Clinical guidelines for interstitial cystitis/bladder pain syndrome

被引：178

作者：

Homma, Yukio ^{[1
]}

Akiyama, Yoshiyuki ^{[2
]}

Tomoe, Hikaru ^{[3
]}

Furuta, Akira ^{[4
]}

Ueda, Tomohiro ^{[5
]}

Maeda, Daichi ^{[6
]}

Lin, Alex Tl ^{[7
]}

Kuo, Hann-Chorng ^{[8
]}

Lee, Ming-Huei ^{[9
]}

Oh, Seung-June ^{[10
]}

Kim, Joon Chul ^{[11
]}

Lee, Kyu-Sung ^{[12
]}

机构：

[1] Japanese Red Cross Med Ctr, Dept Urol, Tokyo, Japan

[2] Univ Tokyo, Grad Sch Med, Dept Urol, Tokyo, Japan

[3] Tokyo Womens Med Univ, Dept Urol, Med Ctr East, Tokyo, Japan

[4] Jikei Univ, Dept Urol, Sch Med, Tokyo, Japan

[5] Ueda Clin, Dept Urol, Kyoto, Japan

[6] Osaka Univ, Grad Sch Med, Dept Clin Genom, Osaka, Japan

[7] Natl Yang Ming Univ, Taipei Vet Gen Hosp, Dept Urol, Taipei, Taiwan

[8] Tzu Chi Univ, Buddhist Tzu Chi Gen Hosp, Sch Med, Dept Urol, Hualien, Taiwan

[9] Feng Yuan Hosp, Dept Urol, Taichung, Taiwan

[10] Seoul Natl Univ, Dept Urol, Seoul, South Korea

[11] Catholic Univ Korea, Dept Urol, Seoul, South Korea

[12] Sungkyunkwan Univ, Samsung Med Ctr, Dept Urol, Sch Med, Seoul, South Korea

来源：

INTERNATIONAL JOURNAL OF UROLOGY | 2020年 / 27卷 / 07期

基金：

日本学术振兴会;

关键词：

bladder pain syndrome; guidelines; Hunner lesions; hypersensitive bladder symptoms; interstitial cystitis; PLACEBO-CONTROLLED TRIAL; CHRONIC PELVIC PAIN; BLADDER MAST-CELLS; SYNDROME/INTERSTITIAL CYSTITIS; HYPERSENSITIVE BLADDER; CHONDROITIN SULFATE; DOUBLE-BLIND; FEMALE-PATIENTS; EFFICACY; HYDRODISTENTION;

D O I：

10.1111/iju.14234

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

The clinical guidelines for interstitial cystitis and related symptomatic conditions were revised by updating our previous guidelines. The current guidelines define interstitial cystitis/bladder pain syndrome as a condition with chronic pelvic pain, pressure or discomfort perceived to be related to the urinary bladder accompanied by other urinary symptoms, such as persistent urge to void or urinary frequency in the absence of confusable diseases. The characteristic symptom complex is collectively referred as hypersensitive bladder symptoms. Interstitial cystitis/bladder pain syndrome is divided into Hunner-type interstitial cystitis and bladder pain syndrome; Hunner-type interstitial cystitis and bladder pain syndrome represent interstitial cystitis/bladder pain syndrome with Hunner lesions and interstitial cystitis/bladder pain syndrome without Hunner lesions, respectively. So-called non-Hunner-type interstitial cystitis featured by glomerulations or bladder bleeding after distension is included in bladder pain syndrome. The symptoms are virtually indistinguishable between Hunner-type interstitial cystitis and bladder pain syndrome; however, Hunner-type interstitial cystitis and bladder pain syndrome should be considered as a separate entity of disorder. Histopathology totally differs between Hunner-type interstitial cystitis and bladder pain syndrome; Hunner-type interstitial cystitis is associated with severe inflammation of the urinary bladder accompanied by lymphoplasmacytic infiltration and urothelial denudation, whereas bladder pain syndrome shows little pathological changes in the bladder. Pathophysiology would also differ between Hunner-type interstitial cystitis and bladder pain syndrome, involving interaction of multiple factors, such as inflammation, autoimmunity, infection, exogenous substances, urothelial dysfunction, neural hyperactivity and extrabladder disorders. The patients should be treated differently based on the diagnosis of Hunner-type interstitial cystitis or bladder pain syndrome, which requires cystoscopy to determine the presence or absence Hunner lesions. Clinical studies are to be designed to analyze outcomes separately for Hunner-type interstitial cystitis and bladder pain syndrome.

引用

页码：578 / 589

页数：12

共 128 条

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