New cystoscopic diagnosis for interstitial cystitis/painful bladder syndrome using narrow‐band imaging system

Ueda, Tomohiro; Nakagawa, Masayuki; Okamura, Motohiro; Tanoue, Hideki; Yoshida, Hiroshi; Yoshimura, Naoki

doi:10.1111/j.1442-2042.2008.02179.x

Cited by 32 publications

(32 citation statements)

References 17 publications

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“…From a diagnostic as well as therapeutic standpoint, it is important to identify all lesions. NBI may be helpful in identifying HL with greenish bleeding in the HL and red areas around the lesion with angiogenesis . (Fig.…”

Section: Resultsmentioning

confidence: 99%

Hunner lesion versus non‐Hunner lesion interstitial cystitis/bladder pain syndrome

et al. 2019

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Background Global consensus on the standardization of terminology for interstitial cystitis/bladder pain syndrome is lacking and is in the formative stages. The Workshop on Hunner lesion versus non‐Hunner lesion at the 2018 International Consultation on Interstitial Cystitis Japan discussed prevalence, performance and outcome of endoscopy, the role of histopathology, and markers. Methods A panel of experts reviewed the literature regarding Hunner lesion vs. non‐Hunner lesion interstitial cystitis/bladder pain syndrome. Results The prevalence of Hunner lesion has been reported to be 5–57%. Older age and smaller anatomic bladder capacity were associated with Hunner lesions. Cystoscopy using local anesthesia is not adequate in diagnosing interstitial cystitis but is needed to rule out confusable diseases. Cystoscopy with hydrodistention and redistention of the bladder is considered standard. A Hunner lesion is visualized as a quite typical inflammatory reaction: a reddened mucosal area with small vessels radiating towards a central scar, splitting at distension, usually associated with a waterfall bleeding pattern. Biopsies from the inflamed area show inflammatory infiltrates, granulation tissue, detrusor mastocytosis, and fibrin deposits. Ablation of Hunner lesions includes transurethral resection of lesions, fulguration, laser ablation, and cortical steroid injections. Mast cell density is a somewhat controversial matter, described differently in different studies: marked increase in Hunner lesion vs. non‐Hunner lesion in the majority of studies, no difference in a few. Nitric oxide appears to be a definitive marker in distinguishing Hunner lesion vs. non‐Hunner lesion disease. Macrophage migration inhibitory factor is elevated in Hunner lesion patients. Increased level of urinary proinflammatory genes expression has also been found in Hunner lesion subjects. Conclusions Hunner lesion patients are clinically and pathologically distinct from non‐Hunner lesion bladder pain syndrome patients.

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Section: Resultsmentioning

confidence: 99%

Hunner lesion versus non‐Hunner lesion interstitial cystitis/bladder pain syndrome

et al. 2019

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“…Furthermore, since hydrodistention interferes with efficacy evaluation, some other key diagnostic approach that could confirm any pathological lesion in the bladder needs to be developed . The author developed a diagnostic method for IC/bladder pain syndrome using a cystoscope with a narrow‐band imaging system that can detect mucosal angiogenic lesions …”

Section: Discussionmentioning

confidence: 99%

Suplatast tosilate in patients with interstitial cystitis: Efficacy and treatment possibilities, with suggestions for future assessments

Ueda¹,

Homma

Yoshimura

2019

Int J of Urology

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Objective Suplatast tosilate, a Th2 cytokine inhibitor, was predicted to relieve interstitial cystitis symptoms. Four studies with suplatast tosilate in Japanese interstitial cystitis patients have been conducted: a single‐arm clinical study, a phase II dose‐ranging trial, a phase III trial with placebo, and a second phase PIII trial with placebo. Treatment efficacy was observed in the first two studies; however, in the phase PIII trials, no significant difference in interstitial cystitis symptom score changes was observed between suplatast tosilate and placebo. We summarized these four studies to investigate factors causing the difference in observed efficacy. Methods Placebo effects in the first two studies and differences regarding study design between the four studies were considered to be possible factors. Therefore, placebo effects were investigated by comparing interstitial cystitis symptom score changes, and the study designs were compared to investigate the effects on observed efficacy. Results Interstitial cystitis symptom score changes in the phase PII treatment groups increased in a dose‐dependent manner and showed an almost linear relationship with interstitial cystitis symptom score changes observed in placebo groups of 2 phase PIII studies. A major difference regarding the phase PIII study design was the use of diagnostic hydrodistention. Diagnostic hydrodistention and its washout period were applied only in the phase PIII trials. Conclusions Comparison of interstitial cystitis symptom score changes suggested that the placebo effect was very small. Use of diagnostic hydrodistention was considered to be a major difference in the population characteristics of the studies and may have resulted in different observed efficacies. Diagnostic hydrodistention, which potentially influences the treatment effect, is probably not essential for trials of suplatast in interstitial cystitis patients.

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“…L'apport des nouvelles techniques de diagnostic comme la fluorescence pourrait permettre de ne faire des biopsies que sur des zones spécifiquement inflammatoires. Les premiers résultats sont prometteurs, mais cette technique est encore en cours d'évaluation [13].…”

Section: Histologieunclassified

Les critères diagnostiques de la vessie douloureuse

et al. 2010

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En 2009, il est admis par les sociétés savantes qu'on ne doit plus parler de « syndrome de cystite à urine claire » ou de « cystite interstitielle », mais d'un ensemble de pathologies regroupées sous une définition clinique : le « syndrome de vessie douloureuse ». Cette façon de faire est pragmatique et donne des grandes règles permettant d'exclure d'autres grands syndromes douloureux du petit bassin. Cette segmentation des pathologies douloureuses devrait aboutir à une meilleure évaluation et, à terme à une meilleure prise en charge. Dans cet article, nous expliquons l'évolution « historique » des définitions proposées. Nous précisions ensuite la démarche diagnostique telle qu'elle a été suggérée par les principales sociétés internationales qui s'intéressent à la prise en charge des vessies douloureuses. Mots clés Syndrome de vessie douloureuse · Douleur sus-pubienne · Pollakiurie · NycturieAbstract In 2009, it is accepted in scholarly circles that the expressions "clear urine cystitis syndrome" and "interstitial cystitis" should be replaced by references to a set of pathologies grouped together under a single clinical definition: "painful bladder syndrome". This approach is pragmatic and it provides some general rules that enable other major painful syndromes affecting the lesser pelvis to be set aside. In this article, we explain the "historical" evolution of the definitions put forward. We then examine details of the diagnostic procedure as it has been suggested by the main international societies concerned with therapy for painful bladders.

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New cystoscopic diagnosis for interstitial cystitis/painful bladder syndrome using narrow‐band imaging system

Cited by 32 publications

References 17 publications

Hunner lesion versus non‐Hunner lesion interstitial cystitis/bladder pain syndrome

Hunner lesion versus non‐Hunner lesion interstitial cystitis/bladder pain syndrome

Suplatast tosilate in patients with interstitial cystitis: Efficacy and treatment possibilities, with suggestions for future assessments

Les critères diagnostiques de la vessie douloureuse

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