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Pathology of interstitial cystitis.

Anna Rosamilia1, Yasuhiko Igawa, Shin Higashi

  • 1annarosamilia@bigpond.com

International Journal of Urology : Official Journal of the Japanese Urological Association
|December 3, 2003
PubMed
Summary

Pathology plays a limited role in diagnosing interstitial cystitis (IC), a condition defined by clinical criteria. While some findings suggest a link to disease severity, bladder biopsies are not mandatory for IC diagnosis.

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Area of Science:

  • Urology
  • Pathology
  • Medical Diagnostics

Background:

  • Interstitial cystitis (IC) is currently diagnosed using clinical criteria established by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
  • Bladder biopsy and histological examination are not required for the routine clinical diagnosis of IC.
  • Existing literature indicates common, yet non-specific and non-universal, pathological findings in IC, including epithelial changes and inflammation.

Purpose of the Study:

  • To evaluate the role of pathology in the diagnosis and management of interstitial cystitis (IC).
  • To review common pathological findings in IC and their association with disease severity.
  • To reach a consensus on the utility of bladder biopsy in the clinical work-up of IC patients.

Main Methods:

  • Workshop discussion involving participants considering the role of pathology in IC.
  • Literature review of pathological findings in interstitial cystitis.
  • Presentations on the association between pathology and disease severity.

Main Results:

  • Pathological changes in IC are not universally present or specific; some studies show normal histology in up to 55% of IC patients.
  • Abnormal pathology appears to correlate with more severe IC symptoms, lower cystoscopic capacity, and poorer prognosis.
  • The decision to perform bladder biopsy varies based on geographical factors, research interests, and the need to rule out malignancy.

Conclusions:

  • Bladder biopsy is considered a non-mandatory, optional test for interstitial cystitis (IC) diagnosis.
  • Urine cytology is recommended for all IC patients.
  • Bladder biopsy may be valuable for research and when other conditions are suspected, potentially aiding in understanding pathogenic processes and future etiology determination.

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