Correlation of Cystoscopically Confirmed Periureterally Located Hunner Lesion With Vesicoureteral Reflux: Preliminary Study in Patients With Interstitial Cystitis

Lee, Ji Eun; Yi, Boem Ha; Lee, Hae Kyung; Lee, Min Hee; Kim, Duk Yoon

doi:10.2214/ajr.14.13108

Cited by 4 publications

(3 citation statements)

References 7 publications

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“…Cystoscopy for Hunner’s disease requires fulguration or resection of lesions concomitantly with hydrodistension to improve treatment outcome. The presence or absence of Hunner ulcer in IC/BPS patients is believed to have an important role in symptom variations, differences in therapeutic success, and the level of pain, especially the pain related to bladder distension [ 104 , 105 ].…”

Section: Clinical Diagnosis For Ic/bpsmentioning

confidence: 99%

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

Lin

Chuang

et al. 2021

Diagnostics

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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.

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Section: Clinical Diagnosis For Ic/bpsmentioning

confidence: 99%

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

Lin

Chuang

et al. 2021

Diagnostics

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“…These ulcers can easily split open with bladder distention which causes bleeding [28]. The presence or absence of Hunner ulcer in IC/BPS patients is believed to have an important role in symptom variations, differences in therapeutic success and the level of pain, especially the pain related to bladder distension [28][29][30]. Mucosal splitting, glomerulations and Hunner ulcers are all signs of mucosal damage.…”

Section: Observations From Cystoscopy and Biopsy Samples From Ic/bps mentioning

confidence: 99%

Purinergic P2X7 receptors as therapeutic targets in interstitial cystitis/bladder pain syndrome; key role of ATP signaling in inflammation

Taidi

Mansfield

Bates

et al. 2019

Bladder

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Interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic lower urinary tract condition. Patients with IC/BPS suffer from debilitating pain and urinary urgency. The underlying etiology of IC/BPS is unknown and as such current treatments are mostly symptomatic with no real cure. Many theories have been proposed to describe the etiology of IC/BPS, but this review focuses on the role of inflammation. In IC/BPS patients, the permeability of the urothelium barrier is compromised and inflammatory cells infiltrate the bladder wall. There are increased levels of many inflammatory mediators in patients with IC/BPS and symptoms such as pain and urgency that have been associated with the degree of inflammation. Recent evidence has highlighted the role of purinergic receptors, specifically the P2X7 receptor, in the process of inflammation. The results from studies in animals including cyclophosphamide-induced hemorrhagic cystitis strongly support the role of P2X7 receptors in inflammation. Furthermore, the deletion of the P2X7 receptor or antagonism of this receptor significantly reduces inflammatory mediator release from the bladder and improves symptoms. Research results from IC/BPS patients and animal models of IC/BPS strongly support the crucial role of inflammation in the pathophysiology of this painful disease. Purinergic signaling and purinergic receptors, especially the P2X7 receptor, play an undisputed role in inflammation. Purinergic receptor antagonists show positive results in treating different symptoms of IC/BPS.

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“…Progressive fibrotic changes in the bladder wall of IC/BPS patients are characterized by excessive deposition of extracellular matrix within the lamina propria and smooth muscle ( Figure 1 ), generation of contractile fibroblasts (myofibroblasts), and decreased capillary density 33 , 34 . These histological changes are associated with the upregulation of collagen genes, collagen I, collagen III, fibronectin, and transforming growth factor-β1 (TGF-β1) 35 and the downregulation of sonic hedgehog, WNT gene family, WNT2B , WNT5A , WNT10A , and WNT11 in the biopsy of non-Hunner-type IC/BPS patients 33 , 36 – 40 . Recent studies report the association of YKL-40 antigenic expression in detrusor mast cell granules and submucosal macrophages with detrusor fibrosis 34 and of the fibrosis in ketamine-induced 41 IC/BPS with the activation of mammalian target of rapamycin (mTOR).…”

Section: Current Understanding Of the Pathologymentioning

confidence: 99%

Recent advances in imaging and understanding interstitial cystitis

et al. 2018

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Interstitial cystitis/bladder pain syndrome (IC/BPS) is a debilitating condition associated with intense pelvic pain and bladder storage symptoms. Since diagnosis is difficult, prevalence estimates vary with the methodology used. There is also a lack of proven imaging tools and biomarkers to assist in differentiation of IC/BPS from other urinary disorders (overactive bladder, vulvodynia, endometriosis, and prostatitis). Current uncertainty regarding the etiology and pathology of IC/BPS ultimately impacts its timely and successful treatment, as well as hampers future drug development. This review will cover recent developments in imaging methods, such as magnetic resonance imaging, that advance the understanding of IC/BPS and guide drug development.

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Correlation of Cystoscopically Confirmed Periureterally Located Hunner Lesion With Vesicoureteral Reflux: Preliminary Study in Patients With Interstitial Cystitis

Cited by 4 publications

References 7 publications

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

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

Purinergic P2X7 receptors as therapeutic targets in interstitial cystitis/bladder pain syndrome; key role of ATP signaling in inflammation

Recent advances in imaging and understanding interstitial cystitis

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