Bladder Wall ◽  
Pain Syndrome ◽  
Bladder Pain Syndrome ◽  
Detrusor Muscle ◽  
Level Of Evidence ◽  
Bladder Pain ◽  
Bladder Biopsy ◽  
The Impact

Objective: To find out whether a correlation exists between denudation of urothelium and time of symptom onset in patients with bladder pain syndrome/interstitial cystitis (BPS/IC), and to search for a correlation between the impact of symptoms. Patients and methods: Fifty-seven consecutive patients underwent cystoscopy under anaesthesia to classify those cases suspected of being affected with BPS/IC. The time elapsed between onset of symptoms and diagnosis at the time of bladder biopsy was also defined as BPS/IC duration. Bladder biopsies were taken including detrusor muscle, three deep cold biopsies of posterior, anterior and lateral bladder wall. Results: Statistical analysis showed significant correlation between BPS/IC duration and the presence of Hunner’s lesions ( P<0.023). Hunner’s lesion with cystoscopy and histological evidence of urothelial denudation with bladder biopsy appear to be related to BPS/IC duration. Thus an early diagnosis allows an appropriate therapeutic approach to be started to prevent a more severe evolution of this multifaceted painful syndrome. Conclusions: Our study shows a correlation between the time of symptom onset and evidence of urothelial denudation and with detrusor mast cell count in the whole group of patients. BPS/IC duration did not seem to correlate with the severity of symptoms, but rather with the presence of associated diseases. Level of evidence: Not applicable for this multicentre audit.

scholarly journals Time of symptom onset and histologic findings in bladder pain syndrome/interstitial cystitis: new findings on useful correlations

2017 ◽  
Vol 30 (1) ◽  
Author(s):  
Daniele Porru ◽  
Valentina Bobbi ◽  
Carmelo Di Franco ◽  
Alessandra Viglio ◽  
Mattia Novario ◽  
...  
Keyword(s):  
Interstitial Cystitis ◽  
Symptom Onset ◽  
Pain Syndrome ◽  
Bladder Pain Syndrome ◽  
Detrusor Muscle ◽  
Comorbid Conditions ◽  
Bladder Pain ◽  
New Findings ◽  
Painful Syndrome ◽  
Mast Cell Count

The aim was to find out whether a correlation exists between denudation of urothelium and time of symptom onset in patients with bladder pain syndrome/interstitial cystitis (BPS/IC), and to search a correlation between impact of symptoms evaluated with ICSI-ICPI and the presence of comorbid conditions associated with BPS/IC. Ninety-seven consecutive patients underwent cystoscopy under general anesthesia to classify those cases suspected of being affected from BPS/IC. Three cold bladder biopsies were taken including detrusor muscle. Statistical analysis showed significant correlation between IC/BPS duration and the presence of Hunner’s lesions (P<0.023). Hunner’s lesion with cystoscopy and histological evidence of urothelial denudation with bladder biopsy appear to be items related to IC/BPS duration. Thus an early diagnosis allows to start an appropriate therapeutic approach and prevent a more severe evolution of this multifaceted painful syndrome. Our study shows a correlation between time of symptom onset and evidence of urothelial denudation and with detrusor mast cell count in the whole group of patients. IC/BPS duration seem to correlate with the presence of associated diseases.

scholarly journals Does cystoscopy method affect the investigation of bladder pain syndrome/interstitial cystitis?

2020 ◽  
Author(s):  
Visha K. Tailor ◽  
Ellen Morris ◽  
Alka A. Bhide ◽  
Ruwan Fernando ◽  
Guiseppe A. Digesu ◽  
...  
Keyword(s):  
Mast Cell ◽  
Cell Count ◽  
Interstitial Cystitis ◽  
Muscularis Propria ◽  
Pain Syndrome ◽  
Bladder Pain Syndrome ◽  
Detrusor Muscle ◽  
Bladder Pain ◽  
Significant Difference ◽  
Mast Cell Count

Abstract Introduction and hypothesis Cystoscopic investigation to identify associated histological findings of increased mast cells in the detrusor muscle has been recommended by the European Society for the Study of Bladder Pain Syndrome (ESSIC) in the investigation of bladder pain syndrome/interstitial cystitis (BPS/IC). The aim of this study was to identify if the cystoscopy approach impacts the biopsy results when investigating women presenting with symptoms of BPS/IC. Methods We performed a single-centre retrospective analysis of 300 bladder biopsy reports from 2015 to 2018 from women undergoing cystoscopy for BPS/IC. Biopsies obtained using closed cup forceps through a flexible (FC) or rigid cystoscope (RC) were compared. Results Fifty-eight FC biopsies were compared with 242 RC biopsies. FC biopsies had a smaller mean diameter (1.6 mm vs 2.9 mm p < 0.01) and volume (4.1 mm3 vs 9.6 mm3p < 0.001) compared with RC biopsies. There was no significant difference in the histological depth of sampling to the muscularis propria. A total of 292 samples had CD117 immunohistochemical staining for mast cell count (MCC) analysis. The MCC/mm2 was significantly lower in FC biopsies (p < 0.01). Sixteen percent of FC samples compared with 60% of RC samples had a high MCC >28/mm2 (p < 0.01). There was no significant difference in positive microbiology culture between FC (21%) and RC (28%) sampling. Conclusion Rigid and flexible cystoscopy can be used to investigate BPS/IC as recommended by international societies. However, the biopsy method impacts the mast cell count analysis, which can influence diagnosis and management. Therefore, RC would be the optimal investigation.

scholarly journals Dysregulation of bladder corticotropin-releasing hormone receptor in the pathogenesis of human interstitial cystitis/bladder pain syndrome

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Jia-Fong Jhang ◽  
Lori A. Birder ◽  
Yuan-Hong Jiang ◽  
Yung-Hsiang Hsu ◽  
Han-Chen Ho ◽  
...  
Keyword(s):  
Interstitial Cystitis ◽  
Hormone Receptor ◽  
Bladder Wall ◽  
Pain Syndrome ◽  
Bladder Pain Syndrome ◽  
Corticotropin Releasing Hormone ◽  
Bladder Pain ◽  
Releasing Hormone ◽  
Control Subjects ◽  
And Control

AbstractStress is associated with exacerbated symptoms in patients with interstitial cystitis/bladder pain syndrome (IC/BPS). To investigate the mechanism of stress implicated on IC/BPS, we investigated expression of stress-response receptor corticotropin-releasing hormone receptor (CRHR) in bladder from IC/BPS patients. Twenty-three IC/BPS patients with Hunner’s lesion (HIC), 51 IC/BPS patients without Hunner’s lesion (NHIC), and 24 patients with stress urinary incontinence as controls were enrolled. Cystoscopic biopsies of bladder wall including mucosa and submucosa were obtained from all patients. Western blotting was used to investigate the bladder expression of the CRHR1 and CRHR2. Immunochemical staining revealed CRHR1 expression was mainly located in the submucosa while CRHR2 expression was mainly in uroepithelial cells. Compared to control subjects, the CRHR1 expression was significantly higher, while CRHR2 expression was significantly lower in IC/BPS patients. Further analysis of patients with HIC, NHIC, and control subjects showed that bladder in patients with HIC had significantly higher expressions of CRHR1 and significantly lower CRHR2. CRHR2 expression was significantly negatively correlated with O’Leary-Sant score and bladder pain. Our results indicate dysregulation of bladder CRHR1 and CRHR2 in patients with IC/BPS, and suggest CRH signaling may be associated with IC/BPS symptoms.

scholarly journals Transcriptome analysis of bladder biopsy from interstitial cystitis/bladder pain syndrome patients

Genomics Data ◽  
2014 ◽  
Vol 2 ◽  
pp. 366-368 ◽  
Author(s):  
Stephen J. Walker ◽  
Marc Colaco ◽  
David S. Koslov ◽  
Tristan Keys ◽  
Robert J. Evans ◽  
...  
Keyword(s):  
Interstitial Cystitis ◽  
Transcriptome Analysis ◽  
Pain Syndrome ◽  
Bladder Pain Syndrome ◽  
Bladder Pain ◽  
Bladder Biopsy

scholarly journals Notch1 Signaling Contributes to Mechanical Allodynia Associated with Cyclophosphamide-Induced Cystitis by Promoting Microglia Activation and Neuroinflammation

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Jialiang Chen ◽  
Honglu Ding ◽  
Bolong Liu ◽  
Xiangfu Zhou ◽  
Xin Zhou ◽  
...  
Keyword(s):  
Interstitial Cystitis ◽  
Mechanical Allodynia ◽  
Pain Syndrome ◽  
Bladder Pain Syndrome ◽  
Microglia Activation ◽  
Bladder Pain ◽  
Withdrawal Threshold ◽  
Notch1 Signaling ◽  
Tnf Α ◽  
The Impact

Aims. Notch1 signaling regulates microglia activation, which promotes neuroinflammation. Neuroinflammation plays an essential role in various kinds of pain sensation, including bladder-related pain in bladder pain syndrome/interstitial cystitis (BPS/IC). However, the impact of Notch1 signaling on mechanical allodynia in cyclophosphamide- (CYP-) induced cystitis is unclear. This study is aimed at determining whether and how Notch1 signaling modulates mechanical allodynia of CYP-induced cystitis. Methods. CYP was peritoneally injected to establish a bladder pain syndrome/interstitial cystitis (BPS/IC) rat model. A γ-secretase inhibitor, DAPT, was intrathecally injected to modulate Notch1 signaling indirectly. Mechanical withdrawal threshold in the lower abdomen was measured with von Frey filaments using the up-down method. The expression of Notch1 signaling, Iba-1, OX-42, TNF-α, and IL-1β in the L6-S1 spinal dorsal horn (SDH) was measured with Western blotting analysis and immunofluorescence staining. Results. Notch1 and Notch intracellular domain (NICD) were both upregulated in the SDH of the cystitis group. Moreover, the expression of Notch1 and NICD was negatively correlated with the mechanical withdrawal threshold of the cystitis rats. Furthermore, treatment with DAPT attenuated mechanical allodynia in CYP-induced cystitis and inhibited microglia activation, leading to decreased production of TNF-α and IL-1β. Conclusion. Notch1 signaling contributes to mechanical allodynia associated with CYP-induced cystitis by promoting microglia activation and neuroinflammation. Our study showed that inhibition of Notch1 signaling might have therapeutic value for treating pain symptoms in BPS/IC.

scholarly journals Differential expression of histamine receptors in the bladder wall tissues of patients with bladder pain syndrome/interstitial cystitis – significance in the responsiveness to antihistamine treatment and disease symptoms

BMC Urology ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Hui Shan ◽  
Er-Wei Zhang ◽  
Peng Zhang ◽  
Xiao-Dong Zhang ◽  
Ning Zhang ◽  
...  
Keyword(s):  
Interstitial Cystitis ◽  
Western Blotting ◽  
Bladder Wall ◽  
Pain Syndrome ◽  
Bladder Pain Syndrome ◽  
Histamine Receptors ◽  
Receptor Expression ◽  
Bladder Pain ◽  
Disease Symptoms ◽  
Female Patients

Abstract Background Activation of mast cells plays an important role in the pathogenesis of bladder pain syndrome/interstitial cystitis (BPS/IC). Histamine, a mast cell-derived mediators, induced inflammation and hypersensitivity of the bladder. The present study investigated the expressions of histamine receptors in the bladder wall tissues of patients with BPS/IC, and its association with the effectiveness of antihistamine therapy and disease symptoms. Methods Bladder tissues were collected from 69 BPS/IC patients and 10 control female patients. The expression of H3R in BPS/IC was further examined in an independent cohort of 10 female patients with BPS/IC and another 10 age-matched female patients. Immunohistochemistry, Western blotting, and quantitative RT-PCR were performed to quantify the expressions of histamine receptors. Statistical analyses of the correlation of histamine receptor expression with antihistamine therapy outcome and severity of disease symptoms were also performed. Results The expression of four histamine receptors was significantly elevated in BPS/IC (H1R, P < 0.001; H2R, P = 0.031; H3R, P = 0.008; H4R, P = 0.048). Western blotting revealed that H3R were significantly reduced in the patients, whereas the mRNA levels of H3R were significantly increased. The patients were further divided into antihistamine responders (n = 38) and nonresponders (n = 22). No significant correlation was found in the expression of histamine receptors between responder and nonresponder groups. However, significant correlations between OLS and H1R (P = 0.003) and H3R (P = 0.045) were found. Conclusion The present study showed that expression of all the 4 histamine receptors were elevated in BPS/IC. There were no statistical significant correlations between the expression levels of the four different histamine receptors and the treatment outcome of antihistamine therapy (amtitriptyline or cimetidine).

scholarly journals A Novel Intravesical Dextrose Injection Improves Lower Urinary Tract Symptoms on Interstitial Cystitis/Bladder Pain Syndrome

2021 ◽  
Vol 12 ◽  
Author(s):  
Chin-Li Chen ◽  
Chien-Chang Kao ◽  
Ming-Hsin Yang ◽  
Gang-Yi Fan ◽  
Juin-Hong Cherng ◽  
...  
Keyword(s):  
Growth Factors ◽  
Interstitial Cystitis ◽  
Bladder Wall ◽  
Pain Syndrome ◽  
Bladder Pain Syndrome ◽  
Bladder Pain ◽  
Dextrose Solution ◽  
Cytokine Analysis ◽  
Limited Effectiveness ◽  
Significant Difference

Interstitial cystitis/bladder pain syndrome (IC/BPS) is a painful recurrent condition characterized by the discomfort of the bladder, and current treatment options have limited effectiveness. Prolotherapy is a well-known treatment that involves the injection of non-biologic solutions to reduce pain and/or promote proliferation of soft tissue, and dextrose is the most common injectate. This study investigated the effects of dextrose prolotherapy in a rat model of IC/BPS and patients with IC/BPS. We used cyclophosphamide to induce IC/BPS in rats, and intravesical instillation of 10% dextrose solution was performed. After 1 week, we conducted a urodynamic test, bladder staining, and ECM-related gene expression analysis to examine the treatment’s efficacy. We found that dextrose treatment could recover the instability of the bladder, reduce frequent urination, and improve the glycosaminoglycan layer regeneration and the bladder wall thickness along with a significant intense expression of CD44 receptors. Furthermore, we enrolled 29 IC/BPS patients with previous hyaluronic acid/Botox treatment for more than 6 months with remained unchanged condition. In this study, they received intravesical injections of 10% dextrose solution followed by assessments for up to 12 weeks. Patient characteristics and a 3-day voiding diary before treatment were recorded. Patient responses were examined using IC/BPS-related questionnaires. Moreover, expressions of growth factors and cytokines were analyzed. The results demonstrated that dextrose prolotherapy in patients with IC/BPS reduced the frequency of treatment over time, with the mean number of treatments being 3.03 ± 1.52, and significantly reduced the incidence of nocturia and questionnaire scores associated with symptoms. Dextrose prolotherapy significantly enhanced EGF level and, in contrast, reduced the level of HGF, PIGF-1, and VEGF-D after several weeks following treatment. The cytokine analysis showed that the expressions of IL-12p70 and IL-10 were significantly up-regulated after dextrose prolotherapy in IC/BPS patients. The levels of most growth factors and cytokines in IC/BPS patients had no significant difference and showed a similar tendency as time progressed when compared to healthy controls. Overall, the alteration of growth factors and cytokines exhibited safe treatment and potential stimulation of tissue remodeling. In summary, our study demonstrated that dextrose prolotherapy is a promising treatment strategy for IC/BPS disease management.

scholarly journals Biopsychosocial predictors of suicide risk in patients with interstitial cystitis/bladder pain syndrome

2021 ◽  
Vol 15 (12) ◽  
Author(s):  
Dean A. Tripp ◽  
Joel Dueck ◽  
Ronald R. Holden ◽  
Julia Moreau ◽  
R. Christopher Doiron ◽  
...  
Keyword(s):  
Interstitial Cystitis ◽  
Support Groups ◽  
Suicide Risk ◽  
Pain Syndrome ◽  
Bladder Pain Syndrome ◽  
Perceived Burdensomeness ◽  
Bladder Pain ◽  
Pain Symptoms ◽  
Risk Predictors ◽  
The Impact

Introduction: The impact of interstitial cystitis/bladder pain syndrome (IC/BPS) is prevalent and severe. Studies examining the IC/BPS prevalence and predictors of suicide risk are limited by their lack of theoretically relevant suicide research variables. This research reports suicide risk prevalence its biopsychosocial predictors for a community IC/BPS sample. Methods: Self-identified female patients suffering from IC/BPS (N=813; 18–80 years, M= 46.60, standard deviation [SD] 14.10) recruited from online IC/BPS support groups completed measures of demographic, pain, symptoms, and psychosocial variables. Descriptive statistics, correlations, and multivariable logistic regressions examined prevalence, variable associations, and suicide risk prediction. Results: Suicide risk prevalence was 38.1%. Suicide risk was associated with greater odds for exposure to suicide, psychache, hopelessness, and perceived burdensomeness to others. Further, examining suicide risk by levels of pain showed that exposure to suicide and hopelessness were consistent suicide risk predictors across pain levels; psychache for lower levels of pain, perceived burdensomeness in moderate and severe pain levels, and depression in moderate levels of pain. Conclusions: The high prevalence of suicide risk is alarming and signifies an imperative for recognizing this risk within the IC/BPS population. The identified psychosocial risk factors may be used in refining screening and treatment and in directing future IC/BPS research.

scholarly journals Possible Association between Bladder Wall Morphological Changes on Computed Tomography and Bladder-Centered Interstitial Cystitis/Bladder Pain Syndrome

Biomedicines ◽  
2021 ◽  
Vol 9 (10) ◽  
pp. 1306
Author(s):  
Jia-Fong Jhang ◽  
Yung-Hsiang Hsu ◽  
Han-Chen Ho ◽  
Yuan-Hong Jiang ◽  
Cheng-Ling Lee ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Interstitial Cystitis ◽  
Morphological Changes ◽  
Bladder Wall ◽  
Pain Syndrome ◽  
Bladder Capacity ◽  
Bladder Pain Syndrome ◽  
Wall Thickening ◽  
Bladder Pain ◽  
Urinary Bladder Wall

This study aimed to evaluate the clinical significance of urinary bladder wall thickening on computed tomography (CT) among patients with interstitial cystitis/bladder pain syndrome (IC/BPS). Patients with IC/BPS were prospectively enrolled and classified into three groups according to bladder CT finding: smooth bladder wall, focal bladder thickening, and diffuse bladder thickening. Among the 100 patients with IC/BPS, 49, 36, and 15 had smooth bladder wall, focal bladder thickening, and diffuse bladder thickening on CT, respectively. Patients with Hunner’s lesion showed a higher proportion of diffuse and focal bladder thickening compared to those without the same (p < 0.001). Patients with diffuse bladder thickening displayed smaller first sensation of filling, cystometric bladder capacity, and voided volume compared to the rest (all p < 0.001). Patients with focal and diffuse thickening had a higher proportion of inflammatory cell infiltration, uroepithelial cell denudation, and granulation tissue compared to those with smooth bladder wall (p = 0.045, 0.002, and 0.005, respectively). Bladder wall thickening on CT was correlated with clinical phenotypes of IC/BPS, including histopathological findings. Focal or diffuse bladder wall thickening on CT might indicate the presence of chronic bladder wall inflammation and fibrosis and could be used to differentiate bladder-centered IC/BPS.

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