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Interstitial cystitis: an updated overview.
Abstract
Interstitial cystitis (IC) is a chronic inflammatory condition of the bladder wall, characterized by pelvic pain, urinary urgency, and frequency. Its etiology is unknown. There are an estimated 700,000 cases of IC in the United States. IC remains a diagnosis of exclusion. Although there are no uniformly effective therapies, many treatment options are currently available. Current research is focused on the cause, diagnosis, and treatment of IC.
... 61 Women are more afflicted by FBS than men. 29,48,63,70 We demonstrated that male and female rats exposed to RLED developed nociception. However, although no difference was observed in the magnitude of the thermal hyperalgesia or mechanical allodynia between male and female rats, female rats developed mechanical allodynia faster than males. ...
... 61 Women are more afflicted by FBS than men. 29,48,63,70 We demonstrated that male and female rats exposed to RLED developed nociception. However, although no difference was observed in the magnitude of the thermal hyperalgesia or mechanical allodynia between male and female rats, female rats developed mechanical allodynia faster than males. ...
We report the development and characterization of a novel, injury-free rat model in which nociceptive sensitization after red light is observed in multiple body areas reminiscent of widespread pain in functional pain syndromes. Rats were exposed to red light-emitting diodes (RLED) (LEDs, 660 nm) at an intensity of 50 Lux for 8 hours daily for 5 days resulting in time- and dose-dependent thermal hyperalgesia and mechanical allodynia in both male and female rats. Females showed an earlier onset of mechanical allodynia than males. The pronociceptive effects of RLED were mediated through the visual system. RLED-induced thermal hyperalgesia and mechanical allodynia were reversed with medications commonly used for widespread pain, including gabapentin, tricyclic antidepressants, serotonin/norepinephrine reuptake inhibitors, and nonsteroidal anti-inflammatory drugs. Acetaminophen failed to reverse the RLED induced hypersensitivity. The hyperalgesic effects of RLED were blocked when bicuculline, a gamma-aminobutyric acid-A receptor antagonist, was administered into the rostral ventromedial medulla, suggesting a role for increased descending facilitation in the pain pathway. Key experiments were subjected to a replication study with randomization, investigator blinding, inclusion of all data, and high levels of statistical rigor. RLED-induced thermal hyperalgesia and mechanical allodynia without injury offers a novel injury-free rodent model useful for the study of functional pain syndromes with widespread pain. RLED exposure also emphasizes the different biological effects of different colors of light exposure. PERSPECTIVE: This study demonstrates the effect of light exposure on nociceptive thresholds. These biological effects of red LED add evidence to the emerging understanding of the biological effects of light of different colors in animals and humans. Understanding the underlying biology of red light-induced widespread pain may offer insights into functional pain states.
... A specific anti-proliferative factor (AFP) was found only in the urine of BPS/IC patients. AFP is the most widely studied biomarker, which is highly specific as well as being sensitive [3,13,232,[237][238][239][240]. However, there is no evidence of AFP expression during early phase detection of IC/PBS. ...
Purpose:
Interstitial cystitis/painful bladder syndrome (IC/PBS) is a chronic pain syndrome and a chronic inflammatory condition prevalent in women that leads to urgency, sleep disruption, nocturia and pain in the pelvic area, to the detriment of the sufferer's quality of life. The aim of this review is to highlight the newest diagnostic strategies and potential therapeutic techniques.
Methods:
A comprehensive literature review was performed on MEDLINE, PubMed, and Cochrane databases gathering all literature about "Interstitial cystitis" and "Painful Bladder Syndrome". Visual analogue scales, epidemiological strategies, pain questionnaires and similar techniques were not included in this literature survey.
Results:
The etiology, exact diagnosis and epidemiology of IC/PBS are still not clearly understood. To date, its prevalence is estimated to be in the range of 45 per 100,000 women and 8 per 100,000 men, whereas joint prevalence in both sexes is 10.6 cases per 100,000. There are no "gold standards" in the diagnosis or detection of IC/PBS, therefore, several etiological theories were investigated, such as permeability, glycosaminoglycans, mast cell, infection and neuroendocrine theory to find new diagnostic strategies and potential biomarkers.
Conclusion:
Due to the fact that this disease is of an intricate nature, and that many of its symptoms overlap with other concomitant diseases, it could be suggested to classify the patients with emphasis on the phenotype, as well as their symptom clusters, to tailor the diagnostic and management choices according to the observed biomarkers.
... Overdistension of bladder has nevertheless remained one of the widely used empirical method of treatment, despite its cytodestructive effects (50,51). The diversity of IC therapies underscores the lack of understanding about the treatment of this syndrome (52). The schematic chart shown in Fig.1.1 shows the current approved treatment of IC and new treatment options evaluated in this project. ...
Over the past two decades, there has been lot of interest in the use of liposomes as lipid-based biocompatible carriers for drugs administered by the intravesical route. The lipidic bilayer structure of liposomes facilitates their adherence to the apical membrane surface of luminal cells in the bladder, and their vesicular shape allows them to co-opt the endocytosis machinery for bladder uptake after instillation. Liposomes have been shown to enhance the penetration of both water-soluble and insoluble drugs, toxins, and oligonucleotides across the bladder epithelium. Empty liposomes composed entirely of the endogenous phospholipid, sphingomyelin, could counter mucosal inflammation and promote wound healing in patients suffering from interstitial cystitis. Recent clinical studies have tested multilamellar liposomes composed entirely of sphingomyelin as a novel intravesical therapy for interstitial cystitis. In addition, liposomes have been used as a delivery platform for the instillation of botulinum toxin in overactive bladder patients. The present review discusses the properties of liposomes that are important for their intrinsic therapeutic effect, summarizes the recently completed clinical studies with intravesical liposomes and covers the latest developments in this field.
Objective: We have proposed an analysis of personality traits to classify patients with interstitial cystitis/bladder pain syndrome (IC/BPS) to determine the association between symptoms, mood, and personality traits in IC/BPS patients.
Materials and methods: A total of 57 patients (7 males and 50 females) diagnosed according to the National Institute of Diabetes and Digestive and Kidney Diseases criteria were recruited from December 2005 to June 2006. All of these patients were newly diagnosed cases of IC/BPS, and the evaluation was made during the admission after hydrodistension. This study used the O'Leary–Sant Symptom Index and Problem Index (interstitial cystitis system index and interstitial cystitis problem index) to record the clinical symptoms of all IC/BPS patients. Basic Personality Inventory and Back Anxiety Inventory were used to analyze personality traits and mood status.
Results: IC/BPS patients have personality traits of depression and hypochondriasis, and show moderate anxiety mood. The duration of the symptoms is longer in depressive IC/BPS patients. Significant positive correlations were found among pain and anxiety mood, symptoms and interpersonal problems, and problem index and depression, respectively. Patients with severe anxiety mood status have abnormal personality traits such as depression, anxiety, self-depreciation, and others.
Conclusions: IC/BPS patients frequently exhibit several mental health disorders and negative personality traits. Therefore, in addition to targeting the bladder pathological condition, psychological intervention focusing on personality traits and anxiety mood status should be provided to improve quality of life of IC/BPS patients.
Interstitial cystitis (IC) is a chronic inflammatory condition of the bladder wall, characterized by pelvic pain, urinary urgency, and frequency. Its etiology is unknown. IC remains a diagnosis of exclusion. Although there are no uniformly effective therapies, many treatment options are currently available. We present an IC patient who successfully underwent LLLT using an 830 nm GaAlAs diode laser. After 40 LLLT treatment sessions, the interstitial symptom index total score which was previously 19 decreased to 8 and the interstitial problem index total score which was previous 15 decreased to 6. Symptoms of severe bladder irritation and pelvic pain, urinary urgency and frequency improved almost completely for an extended period. © 2007, International Phototherapy Association. All rights reserved.
Interstitial cystitis or painful bladder syndrome is a chronic and progressive disease of the lower urinary tract, distinguished by urinary urgency, frequency, and chronic pelvic pain. As a diagnosis of exclusion, interstitial cystitis is commonly misdiagnosed in the clinical setting given its variable symptom presentation, similarity to other gynecologic and urologic diseases, and lack of a definitive diagnostic test. Delay in diagnosis promotes disease progression and can lead to a decreased quality of life. Successful management of interstitial cystitis relies on the clinicians' ability to promptly diagnose the syndrome and initiate effective treatment interventions in the early stages of disease.
Interstitial cystitis (IC) is a condition that is difficult to diagnose. In some cases, it has taken 5years, and five doctors, before a correct diagnosis has occurred, with patients voiding up to 60 times per 24h. There is a wide variation in the prevalence rate, identifying the problems of diagnosing and reporting pelvic bladder syndrome/IC. This paper will identify the history and epidemiology of IC, analysis of the associated symptoms, diagnosis and treatments. © 2009 The Author. Journal compilation
The clinical use of exogenous polysaccharides for the treatment of interstitial cystitis (IC) has lent credence to the concept of a dysfunctional urothelium as the cause of lower urinary tract symptoms (LUTS). Studies have shown that lipids in the apical membrane of the urothelium form an integral component of the permeability barrier in the bladder. This premise is supported by the therapeutic effect of empty liposomes in the irritated bladder. Instillation of liposomes comprised of natural phospholipids can augment bladder barrier function and support repair following injury from protamine sulfate and irritation with high potassium concentration. The mechanism of action proposed for the therapeutic effect of empty liposomes is that liposomes form a coat on the injured urothelium and block irritation of submucosal afferent nerves. Reduced afferent excitation after liposome instillation is reflected in prolonged intercontractile interval in cystometry. Liposomes offer a powerful new treatment option for IC using an intravesical route and as a platform for intravesical drug delivery.
The aim of this cross-sectional study was to report risk factors for painful bladder syndrome in women. We surveyed 645 women presenting for care to general gynecology clinics and a vulvar specialty clinic using a standardized questionnaire and validated outcome measures. We used two definitions for painful bladder syndrome, based on the O'Leary-Sant interstitial cystitis symptom and problem indices. Of those women surveyed, 29.5% met broader criteria and 8.5% met more restrictive criteria for painful bladder syndrome. After adjusting for confounders, bladder pain was significantly associated with current smoking, irritable bowel syndrome, and a generalized pain disorder. Tobacco use, the only modifiable association noted on multivariate analysis, has not been previously identified to our knowledge.
Interstitial cystitis (IC) is a disabling bladder disorder that leads patients on an endless journey in search of treatment options to control their painful symptoms. Although there are some medical treatments available, no one treatment is completely effective. The Neuman model provides the rationale for the use of holistic prevention interventions with IC patients. Holistic interventions can help IC patients to retain, attain, and maintain system stability. A case study of 1 IC patient, who successfully used holistic approaches to achieve system stability, is described.
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