Interstitial Cystitis

Abstract

Painful bladder syndrome/interstitial cystitis (PBS/IC) is a chronic disease of unknown etiology characterized by vague bladder pain and nonspecific urinary symptoms, such as urgency and frequency. Although it was initially considered to be a rare condition, its prevalence has significantly increased, possibly because of different definitions used and greater physician awareness. Because of the multiple diagnostic criteria used, there is significant variation in its prevalence. In addition, there is often a delay in the diagnosis of PBS/IC. It affects predominantly women of middle age, and it significantly decreases quality of life. Diagnosis of PBS/IC is mainly a diagnosis of exclusion; there are no characteristic symptoms or pathognomonic findings. Therefore, it is important to rule out diseases that have a similar clinical picture (i.e., urinary infections, bladder carcinoma) but definite therapies and worse prognosis if left untreated. PBS/IC management suffers from lack of evidence; many therapies are empiric or based on small studies and case series. Treatment includes supportive therapies (psychosocial, behavioral, physical), oral treatments, and intravesical treatments, whereas other more invasive treatments such as electric neuromodulation and reconstructive surgery are reserved for refractory cases. Physicians should always keep in mind the diagnosis of PBS/IC in patients presenting with chronic urinary symptoms after excluding other more common diseases.

Urothelial Tight Junction Barrier Dysfunction Sensitizes Bladder Afferents

“…Interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic voiding disorder that presents with pain in the bladder and surrounding pelvic region (Nickel, 2002; Moutzouris and Falagas, 2009; Hanno et al, 2011; Neuhaus and Schwalenberg, 2012; Birder, 2014). While the cause of IC/BPS is unknown, several lines of evidence indicate that increased urothelial permeability to urine constituents plays an important role in the pathophysiology of this disease (Parsons et al, 1991; Chai and Keay, 2004; Graham and Chai, 2006; Parsons, 2007, 2011).…”

Herpes Simplex Virus Vector-Mediated Gene Delivery of Poreless TRPV1 Channels Reduces Bladder Overactivity and Nociception in Rats

“…1,2 There have been numerous reports attempting to detail source of IC/BPS pathogenesis, [3][4][5][6] but the complete etiology remains unclear. Therefore, effective management of IC/ BPS has not been established yet, and IC/BPS symptoms still result in a poor quality of life with sleep disruption, depression, and sexual dysfunction.…”

Expression of Nitric Oxide Synthase and Aquaporin-3 in Cyclophosphamide Treated rat Bladder

“…Consequently, urinary solutes penetrate the epithelium and activate sensory nerve endings, leading to pain and inflammation [1]. Interstitial cystitis involves primarily changes in urothelial permeability, along with mast cell activation and neurogenic inflammation [11], but the underlying pathophysiology of interstitial cystitis is incompletely understood.…”

“…Its prevalence has significantly increased [1], but many studies for it have used animals because of limitations in clinical research. As of today, bladder inflammation, urethra inflammation, stimuli in lower urinary tract, mechanical bulge within uterus or vagina, or urethra obstruction have been presented as the animal models of interstitial cystitis or overactive bladder syndrome and detrusor overactivity [2,3].…”