Interstitial cystitis: an update
| Autor: | Lothar Hertle, Arndt van Ophoven, Frank Oberpenning |
|---|---|
| Rok vydání: | 2002 |
| Předmět: |
medicine.medical_specialty
Urinary bladder medicine.diagnostic_test business.industry Urology Cystitis Interstitial Interstitial cystitis Evidence-based medicine Cystoscopy Disease medicine.disease Disease Models Animal Urodynamics medicine.anatomical_structure Pathognomonic Biopsy Quality of Life medicine Etiology Animals Humans Intensive care medicine business |
| Zdroj: | Current Opinion in Urology. 12:321-332 |
| ISSN: | 0963-0643 |
| Popis: | PURPOSE OF REVIEW Interstitial cystitis is a chronically progressive, severely debilitating, heterogeneous syndrome affecting the urinary bladder, mainly associated with urgency, frequency and pain. Though known for over a century, its etiology is poorly understood and universally effective treatments are lacking. This review focuses on recently published literature on the disorder. RECENT FINDINGS Appropriate diagnostic tests for interstitial cystitis remain uncertain. The diagnostic criteria developed by the US National Institutes of Health represent research definitions which are subject to controversial debate for their overenthusiastic clinical application. The diagnosis is made clinically and by cystoscopy with hydrodistention and sometimes biopsy when other pathologies have been excluded. In symptomatic patients, glomerulations upon bladder distension are indicative but not pathognomonic for nonulcerative interstitial cystitis. Patients with ulcerative disease represent a separate subgroup with distinct characteristics and treatment implications. The role of bladder permeability tests remains controversial. Promising noninvasive markers for interstitial cystitis have been described but are not yet clinically available. Validated symptom scores are appropriate to assist in diagnostics and to monitor disease course and treatment efficacy. Lately investigated hypotheses for causative factors include occult or resistant microorganisms, urothelial hyperpermeability, neurogenic or hormonal pathomechanisms, and mast cell activation. Increasing evidence for a genetic susceptibility is emerging. SUMMARY Among the multitude of oral, intravesical, interventional and complementary treatments suggested few studies have high levels of evidence. Newly proposed agents must await further controlled studies. Treatment remains empiric until radical surgical procedures should ultimately be considered for severe refractory cases. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|