Detrusor mast cells in refractory idiopathic instability
K H Moore1, P Nickson, D H Richmond
1Department of Obstetrics and Gynaecology, University of Liverpool.
British Journal of Urology
|July 1, 1992
Summary
Interstitial cystitis (IC) may be a cause of refractory bladder instability in women. Increased bladder mast cells, a sign of IC, were found in 29% of patients, suggesting further diagnostic investigation.
Area of Science:
- Urology
- Histology
Background:
- Idiopathic bladder instability is common.
- Interstitial cystitis (IC) diagnosis is often overlooked in these patients.
- Histamine is known to provoke detrusor muscle contractions.
Purpose of the Study:
- To investigate the prevalence of increased detrusor mast cell counts in women with refractory idiopathic bladder instability.
- To explore the potential link between mast cell activation and bladder instability.
- To determine if histological examination aids in diagnosing IC in such cases.
Main Methods:
- Assessed detrusor mast cell counts in 29 females with refractory instability.
- Utilized cystoscopy and bladder biopsy for histological diagnosis.
- Compared mast cell counts with patient history, including childhood nocturnal enuresis.
Main Results:
- Elevated mast cell counts (≥28/mm2), indicative of IC, were observed in 29% of patients.
- Patients with normal mast cell counts frequently reported a history of prolonged childhood nocturnal enuresis (55%).
- Patients with high mast cell counts rarely reported childhood nocturnal enuresis (12%).
Conclusions:
- Interstitial cystitis should be considered in the differential diagnosis of refractory idiopathic bladder instability.
- Bladder biopsy may reveal IC in patients unresponsive to anticholinergic therapy.
- Childhood nocturnal enuresis history may differentiate etiological pathways of bladder instability.
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