Histological evidence supports low anesthetic bladder capacity as a marker of a bladder-centric disease subtype in interstitial cystitis/bladder pain syndrome
| Autor: | Graham E. Parks, Robert J. Evans, Stephen J. Walker, Gopal H. Badlani, Jeffrey S. Schachar, Joao Paulo Zambon |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Urology Urinary Bladder 030232 urology & nephrology Cystitis Interstitial Inflammation urologic and male genital diseases Article 03 medical and health sciences 0302 clinical medicine medicine Humans Aged Anesthetics Retrospective Studies 030219 obstetrics & reproductive medicine medicine.diagnostic_test business.industry Incidence (epidemiology) Obstetrics and Gynecology Interstitial cystitis Histology Cystoscopy Middle Aged medicine.disease Anesthetic Cohort Biomarker (medicine) Female medicine.symptom business medicine.drug |
| Zdroj: | Int Urogynecol J |
| ISSN: | 1433-3023 |
| Popis: | INTRODUCTION AND HYPOTHESIS: Low anesthetic bladder capacity has been shown to be a biomarker for bladder-centric interstitial cystitis/bladder pain syndrome (IC/BPS). The goal of this study was to determine if histopathological evidence from bladder biopsies support anesthetic bladder capacity (BC) as a marker to distinguish a bladder-centric IC/BPS subtype. METHODS: From a review of our large IC/BPS cohort of patients undergoing hydrodistention we identified a total of 41 patients with low BC (≤ 400 ml); an additional 41 consecutive patients with BC > 400mL were selected as the comparator group. The original bladder mucosal biopsy pathology slides were re-reviewed by a single pathologist (blinded to patient information) using a standardized grading scale developed for this study. RESULTS: Histologically the low BC subjects exhibited higher levels of acute inflammation (p = 0.0299), chronic inflammation (p = 0.0139), and erosion on microscopy (p = 0.0155), however there was no significant difference in mast cell count between groups (p=0.4431). There was no significant gender difference between the groups; female patients were the majority in both groups (low BC: 94.12%, non-low BC: 100%; p = 0.1246). Individuals in the low BC group were older (p < 0.0001), had a higher incidence of Hunner’s lesion on cystoscopy (p < 0.0001), and had significantly higher scores, i.e. more bother symptoms, on two IC/BPS questionnaires (ICPI, p = 0.0154; ICSI, p = 0.0005). CONCLUSIONS: IC/BPS patients with low anesthetic bladder capacity have histological evidence of significantly more acute and chronic inflammation when compared to patients with a non-low bladder capacity. These data provide additional evidence to support low bladder capacity as a marker of a distinct bladder-centric IC/BPS phenotype. |
| Databáze: | OpenAIRE |
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