Abstract
Introduction: Bladder pain syndrome/interstitial cystitis (BPS/IC) is either Hunner lesion interstitial cystitis (HL IC) or non-Hunner lesion interstitial cystitis (N-HL IC), differing in the presence of HLs on cystoscopy. Cystoscopy is essential in diagnosing HL but are bladder biopsies useful in N-HL IC patients? Our objective was to assess bladder biopsy in patients with N-HL IC, evaluating whether the count of mast cells (MCs) and percentage of activated MCs could measure severity. Materials and Methods: This is a single-centre retrospective study. Inclusion criteria: diagnosis of BPS/IC by ESSIC definition; absence of HLs. Each patient had three bladder biopsies. Statistical analysis: χ2/Fischer’s exact test; Wilcoxon signed-ranks test/Mann-Whitney U test. Statistical significance: p < 0.05. Results: We separated 48 women into Group 1 with <50% of MCs activated and Group 2 with >50%. We compared the results of the O’Leary-Sant questionnaire between the two groups and did not find any correlation between the severity of the pathology and either the MC count in the detrusor or the percentage of activated MCs in the lamina propria or detrusor. Discussion/Conclusion: These findings cast doubt on the usefulness of bladder biopsy for the evaluation of severity in N-HL IC.
References
1.
Bogart
LM
, Berry
SH
, Clemens
JQ
. Symptoms of interstitial cystitis, painful bladder syndrome and similar diseases in women: a systematic review
. J Urol
. 2007
;177
(2
):450
–6
.2.
van de Merwe
JP
, Nordling
J
, Bouchelouche
P
, Bouchelouche
K
, Cervigni
M
, Daha
LK
, . Diagnostic criteria, classification, and nomenclature for painful bladder syndrome/interstitial cystitis: an ESSIC proposal
. Eur Urol
. 2008
;53
(1
):60
–7
.3.
Berry
SH
, Elliott
MN
, Suttorp
M
, Bogart
LM
, Stoto
MA
, Eggers
P
, . Prevalence of symptoms of bladder pain syndrome/interstitial cystitis among adult females in the United States
. J Urol
. 2011
;186
(2
):540
–4
.4.
Konkle
KS
, Berry
SH
, Elliott
MN
, Hilton
L
, Suttorp
MJ
, Clauw
DJ
, . Comparison of an interstitial cystitis/bladder pain syndrome clinical cohort with symptomatic community women from the RAND Interstitial Cystitis Epidemiology study
. J Urol
. 2012
;187
(2
):508
–12
.5.
Engeler
DS
, Baranowski
AP
, Dinis-Oliveira
P
, Elneil
S
, Hughes
J
, Messelink
EJ
, . The 2013 EAU guidelines on chronic pelvic pain: is management of chronic pelvic pain a habit, a philosophy, or a science? 10 years of development
. Eur Urol
. 2013
;64
(3
):431
–9
.6.
Management of bladder pain syndrome: green-top guideline no. 70
. BJOG
. 2017
;124
(2
):e46
–72
.7.
Cox
A
, Golda
N
, Nadeau
G
, Curtis Nickel
J
, Carr
L
, Corcos
J
, . CUA guideline: diagnosis and treatment of interstitial cystitis/bladder pain syndrome
. Can Urol Assoc J
. 2016
;10
(5–6
):E136
–55
.8.
Hanno
PM
, Erickson
D
, Moldwin
R
, Faraday
MM
; American Urological Association
. Diagnosis and treatment of interstitial cystitis/bladder pain syndrome: AUA guideline amendment
. J Urol
. 2015
;193
(5
):1545
–53
.9.
Hanno
P
, Lin
A
, Nordling
J
, Nyberg
L
, van Ophoven
A
, Ueda
T
, . Bladder pain syndrome committee of the international consultation on incontinence
. Neurourol Urodyn
. 2010
;29
(1
):191
–8
.10.
Payne
RA
, O’Connor
RC
, Kressin
M
, Guralnick
ML
. Endoscopic ablation of Hunner’s lesions in interstitial cystitis patients
. Can Urol Assoc J
. 2009
;3
(6
):473
–7
.11.
Fall
M
, Logadottir
Y
, Peeker
R
. Interstitial cystitis is bladder pain syndrome with Hunner’s lesion
. Int J Urol
. 2014
;21
(Suppl 1
):79
–82
.12.
Ko
KJ
, Cho
WJ
, Lee
YS
, Choi
J
, Byun
HJ
, Lee
KS
. Comparison of the efficacy between transurethral coagulation and transurethral resection of Hunner lesion in interstitial cystitis/bladder pain syndrome patients: a prospective randomized controlled trial
. Eur Urol
. 2020
;77
(5
):644
–51
.13.
Hand
JR
. Interstitial cystitis; report of 223 cases (204 women and 19 men)
. J Urol
. 1949
;61
(2
):291
–310
.14.
Nordling
J
, Anjum
FH
, Bade
JJ
, Bouchelouche
K
, Bouchelouche
P
, Cervigni
M
, . Primary evaluation of patients suspected of having interstitial cystitis (IC)
. Eur Urol
. 2004
;45
(5
):662
–9
.15.
Jiang
YH
, Kuo
HC
. Development of bladder glomerulations after hydrodistension in patients with upper urinary tract urolithiasis suggesting cross talk and bladder inflammation occur between upper and lower urinary tract
. Int J Urol
. 2014
;21
:A14
; Abstr. PO-07.16.
Waxman
JA
, Sulak
PJ
, Kuehl
TJ
. Cystoscopic findings consistent with interstitial cystitis in normal women undergoing tubal ligation
. J Urol
. 1998
;160
(5
):1663
–7
.17.
Richter
B
, Hesse
U
, Hansen
AB
, Horn
T
, Mortensen
SO
, Nordling
J
. Bladder pain syndrome/interstitial cystitis in a Danish population: a study using the 2008 criteria of the European Society for the Study of Interstitial Cystitis
. BJU Int
. 2010
;105
(5
):660
–7
.18.
Wyndaele
JJ
, Van Dyck
J
, Toussaint
N
. Cystoscopy and bladder biopsies in patients with bladder pain syndrome carried out following ESSIC guidelines
. Scand J Urol Nephrol
. 2009
;43
(6
):471
–5
.19.
Logadottir
Y
, Delbro
D
, Lindholm
C
, Fall
M
, Peeker
R
. Inflammation characteristics in bladder pain syndrome ESSIC type 3C/classic interstitial cystitis
. Int J Urol
. 2014
;21
(Suppl 1
):75
–8
.20.
Akiyama
Y
, Homma
Y
, Maeda
D
. Pathology and terminology of interstitial cystitis/bladder pain syndrome: a review
. Histol Histopathol
. 2019
;34
(1
):25
–32
.21.
Maeda
D
, Akiyama
Y
, Morikawa
T
, Kunita
A
, Ota
Y
, Katoh
H
, . Hunner-type (classic) interstitial cystitis: a distinct inflammatory disorder characterized by pancystitis, with frequent expansion of clonal B-cells and epithelial denudation
. PLoS One
. 2015
;10
(11
):e0143316
.22.
O’Leary
MP
, Sant
GR
, Fowler
FJ
Jr, Whitmore
KE
, Spolarich-Kroll
J
. The interstitial cystitis symptom index and problem index
. Urology
. 1997
;49
(5A Suppl
):58
–63
.23.
Kushner
L
, Moldwin
RM
. Efficiency of questionnaires used to screen for interstitial cystitis
. J Urol
. 2006
;176
(2
):587
–92
.24.
Xu
L
, Zhang
P
, Zhang
N
, Yang
Y
, Wu
ZJ
, Zhang
CH
, . [Efficiency of O’Leary-Sant symptom index and problem index in the diagnosis of interstitial cystitis]
. Zhonghua Yi Xue Za Zhi
. 2013 Nov 12
;93
(42
):3347
–50
. Chinese.25.
Malde
S
, Palmisani
S
, Al-Kaisy
A
, Sahai
A
. Guideline of guidelines: bladder pain syndrome
. BJU Int
. 2018
;122
(5
):729
–43
.26.
Rigaud
J
, Delavierre
D
, Sibert
L
, Labat
JJ
. Hydrodistension in the therapeutic management of painful bladder syndrome
. Prog Urol
. 2010
;20
(12
):1054
–9
.27.
Horny
HP
, Sotlar
K
, Valent
P
. Mastocytosis: immunophenotypical features of the transformed mast cells are unique among hematopoietic cells
. Immunol Allergy Clin N Am
. 2014
;34
(2
):315
–21
.28.
Wennevik
GE
, Meijlink
JM
, Hanno
P
, Nordling
J
. The role of glomerulations in bladder pain syndrome: a review
. J Urol
. 2016
;195
(1
):19
–25
.29.
Sant
GR
, Kempuraj
D
, Marchand
JE
, Theoharides
TC
. The mast cell in interstitial cystitis: role in pathophysiology and pathogenesis
. Urology
. 2007
;69
(4 Suppl
):34
–40
.30.
Theoharides
TC
, Kempuraj
D
, Sant
GR
. Mast cell involvement in interstitial cystitis: a review of human and experimental evidence
. Urology
. 2001
;57
(6 Suppl 1
):47
–55
.31.
Akiyama
Y
, Luo
Y
, Hanno
PM
, Maeda
D
, Homma
Y
. Interstitial cystitis/bladder pain syndrome: the evolving landscape, animal models and future perspectives
. Int J Urol
. 2020
;27
(6
):491
–503
.© 2022 S. Karger AG, Basel
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
2022
You do not currently have access to this content.
