BACKGROUND Interstitial cystitis/bladder pain syndrome(IC/BPS)is an at least 6-mo noninfectious bladder inflammation of unknown origin characterized by chronic suprapubic,abdominal,and/or pelvic pain.Although the term...BACKGROUND Interstitial cystitis/bladder pain syndrome(IC/BPS)is an at least 6-mo noninfectious bladder inflammation of unknown origin characterized by chronic suprapubic,abdominal,and/or pelvic pain.Although the term cystitis suggests an inflammatory or infectious origin,no definite cause has been identified.It occurs in both sexes,but women are twice as much affected.AIM To systematically review evidence of psychiatric/psychological changes in persons with IC/BPS.METHODS Hypothesizing that particular psychological characteristics could underpin IC/BPS,we investigated in three databases the presence of psychiatric symptoms and/or disorders and/or psychological characteristics in patients with IC/BPS using the following strategy:("interstitial cystitis"OR"bladder pain syndrome")AND("mood disorder"OR depressive OR antidepressant OR depression OR depressed OR hyperthymic OR mania OR manic OR rapid cyclasterisk OR dysthymiasterisk OR dysphoriasterisk).RESULTS On September 27,2023,the PubMed search produced 223 articles,CINAHL 62,and the combined PsycLIT/PsycARTICLES/PsycINFO/Psychology and Behavioral Sciences Collection search 36.Search on ClinicalTrials.gov produced 14 studies,of which none had available data.Eligible were peer-reviewed articles reporting psychiatric/psychological symptoms in patients with IC/BPS,i.e.63 articles spanning from 2000 to October 2023.These studies identified depression and anxiety problems in the IC/BPS population,along with sleep problems and the tendency to catastrophizing.CONCLUSION Psychotherapies targeting catastrophizing and life stress emotional awareness and expression reduced perceived pain in women with IC/BPS.Such concepts should be considered when implementing treatments aimed at reducing IC/BPS-related pain.展开更多
Introduction: Hyperbaric oxygen therapy (HBO) is emerging as an alternative technique for treating refractory interstitial cystitis (IC). The theory is that the increased dissolved oxygen in the blood raises the level...Introduction: Hyperbaric oxygen therapy (HBO) is emerging as an alternative technique for treating refractory interstitial cystitis (IC). The theory is that the increased dissolved oxygen in the blood raises the levels of oxygen in the tissues and improves tissue healing. Other urological disorders such as radiation cystitis, Fournier’s gangrene and cyclophosphamide cystitis have also shown a good response to HBO therapy. Method: A literature search with the terms “interstitial cystitis”, “painful bladder syndrome” and “hyperbaric oxygen therapy” found four papers that have trialed HBO therapy in IC patients;three case series and one randomized control trial. Results: A total of 31 patients have been treated with HBO therapy. All four studies show a symptomatic improvement in pain, urgency, bladder capacity and O’Leary-Sant interstitial cystitis index. Urinary frequency only improved in three out of four of the trials. The percentage of patients considered as responders to treatment varied at 25%, 66.7%, 82% and 100%. Conclusion: Preliminary trials of HBO therapy seem to have a good patient response with effective symptomatic relief. The patient response rates varied greatly between the trials. This is due to each trial’s different definition of a “patient responder”. Further work in urology departments at HBO centers is required to further assess the benefits of HBO treatment in IC.展开更多
Purpose: The effectiveness of daily or weekly instillation of non-alkalinized lidocaine for patients suffering interstitial cystitis and/or bladder pain syndrome was evaluated retrospectively. Patients and methods: Fi...Purpose: The effectiveness of daily or weekly instillation of non-alkalinized lidocaine for patients suffering interstitial cystitis and/or bladder pain syndrome was evaluated retrospectively. Patients and methods: Five female patients (40 - 71 years old) diagnosed as interstitial cystitis by cystoscopic findings and a 68 year-old bladder pain syndrome patient were enrolled. All patients, having interstitial cystitis, had undergone hydrodistention therapy previously and had not improved their symptoms by empirical therapies. Daily or weekly (upon their severity of symptoms) intravesical instillation of 20 ml of 4% non-alkalinized (pH 6.0 - 7.0) lidocaine solution was performed for several times, and patients were asked to keep them in the bladder as long as two hours each time. Previous medications such as anti-cholinergic drugs and analgesics were continued according to patient's requirements and symptoms. The treatment effect was evaluated comparing O'Leary-Sant Symptom Index for interstitial cystitis patients and visual analog pain scale before and after the series of lidocaine therapies. Results: Instillation was made 6 to 16 times. Patients with interstitial cystitis improved their symptoms from O'Leary-Sant Symptom Index 17.5 to 10, Problem Index from 14.8 to 6 in an average. Crouching pain disappeared in all these patients after the instillation therapy. Severe interstitial cystitis findings on cystoscopy disappeared completely in one patient after the therapy. One patient having bladder pain syndrome reduced her analgesics use, and bladder-filling pain decreased from 7 to 3 as a visual analog scale score. One patient complained palpitation at 11th instillation and abandoned treatment thereafter, otherwise, none of these patients showed side effect concerning lidocaine toxicity. Conclusions: Intravesical non-alkalinized lidocaine instillation therapy for interstitial cystitis/bladder pain syndrome patients were an easy, safe and effective treatment.展开更多
Interstitial cystitis/bladder pain syndrome(IC/BPS)is a debilitating,chronic condition characterized by chronic pelvic pain,urinary urgency,and frequency and is well-known to be associated with a decrease in work prod...Interstitial cystitis/bladder pain syndrome(IC/BPS)is a debilitating,chronic condition characterized by chronic pelvic pain,urinary urgency,and frequency and is well-known to be associated with a decrease in work productivity,emotional changes,sleep,sexual dysfunction,and mobility.Many metrics of quality of life(QoL)in this patient population have been developed;however,a unified,standardized approach to QoL in these patients has not been determined.The effects of IC/BPS and co-morbid conditions on QoL are described using current validated metrics.Next,data regarding successful treatment of IC/BPS in terms of QoL improvement are reviewed.While QoL is the single most important clinical measure of success in the treatment of patients suffering from IC/BPS,addressing QoL in this patient population remains a significant challenge,as its effects on QoL are highly variable and unable to be differentiated from the effects of comorbid conditions on QoL,including depression,poor sleep,and inability to work.Future studies will need to address treatment efficacy on the basis of IC/BPS specific QoL metrics,and multi-modal assessment and therapy to address comorbid disease will also play an important role in the future to ensure comprehensive management of these patients.展开更多
Objective:The aim of this study was to evaluate the feasibility of intravesical instillation of platelet-rich plasma(PRP)to treat interstitial cystitis/bladder pain syndrome(IC/BPS).Materials and methods:Twenty PRP sa...Objective:The aim of this study was to evaluate the feasibility of intravesical instillation of platelet-rich plasma(PRP)to treat interstitial cystitis/bladder pain syndrome(IC/BPS).Materials and methods:Twenty PRP samples were tested in vitro for stability after exposure to urine samples with different pH.A pilot study involving 21 female patients with IC/BPS was conducted,and 6 weekly doses of autologous PRP(50 mL)were administered.Patients were followed up at the 2nd,4th,8th,and 12th weeks after terminating instillation.The primary endpoint was the visual analog scale(VAS)for pain,and the secondary endpoints included the IC symptom index,IC problem index of the O'Leary-Sant questionnaire and global response assessment,urine culture,and uroflowmetry.Success was defined as a reduction in VAS by 30%or more compared with basal level,and adverse events were recorded.Results:The mean±SD of VAS was significantly reduced compared with basal level(4.4±2.6 vs.8.8±1.1,respectively,p=0.001).Meanwhile,80%of cases were considered successful,with a 50.1%reduction in the mean score compared with the basal level.The mean±SD of IC symptom index and IC problem index significantly improved compared with the basal level.Global response assessment was markedly,moderately,and slightly improved in 2(10%),10(50%),and 5(25%)patients,respectively,and showed no change in 3(15%).Three patients had positive urine cultures at follow-up,but 1 withdrew after 2 sessions because of a lack of efficacy.Conclusions:Repeated intravesical instillation of PRP could be considered an effective and safe approach for treating IC/BPS.展开更多
Background Despite 100 years of research, the continued absence of well-established risk factors impedes the diagnosis and treatment of interstitial cystitis/painful bladder syndrome （IC/PBS）. We aimed to identify r...Background Despite 100 years of research, the continued absence of well-established risk factors impedes the diagnosis and treatment of interstitial cystitis/painful bladder syndrome （IC/PBS）. We aimed to identify risk factors in patients with lower urinary tract symptoms （LUTS） without urinary tract infection or benign prostate hyperplasia in China.Methods A total of 397 outpatients with LUTS presenting for care to urology clinics in several hospitals throughout China were surveyed using a standardized questionnaire and validated outcome measures. The definitions for painful bladder syndrome based on the O‘Leary-Sant interstitial cystitis symptom and problem indices were used. The prevalence of possible risk factors was analyzed using the Fisher＇s exact test and Pearson chi-square test, and multivariate predictive models were developed using binary Logistic regression methods.Results Of those multi-centre patients surveyed, including 174 women and 223 men, 41% （162/397） met criteria for painful bladder syndrome. There was a significant difference between women and men （55% （95/174） vs. 30% （67/223）,P 〈0.001）. Women with IC/PBS were more likely than those without IC/PBS to report a history of gynecological infections （odds ratio （OR）： 2.85; 95% confidence interval （CI）： 1.32-6.16, P=0.007）, intake of stimulatory foods （OR： 3.52; 95% CI：1.50-8.30; P=0.004）, irritable bowel （OR： 3.46; 95% CI： 1.22-9.80; P=0.014） and/or anorectal disease （OR： 2.68; 95% CI：1.12-6.40, P=0.023）. After adjusting for confounding factors, bladder pain was significantly associated with stimulatory foods （OR： 3.85; 95% CI： 1.58-9.36, P=0.003） and anorectal disease （OR： 2.76; 95% CI： 1.09-7.04, P=0.03） in women.Caffeine beverage intake （OR： 3.54; 95% CI： 1.54-8.12, P=0.003） was identified the only modifiable association noted in multivariate analysis of men.Conclusions We found that stimutatory foods, anorectal disease and caffeine beverages are potential risk factors for IC/PBS. Further studies are necessary to determine their role in the pathogenesis of this disorder.展开更多
文摘BACKGROUND Interstitial cystitis/bladder pain syndrome(IC/BPS)is an at least 6-mo noninfectious bladder inflammation of unknown origin characterized by chronic suprapubic,abdominal,and/or pelvic pain.Although the term cystitis suggests an inflammatory or infectious origin,no definite cause has been identified.It occurs in both sexes,but women are twice as much affected.AIM To systematically review evidence of psychiatric/psychological changes in persons with IC/BPS.METHODS Hypothesizing that particular psychological characteristics could underpin IC/BPS,we investigated in three databases the presence of psychiatric symptoms and/or disorders and/or psychological characteristics in patients with IC/BPS using the following strategy:("interstitial cystitis"OR"bladder pain syndrome")AND("mood disorder"OR depressive OR antidepressant OR depression OR depressed OR hyperthymic OR mania OR manic OR rapid cyclasterisk OR dysthymiasterisk OR dysphoriasterisk).RESULTS On September 27,2023,the PubMed search produced 223 articles,CINAHL 62,and the combined PsycLIT/PsycARTICLES/PsycINFO/Psychology and Behavioral Sciences Collection search 36.Search on ClinicalTrials.gov produced 14 studies,of which none had available data.Eligible were peer-reviewed articles reporting psychiatric/psychological symptoms in patients with IC/BPS,i.e.63 articles spanning from 2000 to October 2023.These studies identified depression and anxiety problems in the IC/BPS population,along with sleep problems and the tendency to catastrophizing.CONCLUSION Psychotherapies targeting catastrophizing and life stress emotional awareness and expression reduced perceived pain in women with IC/BPS.Such concepts should be considered when implementing treatments aimed at reducing IC/BPS-related pain.
文摘Introduction: Hyperbaric oxygen therapy (HBO) is emerging as an alternative technique for treating refractory interstitial cystitis (IC). The theory is that the increased dissolved oxygen in the blood raises the levels of oxygen in the tissues and improves tissue healing. Other urological disorders such as radiation cystitis, Fournier’s gangrene and cyclophosphamide cystitis have also shown a good response to HBO therapy. Method: A literature search with the terms “interstitial cystitis”, “painful bladder syndrome” and “hyperbaric oxygen therapy” found four papers that have trialed HBO therapy in IC patients;three case series and one randomized control trial. Results: A total of 31 patients have been treated with HBO therapy. All four studies show a symptomatic improvement in pain, urgency, bladder capacity and O’Leary-Sant interstitial cystitis index. Urinary frequency only improved in three out of four of the trials. The percentage of patients considered as responders to treatment varied at 25%, 66.7%, 82% and 100%. Conclusion: Preliminary trials of HBO therapy seem to have a good patient response with effective symptomatic relief. The patient response rates varied greatly between the trials. This is due to each trial’s different definition of a “patient responder”. Further work in urology departments at HBO centers is required to further assess the benefits of HBO treatment in IC.
文摘Purpose: The effectiveness of daily or weekly instillation of non-alkalinized lidocaine for patients suffering interstitial cystitis and/or bladder pain syndrome was evaluated retrospectively. Patients and methods: Five female patients (40 - 71 years old) diagnosed as interstitial cystitis by cystoscopic findings and a 68 year-old bladder pain syndrome patient were enrolled. All patients, having interstitial cystitis, had undergone hydrodistention therapy previously and had not improved their symptoms by empirical therapies. Daily or weekly (upon their severity of symptoms) intravesical instillation of 20 ml of 4% non-alkalinized (pH 6.0 - 7.0) lidocaine solution was performed for several times, and patients were asked to keep them in the bladder as long as two hours each time. Previous medications such as anti-cholinergic drugs and analgesics were continued according to patient's requirements and symptoms. The treatment effect was evaluated comparing O'Leary-Sant Symptom Index for interstitial cystitis patients and visual analog pain scale before and after the series of lidocaine therapies. Results: Instillation was made 6 to 16 times. Patients with interstitial cystitis improved their symptoms from O'Leary-Sant Symptom Index 17.5 to 10, Problem Index from 14.8 to 6 in an average. Crouching pain disappeared in all these patients after the instillation therapy. Severe interstitial cystitis findings on cystoscopy disappeared completely in one patient after the therapy. One patient having bladder pain syndrome reduced her analgesics use, and bladder-filling pain decreased from 7 to 3 as a visual analog scale score. One patient complained palpitation at 11th instillation and abandoned treatment thereafter, otherwise, none of these patients showed side effect concerning lidocaine toxicity. Conclusions: Intravesical non-alkalinized lidocaine instillation therapy for interstitial cystitis/bladder pain syndrome patients were an easy, safe and effective treatment.
文摘Interstitial cystitis/bladder pain syndrome(IC/BPS)is a debilitating,chronic condition characterized by chronic pelvic pain,urinary urgency,and frequency and is well-known to be associated with a decrease in work productivity,emotional changes,sleep,sexual dysfunction,and mobility.Many metrics of quality of life(QoL)in this patient population have been developed;however,a unified,standardized approach to QoL in these patients has not been determined.The effects of IC/BPS and co-morbid conditions on QoL are described using current validated metrics.Next,data regarding successful treatment of IC/BPS in terms of QoL improvement are reviewed.While QoL is the single most important clinical measure of success in the treatment of patients suffering from IC/BPS,addressing QoL in this patient population remains a significant challenge,as its effects on QoL are highly variable and unable to be differentiated from the effects of comorbid conditions on QoL,including depression,poor sleep,and inability to work.Future studies will need to address treatment efficacy on the basis of IC/BPS specific QoL metrics,and multi-modal assessment and therapy to address comorbid disease will also play an important role in the future to ensure comprehensive management of these patients.
文摘Objective:The aim of this study was to evaluate the feasibility of intravesical instillation of platelet-rich plasma(PRP)to treat interstitial cystitis/bladder pain syndrome(IC/BPS).Materials and methods:Twenty PRP samples were tested in vitro for stability after exposure to urine samples with different pH.A pilot study involving 21 female patients with IC/BPS was conducted,and 6 weekly doses of autologous PRP(50 mL)were administered.Patients were followed up at the 2nd,4th,8th,and 12th weeks after terminating instillation.The primary endpoint was the visual analog scale(VAS)for pain,and the secondary endpoints included the IC symptom index,IC problem index of the O'Leary-Sant questionnaire and global response assessment,urine culture,and uroflowmetry.Success was defined as a reduction in VAS by 30%or more compared with basal level,and adverse events were recorded.Results:The mean±SD of VAS was significantly reduced compared with basal level(4.4±2.6 vs.8.8±1.1,respectively,p=0.001).Meanwhile,80%of cases were considered successful,with a 50.1%reduction in the mean score compared with the basal level.The mean±SD of IC symptom index and IC problem index significantly improved compared with the basal level.Global response assessment was markedly,moderately,and slightly improved in 2(10%),10(50%),and 5(25%)patients,respectively,and showed no change in 3(15%).Three patients had positive urine cultures at follow-up,but 1 withdrew after 2 sessions because of a lack of efficacy.Conclusions:Repeated intravesical instillation of PRP could be considered an effective and safe approach for treating IC/BPS.
文摘Background Despite 100 years of research, the continued absence of well-established risk factors impedes the diagnosis and treatment of interstitial cystitis/painful bladder syndrome （IC/PBS）. We aimed to identify risk factors in patients with lower urinary tract symptoms （LUTS） without urinary tract infection or benign prostate hyperplasia in China.Methods A total of 397 outpatients with LUTS presenting for care to urology clinics in several hospitals throughout China were surveyed using a standardized questionnaire and validated outcome measures. The definitions for painful bladder syndrome based on the O‘Leary-Sant interstitial cystitis symptom and problem indices were used. The prevalence of possible risk factors was analyzed using the Fisher＇s exact test and Pearson chi-square test, and multivariate predictive models were developed using binary Logistic regression methods.Results Of those multi-centre patients surveyed, including 174 women and 223 men, 41% （162/397） met criteria for painful bladder syndrome. There was a significant difference between women and men （55% （95/174） vs. 30% （67/223）,P 〈0.001）. Women with IC/PBS were more likely than those without IC/PBS to report a history of gynecological infections （odds ratio （OR）： 2.85; 95% confidence interval （CI）： 1.32-6.16, P=0.007）, intake of stimulatory foods （OR： 3.52; 95% CI：1.50-8.30; P=0.004）, irritable bowel （OR： 3.46; 95% CI： 1.22-9.80; P=0.014） and/or anorectal disease （OR： 2.68; 95% CI：1.12-6.40, P=0.023）. After adjusting for confounding factors, bladder pain was significantly associated with stimulatory foods （OR： 3.85; 95% CI： 1.58-9.36, P=0.003） and anorectal disease （OR： 2.76; 95% CI： 1.09-7.04, P=0.03） in women.Caffeine beverage intake （OR： 3.54; 95% CI： 1.54-8.12, P=0.003） was identified the only modifiable association noted in multivariate analysis of men.Conclusions We found that stimutatory foods, anorectal disease and caffeine beverages are potential risk factors for IC/PBS. Further studies are necessary to determine their role in the pathogenesis of this disorder.
