Bladder pain syndrome: do the different morphological and cystoscopic features correlate?

Area of Science:

• Urology
• Pathology
• Histology

Background:

• Bladder pain syndrome (BPS) diagnosis relies on cystoscopy with hydrodistension and biopsies per ESSIC guidelines.
• Evaluating the correlation between histological findings and cystoscopic results in BPS is crucial.

Purpose of the Study:

• To assess the correlation between histological findings in bladder biopsies and cystoscopic findings in BPS patients.
• To determine the significance of histological features in BPS diagnosis.

Main Methods:

• 108 patients (15 men, 93 women) with BPS underwent cystoscopy with hydrodistension.
• At least three deep bladder biopsies including detrusor muscle were obtained.
• Leder stain was used for cell count, with a 28 mast cells/mm² cut-off for detrusor mastocytosis.

Main Results:

• Significant correlation found between urothelial damage and inflammatory infiltrate (p < 0.001).
• Detrusor mastocytosis was higher in normal urothelium compared to damaged urothelium (p < 0.0001).
• No other significant correlations were observed between histological or between histological and cystoscopic findings.

Conclusions:

• Cystoscopy with hydrodistension and histology reveal distinct pathophysiological mechanisms in BPS.
• Combined use of cystoscopy and histology aids in the classification of BPS patients.