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Destroyed bladders: Characterization of progressive inflammatory cystitis.
Anna Faris1, Giulia I Lane1, Rohit Mehra2
1Department of Urology, University of Michigan, Ann Arbor, Michigan, USA.
Neurourology and Urodynamics
|May 1, 2023
Summary
Progressive inflammatory cystitis (PIC) is a severe noninfectious bladder condition causing reduced capacity and urinary issues. Many patients require urinary diversion due to rapid disease progression.
Area of Science:
- Urology
- Pathology
- Inflammatory Diseases
Background:
- Noninfectious cystitis can present with severe, refractory symptoms.
- A subset of patients exhibits diffuse inflammation, reduced bladder capacity, and vesicoureteral reflux (VUR).
- This distinct clinical entity is termed progressive inflammatory cystitis (PIC).
Purpose of the Study:
- To describe the clinical phenotype of PIC.
- To report disease outcomes in patients with PIC.
- To detail the pathologic findings associated with PIC.
Main Methods:
- Retrospective cohort study of 46 patients with PIC.
- Exclusion criteria: pelvic radiation, urologic malignancy, neurogenic bladder.
- Bivariate analyses and Kaplan-Meier methods were used.
Main Results:
- Median age at symptom onset was 63 years; common symptoms included urgency/frequency and incontinence.
- Urodynamics revealed a median bladder capacity of 80 mL, with frequent VUR (68%) and hydronephrosis (59%).
- Pathology showed ulceration, acute/chronic inflammation (80% eosinophils), lymphoid follicles, and mast cells.
Conclusions:
- PIC is a distinct entity with diminished bladder capacity and upper tract changes, progressing to urinary diversion.
- Further prospective studies are needed to characterize this severe phenotype.
- Earlier diagnosis and management strategies for PIC require further investigation.
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