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[Interstitial cystitis]

E Lechevallier1

  • 1Service d'Urologie et de Transplantation Rénale, Hôpital Salvator, Marseille.

Progres En Urologie : Journal De L'Association Francaise D'Urologie Et De La Societe Francaise D'Urologie
|February 1, 1995
PubMed
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Interstitial cystitis (IC) is a chronic bladder condition affecting middle-aged women, with pathogenesis theories including epithelial permeability and mast cell involvement. Diagnosis relies on clinical evaluation and specific investigations, with treatments ranging from conservative measures to surgery for refractory cases.

Area of Science:

  • Urology
  • Pathology
  • Immunology

Context:

  • Interstitial cystitis (IC) is a complex urological condition with a century-long history, primarily affecting middle-aged women.
  • Pathogenesis theories include a permeable bladder epithelium and mast cell activation, with additional contributing factors like vascular, neurological, infectious, and immune elements.
  • The disease follows a chronic course, and specific histological markers are lacking, though histology aids in excluding other bladder pathologies such as carcinoma in situ.

Purpose:

  • To provide a comprehensive overview of interstitial cystitis (IC), covering its classification challenges, pathogenesis theories, diagnostic approaches, and treatment modalities.
  • To highlight the diagnostic criteria for IC, emphasizing the importance of clinical examination, endoscopy, cystoscopy, and cystomanometry after excluding other conditions.
  • To outline the spectrum of treatment options for IC, from conservative management to surgical interventions for severe or refractory cases.

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Summary:

  • IC diagnosis is primarily clinical and endoscopic, necessitating exclusion of other diseases, with cystoscopy and cystomanometry as key investigations.
  • Conservative treatments include vesical hydrodistension, bladder retraining, DMSO instillations, and systemic sodium pentosanpolysulfate.
  • Surgical options, reserved for 1-5% of patients, involve ulcer coagulation, partial cystectomy with cystoplasty, or cystourethrectomy with urinary diversion for advanced cases.

Impact:

  • Improved understanding of IC pathogenesis and diagnostic pathways can lead to earlier and more accurate diagnoses.
  • Standardized diagnostic protocols and a range of treatment options can enhance patient management and quality of life.
  • Further research into the multifactorial causes of IC may yield more targeted and effective therapies, potentially reducing the need for invasive surgery.