scholarly journals Evidence for Bladder Urothelial Pathophysiology in Functional Bladder Disorders

2014 ◽  
Vol 2014 ◽  
pp. 1-15 ◽  
Author(s):  
Susan K. Keay ◽  
Lori A. Birder ◽  
Toby C. Chai
Keyword(s):  
Urinary Tract ◽  
Interstitial Cystitis ◽  
Pain Syndrome ◽  
Upper Urinary Tract ◽  
Bladder Pain Syndrome ◽  
Bladder Function ◽  
Voiding Function ◽  
Bladder Pain ◽  
Urinary Tract Symptoms ◽  
Bladder Disorders

Understanding of the role of urothelium in regulating bladder function is continuing to evolve. While the urothelium is thought to function primarily as a barrier for preventing injurious substances and microorganisms from gaining access to bladder stroma and upper urinary tract, studies indicate it may also function in cell signaling events relating to voiding function. This review highlights urothelial abnormalities in bladder pain syndrome/interstitial cystitis (BPS/IC), feline interstitial cystitis (FIC), and nonneurogenic idiopathic overactive bladder (OAB). These bladder conditions are typified by lower urinary tract symptoms including urinary frequency, urgency, urgency incontinence, nocturia, and bladder discomfort or pain. Urothelial tissues and cells from affected clinical subjects and asymptomatic controls have been compared for expression of proteins and mRNA. Animal models have also been used to probe urothelial responses to injuries of the urothelium, urethra, or central nervous system, and transgenic techniques are being used to test specific urothelial abnormalities on bladder function. BPS/IC, FIC, and OAB appear to share some common pathophysiology including increased purinergic, TRPV1, and muscarinic signaling, increased urothelial permeability, and aberrant urothelial differentiation. One challenge is to determine which of several abnormally regulated signaling pathways is most important for mediating bladder dysfunction in these syndromes, with a goal of treating these conditions by targeting specific pathophysiology.

scholarly journals Urinary Biomarkers in Interstitial Cystitis/Bladder Pain Syndrome and Its Impact on Therapeutic Outcome

Diagnostics ◽  
2021 ◽  
Vol 12 (1) ◽  
pp. 75
Author(s):  
Hung-Yu Lin ◽  
Jian-He Lu ◽  
Shu-Mien Chuang ◽  
Kuang-Shun Chueh ◽  
Tai-Jui Juan ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Interstitial Cystitis ◽  
Pain Syndrome ◽  
Bladder Pain Syndrome ◽  
Therapeutic Outcome ◽  
Urinary Biomarkers ◽  
Unknown Etiology ◽  
Bladder Pain ◽  
Urinary Tract Symptoms ◽  
Urgency Symptoms

Interstitial cystitis/bladder pain syndrome (IC/BPS) is defined as a chronic bladder disorder with suprapubic pain (pelvic pain) and pressure and/or discomfort related to bladder filling accompanied by lower urinary tract symptoms, such as urinary frequency and urgency without urinary tract infection (UTI) lasting for at least 6 weeks. IC/BPS presents significant bladder pain and frequency urgency symptoms with unknown etiology, and it is without a widely accepted standard in diagnosis. Patients’ pathological features through cystoscopy and histologic features of bladder biopsy determine the presence or absence of Hunner lesions. IC/PBS is categorized into Hunner (ulcerative) type IC/BPS (HIC/BPS) or non-Hunner (nonulcerative) type IC/BPS (NHIC/BPS). The pathophysiology of IC/BPS is composed of multiple possible factors, such as chronic inflammation, autoimmune disorders, neurogenic hyperactivity, urothelial defects, abnormal angiogenesis, oxidative stress, and exogenous urine substances, which play a crucial role in the pathophysiology of IC/BPS. Abnormal expressions of several urine and serum specimens, including growth factor, methylhistamine, glycoprotein, chemokine and cytokines, might be useful as biomarkers for IC/BPS diagnosis. Further studies to identify the key molecules in IC/BPS will help to improve the efficacy of treatment and identify biomarkers of the disease. In this review, we discuss the potential medical therapy and assessment of therapeutic outcome with urinary biomarkers for IC/BPS.

scholarly journals Risk of Urinary Tract Carcinoma among Subjects with Bladder Pain Syndrome/Interstitial Cystitis: A Nationwide Population-Based Study

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Ming Ping Wu ◽  
Hao Lun Luo ◽  
Shih Feng Weng ◽  
Chung-Han Ho ◽  
Michael B. Chancellor ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Interstitial Cystitis ◽  
Subsequent Development ◽  
Pain Syndrome ◽  
Population Based ◽  
Bladder Pain Syndrome ◽  
Control Group ◽  
Bladder Pain ◽  
Comorbidity Index

Objective. To investigate the subsequent risks of urinary tract cancers among individuals with bladder pain syndrome/interstitial cystitis (BPS/IC), and gender differences, as well as the effect of associated comorbidity using a population-based administrative database in Taiwan. Patients and Methods. BPS/IC subjects (10192) and their age- and sex-matched non-BPS/IC control subjects (30576), who had no previous upper urinary tract cancer (UUC), bladder cancer (BC), and prostate cancer (PC), subsequently developed these disorders from the recruited date between 2002 and 2008 and the end of follow-up 2011. A Cox proportional hazards regression model was constructed to estimate the risk of subsequent UUC, BC, and PC following a diagnosis of IC/BPS. The effect of associated comorbidities was measured by Charlson Comorbidity Index (CCI). The risk of outcomes was assessed with Kaplan-Meier curves. Results. In the BPS/IC subjects, 37 (0.36%) received a diagnosis of BC, and 22 (0.22%) received a diagnosis of UUC; both were significantly higher than the control group, 19 (0.06%) for BC and 30 (0.10%) for UUC. Cox proportional analysis revealed that the adjusted HR for BC and UUC during the follow-up period for patients with IC/BPS was 5.44 (95% CI: 3.10-9.54) and 1.97 (95% CI: 1.13-3.45) than that of comparison subjects. The HRs went up to 5.66 (95% CI: 3.21-9.99) and 2.01 (95% CI: 1.14-3.55) after adjusted by Comorbidity Index (CCI). The male BPS/IC patients have a higher adjusted HR for BC; however, female patients have a higher adjusted HR for both BC and UUC. The adjusted HR for PC has no difference between BPS/IC and control group. Conclusion. Patients with BPS/IC are at risk of developing BC in both males and females, and UUC in females. This result reminds physicians to evaluate the potential risk of subsequent development of BC and UUC among individuals with BPS/IC.

scholarly journals Painful bladder syndrome/interstitial cystitis: Aetiology, evaluation and management

2014 ◽  
Vol 86 (2) ◽  
pp. 126 ◽  
Author(s):  
William Rourke ◽  
Shahid Aziz Anwer Khan ◽  
Kamran Ahmed ◽  
Shikohe Masood ◽  
Prokar Dasgupta ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Interstitial Cystitis ◽  
Pain Syndrome ◽  
Bladder Pain Syndrome ◽  
Multimodal Approach ◽  
Bladder Pain ◽  
Abdominal Tenderness ◽  
Diagnosis And Management ◽  
Painful Bladder

Interstitial cystitis or bladder pain syndrome (BPS) is often a chronic debilitating condition characterised by predominantly storage symptoms and associated frequently with pelvic pain that varies with bladder filling. The aetiology is uncertain as the condition occurs in the absence of a urinary tract infection or other obvious pathology. Resulting discomfort may vary and ranges from abdominal tenderness to intense bladder spasms. Diagnosis and management of this syndrome may be difficult and is often made by its typical cystoscopic features. This review discusses the diagnosis and management of interstitial cystitis according to the current available best evidence and advises a multimodal approach in its management.

scholarly journals Interstitial cystitis/bladder pain syndrome and recurrent urinary tract infection and the potential role of the urinary microbiome

2020 ◽  
Vol 26 (2) ◽  
pp. 87-90
Author(s):  
Alka Bhide ◽  
Visha Tailor ◽  
Vik Khullar
Keyword(s):  
Urinary Tract ◽  
Interstitial Cystitis ◽  
Urinary Tract Infections ◽  
Potential Role ◽  
Pain Syndrome ◽  
Bladder Pain Syndrome ◽  
Bladder Pain ◽  
Urinary Microbiome ◽  
Tract Infections

Interstitial cystitis/bladder pain syndrome and recurrent urinary tract infections carry significant burden for those affected. As women enter the menopause, other factors may influence how these conditions manifest. The urinary microbiome has shown that the urine contains extensive numbers of bacteria. There is some evidence to suggest that it is altered depending on the menopausal state of the individual. It is possible that this alteration may go on to influence how the disease course of interstitial cystitis/bladder pain syndrome and recurrent urinary tract infections runs in the post-menopausal group. The review will explore these two conditions and the potential role of the urinary microbiome.

The Therapeutic Approach to Different forms of Cystitis: Impact on Public Health

2017 ◽  
Vol 84 (1_suppl) ◽  
pp. 8-15
Author(s):  
Stéphane Droupy
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Negative Impact ◽  
Symptom Relief ◽  
Pain Syndrome ◽  
Bladder Pain Syndrome ◽  
Bladder Pain ◽  
Recurrent Urinary Tract Infections ◽  
Bladder Disorders ◽  
Tract Infections

Interstitial cystitis/bladder pain syndrome, recurrent urinary tract infections and other forms of cystitis signifi-cantly impact the quality of life of patients with chronic bladder disorders and impose a considerable economic burden on health systems. Effective management is essential to provide symptom relief and to reduce the negative impact of chronic bladder disorders. Identifying the appropriate pharmacological or non-pharmacological approach is essential, and there is a growing evidence base for the use of intravesical hyaluronic acid and chon-droitin sulfate in several bladder conditions, including recurrent urinary tract infections.

scholarly journals Treatment of Interstitial Cystitis/Bladder Pain Syndrome: A Contemporary Review

2020 ◽  
Keyword(s):  
Interstitial Cystitis ◽  
Negative Impact ◽  
Treatment Options ◽  
Pain Syndrome ◽  
Bladder Pain Syndrome ◽  
Female Population ◽  
Bladder Pain ◽  
Urinary Tract Symptoms ◽  
Surgical Options ◽  
American Urological Association

Interstitial cystitis/bladder pain syndrome (IC/BPS) is a debilitating condition affecting approximately 3% of the female population. IC/BPS is defined as an unpleasant sensation (pain, pressure, discomfort) perceived to be related to the urinary bladder, associated with lower urinary tract symptoms for more than six weeks duration, in the absence of infection or other identifiable cause. This condition is known to have a profound negative impact on quality of life. There are few well-studied treatment options and no cure for this condition, which is therefore challenging to treat. The purpose of this narrative review is to summarise the contemporary literature, including the Canadian Urological Association (CUA) and American Urological Association (AUA) guidelines, on various treatment options that exist for IC/BPS, including conservative therapies, oral therapies, intravesical therapies, and more invasive surgical options. Most importantly, this review highlights the need for an individualised, multimodal approach to the treatment of IC/BPS.

Sign in / Sign up

Export Citation Format

Share Document