scholarly journals Mirabegron as adjuvant treatment for patients with interstitial cystitis/bladder pain syndrome

2017 ◽  
Vol 12 (3) ◽  
pp. E100-4 ◽  
Author(s):  
Michael Di Lena ◽  
Victoria Tolls ◽  
Kerri-Lynn Kelly ◽  
J. Curtis Nickel
Keyword(s):  
Interstitial Cystitis ◽  
Adjuvant Treatment ◽  
Treatment Options ◽  
Pain Syndrome ◽  
Bladder Pain Syndrome ◽  
Post Treatment ◽  
Symptom Scale ◽  
Symptom Index ◽  
Bladder Pain ◽  
Significant Difference

Introduction: Interstitial cystitis/bladder pain syndrome (IC/BPS) patients represent a heterogeneous group with pain and urinary storage symptoms and varying responses to current treatment options. The novel beta-3 agonist, mirabegron, has been shown to improve storage symptoms of patients with bladder overactivity; however, its effect on symptoms in the IC/BPS population has yet to be studied.Methods: Patients diagnosed at a single IC centre with IC/BPS undergoing standard therapy were treated with additional daily mirabegron 25 mg and seen in followup post-treatment. Patients completed the Interstitial Cystitis Symptom Index and Problem Index (ICSI/ICPI), and the Pelvic Pain and Urgency/Frequency Patient Symptom Scale (PUF) prior to and following mirabegron treatment. Global (NRS) and symptom-specific outcomes were assessed by comparing the pre- and post-treatment mean scores using tailed-t test (p<0.05 considered statistically significant).Results: A total of 23 patients were available for review pre- and post-mirabegron treatment. There was no significant difference in ICSI (p=0.448), ICPI (p=0.352), or PUF (p=0.869) pre- and post-treatment. Analysis of symptom-specific outcomes show statistically significant improvements in urgency (p=0.048); however, no statistically significant improvements in frequency (p=0.951) or pain (p=0.952) were observed with mirabegron therapy.Conclusions: IC/BPS patients treated with mirabegron had improvement of urinary urgency, but no significant benefit in terms of pain or urinary frequency. This data suggests that mirabegron’s role in the IC/BPS patient should be that of adjuvant treatment to ameliorate urgency.

scholarly journals Clinical comparision of intravesical hyaluronic acid and hyaluronic acid-chondroitin sulphate therapy for patients with bladder pain syndrome/interstitital cystitis

2014 ◽  
Vol 8 (9-10) ◽  
pp. 610 ◽  
Author(s):  
Ömer Gülpınar ◽  
Aytaç Kayış ◽  
Evren Süer ◽  
Mehmet İlker Gökçe ◽  
Adil Güçal Güçlü ◽  
...  
Keyword(s):  
Hyaluronic Acid ◽  
Interstitial Cystitis ◽  
Chondroitin Sulphate ◽  
Sodium Hyaluronate ◽  
Previous Treatment ◽  
Pain Syndrome ◽  
Bladder Pain Syndrome ◽  
Symptom Index ◽  
Bladder Pain ◽  
Significant Difference

Introduction: Patients with a history of bladder pain syndrome/interstitial cystitis (BPS/IC) and who responded poorly or unsatisfactorily with previous treatment were compared taking intravesical hyaluronic acid (HA) or hyaluronic acid-chondroitin sulphate (HA-CS).Methods: Patients were treated with intravesical instillation with 50 mL sterile sodium hyalurinic acid (Hyacyst, Syner-Med, Surrey, UK) (n = 32) and sodium hyaluronate 1.6% sodium chondroitin sulphate 2% (Ialuril, Aspire Pharma, UK) (n = 33). Intravesical instillations were performed weekly in first month, every 15 days in the second month and monthly in third and fourth months, for a total of 8 doses. Patients were evaluated using a visual analog pain scale (VAS), interstitial cystitis symptom index (ICSI), interstitial cystitis problem index (ICPI), voiding diary for frequency/nocturia, cystometric bladder capacity and voided volume at the beginning and at 6 months. All patients had a potassium sensitivity test (PST) initially. Wilcoxon and Mann-Whitney U tests were used for statistical analysis.Results: In total, 53 patients met the study criteria. There were 30 patients in the HA-CS group (mean age: 48.47) and 23 patients in the HA group (mean age: 49.61) (p > 0.05). The initial PST was positive in 71.7% patients (38/53) overall with no difference between groups (p > 0.05). Responses for VAS, ICCS, ICPS, 24-hour frequency/nocturia statistically improved in both groups at 6 months. There was no significant difference in symptomatic improvement (p > 0.05). Eight patients had mild adverse events.Conclusion: HA and HA/CS instillation can be effective in BPS/IC patients who do not respond to conservative treatment. An important limitation of our study is that the HA dosage of the 2 treatment arms were different. It would be more appropriate with same HA dosage in both groups; however, there was no commercially available glycosaminoglycan (GAG) substance with same HA dosage for single and combination therapy. Large, long-term randomized studies are required to determine if there is a difference between these treatments.

scholarly journals Immune Cell Profiles and Cytokine Levels of Patients with Interstitial Cystitis/Bladder Pain Syndrome

2020 ◽  
Author(s):  
Robert M. Moldwin ◽  
Vishaan Nursey ◽  
Oksana Yaskiv ◽  
Siddhartha Dalvi ◽  
Michael Funaro ◽  
...  
Keyword(s):  
Interstitial Cystitis ◽  
Plasma Cells ◽  
Immune Cell ◽  
Pain Syndrome ◽  
Fold Increase ◽  
Bladder Pain Syndrome ◽  
Bladder Tissue ◽  
Bladder Pain ◽  
Tnf Α ◽  
Significant Difference

AbstractAimsTo quantify the number of immune cells in the bladder urothelium and concentrations of urinary cytokines in patients with Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS). To identify differences in these measures in IC/BPS patients with Hunner’s lesions (IC/BPS-HL) and without Hunner’s lesions (IC/BPS-NHL).MethodsBladder tissue biopsies were obtained from 48 patients with IC/BPS-HL and unaffected controls (UC) and stained with antibodies for various immune cell markers such as CD138, CD20 and CD56. Levels of cytokines (Interferon (IFN)-γ, Interleukin (IL)-1β, IL-2, IL- 4, IL-6, IL-8, IL12P70, IL-13, and TNF-α) were measured from normalized urine obtained from 18 IC/BPS-HL, 18 IC/BPS-NHL, and 4 UC.ResultsNumbers of CD138+ plasma cells, CD20+ B cells, and CD3+ T cells were significantly increased (50 fold, 30 fold, and an almost 3 fold increase, respectively; p-values: 1.34E-06, 3.26E-04, and 2.52E-6) in the bladders of IC/BPS-HL patients compared to UC. Patients with IC/BPS-HL had significantly elevated urinary levels of IL-6 (p=0.0028) and TNF-α (p=0.009) compared to patients with IC/BPS-NHL and UC. In contrast, IL-12p70 levels were significantly higher in the patients with IC/BPS-NHL than in HL patients (p=0.033). No significant difference in IL-12p70 levels were observed between IC/BPS-HL and UC.ConclusionDifferent cytokines were elevated in the urine of IC/BPS patients with and without HL, suggesting differences in underlying disease processes. Elevated levels of CD138+, CD20+, and CD3+ cells in HL indicate B and T-cell involvement in lesion formation. Determining which cytokines and immunological pathways are present in IC/BPS-HL could elucidate the disease mechanism.

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 Clinical efficacy of submucosal injection of triamcinolone acetonide in the treatment of type II/III interstitial cystitis/bladder pain syndrome

2020 ◽  
Author(s):  
Tao Jiang ◽  
Xiaozhou Zhou ◽  
Zhipeng Chen ◽  
Tailing Xiong ◽  
Jian Fu ◽  
...  
Keyword(s):  
Interstitial Cystitis ◽  
Triamcinolone Acetonide ◽  
Pelvic Pain ◽  
Pain Syndrome ◽  
Bladder Pain Syndrome ◽  
Type Ii ◽  
Symptom Scale ◽  
Bladder Pain ◽  
Submucosal Injection ◽  
Symptom Scores

Abstract Background: To evaluate the efficacy of submucosal injection of triamcinolone acetonide for the treatment of type II/III interstitial cystitis/bladder pain syndrome. Methods: A retrospective analysis of the clinical data of type II/III interstitial cystitis/bladder pain syndrome patients treated in our department from April 2016 to August 2018 was conducted, and changes in International Prostate Symptom Scores and the Pelvic Pain and Urgency/Frequency symptom scale after surgery were evaluated to explore factors that may affect patient outcomes. Results: A total of 27 female patients and 8 male patients were enrolled, with type II patients accounting for 62.9% of the sample, and the median follow-up duration was 31 months (range: 12-40 months). Twenty-two patients (74.3%) had significantly improved questionnaire scores at 4 weeks postoperatively. Treatment efficacy was sustained for at least 1 year in 15 patients, and persistent effectiveness was noted in 10 (28.6%) patients. Patients with an advanced age (p=0.015), high pain scores (p=0.040), and higher International Prostate Symptom Scores (p=0.037) and Pelvic Pain and Urgency/Frequency symptom scale scores (p=0.020) were more likely to benefit from submucosal injection of triamcinolone acetonide. Gender, disease duration, and the presence of Hunner’s lesions had no predictive value for treatment outcomes. Conclusion: Submucosal injection of triamcinolone acetonide can improve the clinical symptoms and quality of life in both men and women with type II/III interstitial cystitis/bladder pain syndrome. Patients with an advanced age and more severe interstitial cystitis/bladder pain syndrome related symptoms may benefit more from triamcinolone acetonide injection.

scholarly journals Erratum: Chondroitin Sulfate and Hyaluronic Acid Perfusion for Interstitial Cystitis/Bladder Pain Syndrome: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 39 (5) ◽  
pp. 419
Author(s):  
Xiang Xiao ◽  
Huan Deng ◽  
Mumba Mulutula Chilufya ◽  
Yizhen Lv ◽  
Yan Zhao ◽  
...  
Keyword(s):  
Systematic Review ◽  
Hyaluronic Acid ◽  
Chondroitin Sulfate ◽  
Interstitial Cystitis ◽  
Meta Analysis ◽  
Pain Syndrome ◽  
Bladder Pain Syndrome ◽  
Symptom Index ◽  
Bladder Pain ◽  
Acid Perfusion

Paper link corrected: https://bonoi.org/index.php/si/article/view/636 It has been brought to authors attention that there is a missing part in “Materials and Methods” of the Systematic Review article by Xiao et al., entitled “Chondroitin Sulfate and Hyaluronic Acid Perfusion for Interstitial Cystitis/Bladder Pain Syndrome: A Systematic Review and Meta-Analysis” in the Volume 39, No. 4 of Science Insights (pp.363-373). The missing part of the “Materials and Methods” is as below: Population: Patients with IC/BPS.Intervention: All patients underwent intravesical HA and/or CS treatment regimen.Comparison: Improvement in symptoms pre-treatment and post-treatment or other treatment regimen.Outcome: The primary outcome was the change in visual analogue scale (VAS) for pain symptom from baseline to the follow-up period; secondary outcomes were the changes in total scores of the O’Leary-Sant Interstitial Cystitis Symptom Index (ICSI) and Problem Index (ICPI), storage symptoms including frequency and urgency, and bladder capacity.

scholarly journals The voiding dysfunctions in patients with non-Hunner-type interstitial cystitis/bladder pain syndrome do not affect long-term treatment outcome

2021 ◽  
Author(s):  
Wan-Ru Yu ◽  
Wei-Chuan Chang ◽  
Hann-Chorng Kuo
Keyword(s):  
Treatment Outcome ◽  
Interstitial Cystitis ◽  
Pain Syndrome ◽  
Bladder Pain Syndrome ◽  
Term Treatment ◽  
Bladder Pain ◽  
Long Term Treatment ◽  
Significant Difference ◽  
Voiding Dysfunctions

Aims: The role of urodynamic studies in the diagnosis and prognosis of interstitial cystitis/bladder pain syndrome (IC/BPS) remains controversial. We evaluated the correlation of baseline voiding dysfunctions with long-term treatment outcome in a large cohort of patients with IC/BPS. Methods: We studied 211 patients with nonulcerative IC/BPS. All patients underwent video urodynamic examination at baseline to identify their voiding conditions and they received subsequent treatments. The primary endpoint was the global response assessment (GRA) at the current interview. Secondary endpoints included O’Leary-Sant score (OSS), Visual Analog Scale (VAS) for pain, and the rate of IC symptom flare-up. Results: Mean patient age was 56.8 ± 12.8 years and mean IC symptom duration was 16.0 ± 9.9 years. At baseline, 83 (39.3%) patients had a voiding problem and 62.7% had one to three comorbidities. The duration, comorbidity, treatments, changes in OSS and VAS, maximum bladder capacity (MBC), glomerulations, GRA, and flare-up rate were not significantly different among the different voiding subtypes. When we divided the patients by their voiding conditions of normal (n = 32) and hypersensitive bladder with (n = 76) and without (n = 103) voiding dysfunctions, only MBC (P = 0.002) and glomerulation (P = 0.021) demonstrated a significant difference. When we analyzed subgroups by GRA, patients with a GRA ≥ 2 had a significantly shorter disease duration. There also were significant associations between GRA and the changes in OSS and VAS (P < 0.001). Conclusions: Voiding dysfunctions in patients with non-Hunner IC/BPS do not affect long-term treatment outcome.

scholarly journals Micronized Palmitoylethanolamide-Polydatin Reduces the Painful Symptomatology in Patients with Interstitial Cystitis/Bladder Pain Syndrome

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
M. Cervigni ◽  
L. Nasta ◽  
C. Schievano ◽  
N. Lampropoulou ◽  
E. Ostardo
Keyword(s):  
Interstitial Cystitis ◽  
Pelvic Pain ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Pain Syndrome ◽  
Bladder Pain Syndrome ◽  
Symptom Scale ◽  
Open Label ◽  
Bladder Pain ◽  
Over Time

Aims. To assess the efficacy of a micronized-palmitoylethanolamide-polydatin (m-PEA-Pol) based product on chronic pelvic pain and severity of other symptoms in interstitial cystitis/bladder pain syndrome (IC/BPS) patients refractory to conventional therapies. Methods. A pilot, open-label bicentric study was carried out involving 32 IC/BPS patients. Chronic, oral m-PEA-Pol treatment lasted 6 months. Bladder pain was evaluated using the visual analog scale, while changes from baseline in other urinary symptoms were evaluated by means of the O’Leary-Sant Interstitial Cystitis Symptom and Problem Index and the Pelvic Pain and Urgency/Frequency (PUF) symptom scale questionnaires. The generalized linear mixed model was used to evaluate significant mean changes across time. Results. A significant and progressive reduction of pain intensity was observed during m-PEA-Pol treatment (p<0.0001 for reduction over time). The effect was associated with a reduction in severity of patients’ symptoms evaluated with the O’Leary-Sant questionnaire (p=0.0110 and p=0.0014 for cystitis symptoms and problem mean scores, respectively) and the PUF scale (p=0.0163 and p=0.0005 for symptom and bother mean scores, respectively). m-PEA-Pol therapy elicited a significant reduction over time in the urinary frequency evaluated with voiding diary (p=0.0005) and a small but not significant improvement of bladder capacity. Conclusions. These data highlight the potential benefit of m-PEA-Pol in patients with rare pathology such as IC/BPS and confirm the good safety profile of micronized PEA-based products.

scholarly journals Clinical Remission Using Personalized Low-Dose Intravenous Infusions of N-acetylcysteine with Minimal Toxicities for Interstitial Cystitis/Bladder Pain Syndrome

2021 ◽  
Vol 11 (5) ◽  
pp. 342
Author(s):  
Dipnarine Maharaj ◽  
Gayathri Srinivasan ◽  
Sarah Makepeace ◽  
Christopher J. Hickey ◽  
Jacqueline Gouvea
Keyword(s):  
Adverse Events ◽  
Interstitial Cystitis ◽  
Clinical Remission ◽  
Low Dose ◽  
Treatment Options ◽  
Pain Syndrome ◽  
Bladder Pain Syndrome ◽  
Infusion Therapy ◽  
Blurred Vision ◽  
Bladder Pain

Interstitial Cystitis or Bladder Pain Syndrome (IC/BPS) is a heterogeneous condition characterized by elevated levels of inflammatory cytokines, IL-1β, IL-6, IL-8, IL-10, TNF-α, and is associated with debilitating symptoms of pelvic pain and frequent urination. A standard of care for IC/BPS has not been established, and most patients must undergo a series of different treatment options, with potential for severe adverse events. Here, we report a patient with a 26-year history of IC/BPS following treatment with multiple therapies, including low doses of etodolac, amitriptyline and gabapentin, which she was unable to tolerate because of adverse effects, including headaches, blurred vision and cognitive impairment. The patient achieved a complete clinical remission with minimal adverse events after 16 cycles of N-acetylcysteine (NAC) intravenous (IV) infusions over a period of 5 months, and pro-inflammatory cytokine levels were reduced when compared to measurements taken at presentation. Personalized low dose NAC IV infusion therapy represents an effective, safe, anti-inflammatory therapy administered in the outpatient setting for IC/BPS, and warrants further investigation.

scholarly journals Clinical efficacy of submucosal injection of triamcinolone acetonide in the treatment of type II/III interstitial cystitis/bladder pain syndrome

2020 ◽  
Author(s):  
Tao Jiang ◽  
Xiaozhou Zhou ◽  
Zhipeng Chen ◽  
Tailing Xiong ◽  
Jian Fu ◽  
...  
Keyword(s):  
Interstitial Cystitis ◽  
Triamcinolone Acetonide ◽  
Pelvic Pain ◽  
Pain Syndrome ◽  
Bladder Pain Syndrome ◽  
Type Ii ◽  
Symptom Scale ◽  
Bladder Pain ◽  
Submucosal Injection ◽  
Symptom Scores

Abstract Background: To evaluate the efficacy of submucosal injection of triamcinolone acetonide for the treatment of type II/III interstitial cystitis/bladder pain syndrome.Methods: A retrospective analysis of the clinical data of type II/III interstitial cystitis/bladder pain syndrome patients treated in our department from April 2016 to August 2018 was conducted, and changes in International Prostate Symptom Scores and the Pelvic Pain and Urgency/Frequency symptom scale after surgery were evaluated to explore factors that may affect patient outcomes.Results: A total of 27 female patients and 8 male patients were enrolled, with type II patients accounting for 62.9% of the sample, and the median follow-up duration was 31 months (range: 12-40 months). Twenty-two patients (74.3%) had significantly improved questionnaire scores at 4 weeks postoperatively. Treatment efficacy was sustained for at least 1 year in 15 patients, and persistent effectiveness was noted in 10 (28.6%) patients. Patients with an advanced age (p=0.015), high pain scores (p=0.040), and higher International Prostate Symptom Scores (p=0.037) and Pelvic Pain and Urgency/Frequency symptom scale scores (p=0.020) were more likely to benefit from submucosal injection of triamcinolone acetonide. Gender, disease duration, and the presence of Hunner’s lesions had no predictive value for treatment outcomes.Conclusion: Submucosal injection of triamcinolone acetonide can improve the clinical symptoms and quality of life in both men and women with type II/III interstitial cystitis/bladder pain syndrome. Patients with an advanced age and more severe interstitial cystitis/bladder pain syndrome related symptoms may benefit more from triamcinolone acetonide injection.

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