Bladder pain syndrome international consultation on incontinence

Abstract

Aims of Study:The Bladder Pain Syndrome Committee of the International Consultation on Incontinence was assigned the task by the consultation of reviewing the syndrome, formerly known as interstitial cystitis, in a comprehensive fashion. This included the topics of definition, nomenclature, taxonomy, epidemiology, etiology, pathology, diagnosis, symptom scales, outcome assessment, principles of management, specific therapies, and future directions in research. Study Design, Materials, Methods: The emphasis was on new information developed since the last consultation 4 years previously. Where possible, existing evidence was assessed and a level of recommendation was developed according to the Oxford system of classification. Results: The consultation decided to refer to the condition as ''bladder pain syndrome'' (BPS) because the designation is more descriptive of the clinical condition and better fits standard classification taxonomy. Reasonable definitions of BPS include the definition of the ESSIC European group and a slight modification made at a SUFU sponsored Miami meeting in early 2008. Males or females with pain, pressure, or discomfort that they perceive to be related to the bladder with at least one urinary symptom, such as frequency not obviously related to high fluid intake, or a persistent urge to void should be evaluated for possible BPS. The initial assessment consists of a frequency/volume chart, focused physical examination, urinalysis, and urine culture. Urine cytology and cystoscopy are recommended if clinically indicated. Treatment progresses from conservative management through various oral and intravesical therapies, with most surgical therapies reserved for unresponsive cases. Pain management is critical throughout the treatment process. The consultation believes that the disorder is best viewed as one of a group of chronic pain syndromes, rather than as primarily an inflammatory bladder disorder. Recommendations for future research pathways are suggested.

Protective Effect of Intravesical Platelet-Rich Plasma on Cyclophosphamide-Induced Hemorrhagic Cystitis

“…Interstitial cystitis (IC) is a chronic non-inflammatory disease especially with irritative urinary symptoms, mostly on women [15]. The Society of Urodynamics, Female Pelvic Medicine, and Urogenital Reconstruction (SUFU) defined IC as "an unpleasant sensation (pain, pressure, discomfort) perceived to be related to the urinary bladder, associated with lower urinary tract symptoms of more than 6 weeks duration, in the absence of infection or other identifiable causes" [16].…”

“…PRP contains many growth factors and proteins, such as platelet-derived growth factors (PGDF), transforming growth factor beta (TGF-β), fibroblast growth factor (FGF), insulin-like growth factor 1(IGF-1), connective tissue growth factor (CTGF) and epidermal growth factor (EGF) [12,13]. These factors that are present in PRP promote accelerated repair with better tissue differentiation at the area of the injury [15].…”

Evaluation of the metabolism of glycosaminoglycans in patients with interstitial cystis

“…Moreover, unlike previous studies, the technique employed in this study showed that the reduction in urinary GAG excretion in patients with PBS/IC occurred uniformly, with no predilection for any urinary GAG. Our study was not managed to analyze urinary GAG and the activity of the disease, such as degree of symptoms, glomerulation and histologic findings since they are not reliable isolated markers today (29). As for the HA, although the average urinary concentration was lower in the PBS/IC group but there was no significant difference when compared to control.…”

The challenge of bladder pain syndrome

“…1 BPS mainly affects adult females; however, it can occur at any age. The female to male ratio is >5:1.…”