nach oben

Erschienen in:

28.10.2019 | Zystitis | Leitlinien der DGU

Diagnostik und Therapie der interstitiellen Zystitis (IC/BPS)

S2k-Leitlinie der Deutschen Gesellschaft für Urologie

verfasst von: Prof. Dr. med. Dr. phil. T. Bschleipfer, F.E.B.U., R. Doggweiler, D. Schultz-Lampel, J. de Jong, A. Gonsior, J. Hensen, E. Heßdörfer, B. T. Kaftan, A. Kuhn, U. Kunzendorf, A. Lampel, A. Landmesser, A. Loch, O. Moormann, B. Müller, J. Neuhaus, A. Reich, R. Roth, S. Schumacher, R. Stratmeyer, W. Vahlensieck, A. Wördehoff, B. Münder-Hensen

Erschienen in: Die Urologie | Ausgabe 11/2019

Einloggen, um Zugang zu erhalten

Zusammenfassung

Dieser Übersichtsartikel beschreibt alle relevanten Aspekte entsprechend der neuen S2k-Leitlinie der Deutschen Gesellschaft für Urologie (DGU) zur Diagnostik und Behandlung der IC/BPS (interstitielle Zystitis/Blasenschmerzsyndrom). Eine Aufstellung notwendiger und optionaler Untersuchungen und der Notwendigkeit einer Ausschlussdiagnostik werden zusammenfassend dargestellt und gewertet. Auch entsprechend aufgelistete Therapieoptionen (von konservativen, oral-medikamentösen, komplementär-medizinischen bis hin zu intravesikalen und interventionell-operativen Verfahren) geben dem Leser einen guten Überblick über die Inhalte der Leitlinie und möglicher therapeutischer Ansätze. Letztlich werden auch Übersichten der Empfehlungen inklusive Konsens der Leitliniengruppe in verschiedenen Infoboxen beschrieben.

Akiyama Y, Nomiya A, Niimi A et al (2015) Botulinum toxin type A injection for refractory interstitial cystitis: a randomized comparative study and predictors of treatment response. Int J Urol 22:835–841PubMed

Al-Zahrani AA, Gajewski JB (2011) Long-term efficacy and tolerability of pentosan polysulphate sodium in the treatment of bladder pain syndrome. Can Urol Assoc J 5:113–118PubMedPubMedCentral

Anderson RU, Wise D, Sawyer T et al (2016) Equal improvement in men and women in the treatment of urologic chronic pelvic pain syndrome using a multi-modal protocol with an internal myofascial trigger point wand. Appl Psychophysiol Biofeedback 41:215. https://doi.org/10.1007/s10484-015-9325-6 CrossRefPubMed

Bassaly R, Downes K, Hart S (2011) Dietary consumption triggers in interstitial cystitis/bladder pain syndrome patients. Female Pelvic Med Reconstr Surg 17:36–39PubMed

Bschleipfer T, Doggweiler R, Mündner-Hensen B et al (2018) Leitlinienreport zur S2k Leitlinie “Diagnostik und Therapie der Interstitiellen Zystitis (IC/BPS)” – AWMF Registry No. 043–050. https://www.awmf.org/leitlinien/detail/ll/043-050.html. Zugegriffen: 15.09.2019

Bschleipfer T, Doggweiler R, Mündner-Hensen B et al (2018) S2k Leitlinie „Diagnostik und Therapie der Interstitiellen Zystitis (IC/BPS)“ – AWMF Registry No. 043–050. https://www.awmf.org/leitlinien/detail/ll/043-050.html. Zugegriffen: 15.09.2019

Cervigni M, Natale F, Nasta L et al (2008) A combined intravesical therapy with hyaluronic acid and chondroitin for refractory painful bladder syndrome/interstitial cystitis. Int Urogynecol J Pelvic Floor Dysfunct 19:943–947PubMed

Chen H, Wang F, Chen W et al (2014) Efficacy of daily low-dose sildenafil for treating interstitial cystitis: results of a randomized, double-blind, placebo-controlled trial—treatment of interstitial cystitis/painful bladder syndrome with low-dose sildenafil. Urology 84:51–56PubMed

Cox M, Klutke JJ, Klutke CG (2009) Assessment of patient outcomes following submucosal injection of triamcinolone for treatment of Hunner’s ulcer subtype interstitial cystitis. Can J Urol 16:4536–4540PubMed

10.

Daha LK, Riedl CR, Hohlbrugger G et al (2003) Comparative assessment of maximal bladder capacity, 0.9 % NaCl versus 0.2 M Kcl, for the diagnosis of interstitial cystitis: a prospective controlled study. J Urol 170:807–809PubMed

11.

Dalpiaz O, Kerschbaumer A, Mitterberger M et al (2008) Chronic pelvic pain in women: still a challenge. BJU Int 102:1061–1065PubMed

12.

Dasgupta P, Sharma SD, Womack C et al (2001) Cimetidine in painful bladder syndrome: a histopathological study. BJU Int 88:183–186PubMed

13.

Davis N, Brady C, Creagh T (2014) Interstitial cystitis/painful bladder syndrome: epidemiology, pathophysiology and evidence-based treatment options. Eur J Obstet Gynecol Reprod Biol 175:30–37PubMed

14.

Doggweiler-Wiygul R, Wiygul JP (2002) Interstitial cystitis, pelvic pain, and the relationship to myofascial pain and dysfunction: a report on four patients. World J Urol 20:310–314PubMed

15.

EMA (2016) Review of Symbioflor 2 (EMA/233358/2016)

16.

Engelhardt PF, Morakis N, Daha LK et al (2011) Long-term results of intravesical hyaluronan therapy in bladder pain syndrome/interstitial cystitis. Int Urogynecol J 22:401–405PubMed

17.

Fabisiak A, Wlodarczyk J, Fabisiak N et al (2017) Targeting histamine receptors in irritable bowel syndrome: a critical appraisal. J Neurogastroenterol Motil 23:341–348PubMedPubMedCentral

18.

Fleischmann J (1994) Calcium channel antagonists in the treatment of interstitial cystitis. Urol Clin North Am 21:107–111PubMed

19.

Fleischmann JD, Huntley HN, Shingleton WB et al (1991) Clinical and immunological response to nifedipine for the treatment of interstitial cystitis. J Urol 146:1235–1239PubMed

20.

Forrest JB, Payne CK, Erickson DR (2012) Cyclosporine A for refractory interstitial cystitis/bladder pain syndrome: experience of 3 tertiary centers. J Urol 188:1186–1191PubMed

21.

Forsell T, Ruutu M, Isoniemi H et al (1996) Cyclosporine in severe interstitial cystitis. J Urol 155:1591–1593PubMed

22.

Friedlander JI, Shorter B, Moldwin RM (2012) Diet and its role in interstitial cystitis/bladder pain syndrome (IC/BPS) and comorbid conditions. BJU Int 109:1584–1591

23.

Fritjofsson A, Fall M, Juhlin R et al (1987) Treatment of ulcer and nonulcer interstitial cystitis with sodium pentosanpolysulfate: a multicenter trial. J Urol 138:508–512PubMed

24.

Giberti C, Gallo F, Cortese P et al (2013) Combined intravesical sodium hyaluronate/chondroitin sulfate therapy for interstitial cystitis/bladder pain syndrome: a prospective study. Ther Adv Urol 5:175–179PubMedPubMedCentral

25.

Ginting JV, Tripp DA, Nickel JC et al (2011) Spousal support decreases the negative impact of pain on mental quality of life in women with interstitial cystitis/painful bladder syndrome. BJU Int 108:713–717PubMed

26.

Goldman HB (2000) Interstitial cystitis—the great enigma. J Urol 164:1921PubMed

27.

Gupta SK, Pidcock L, Parr NJ (2005) The potassium sensitivity test: a predictor of treatment response in interstitial cystitis. BJU Int 96:1063–1066PubMed

28.

Gürpinar T, Wong H, Griffith DP (1996) Electromotive administration of intravesical lidocaine in patients with interstitial cystitis. J Endourol 10:443–447

29.

Hanno PM, Burks DA, Clemens JQ et al (2011) AUA guideline for the diagnosis and treatment of interstitial cystitis/bladder pain syndrome. J Urol 185:2162–2170PubMed

30.

Hanno PM, Wein AJ (1991) Conservative therapy of interstitial cystitis. Semin Urol 9:143–147PubMed

31.

Hillelsohn JH, Rais-Bahrami S, Friedlander JI et al (2012) Fulguration for Hunner ulcers: long-term clinical outcomes. J Urol 188:2238–2241PubMed

32.

Homma Y (2014) Hypersensitive bladder: a solution to confused terminology and ignorance concerning interstitial cystitis. Int J Urol 21:43–47PubMed

33.

Homma Y, Ueda T, Tomoe H et al (2009) Clinical guidelines for interstitial cystitis and hypersensitive bladder syndrome. Int J Urol 16:597–615PubMed

34.

Homma Y, Ueda T, Tomoe H et al (2016) Clinical guidelines for interstitial cystitis and hypersensitive bladder updated in 2015. Int J Urol 23:542–549PubMed

35.

Irwin PP, Galloway NT (1994) Surgical management of interstitial cystitis. Urol Clin North Am 21:145–151

36.

Istek A, Gungor Ugurlucan F, Yasa C et al (2014) Randomized trial of long-term effects of percutaneous tibial nerve stimulation on chronic pelvic pain. Arch Gynecol Obstet 290:291–298

37.

Jocham B (2012) Lebensbilder von Frauen mit interstitieller Cystitis: Emotionale und kognitive Faktoren als modifizierende Elemente bei der Entstehung, Aufrechterhaltung und Reduktion chronischer Schmerzen am Beispiel IC-BPS Bd. 1. Shaker, Aachen

38.

Jocham D, Froehlich G, Sandig F et al (2013) Die Versorgungssituation von Patienten mit interstitieller Zystitis in Deutschland. Urologe 52:691–702

39.

Kaftan BT, Wiedemann A (2018) Hydrodistension der Harnblase zur Diagnostik und Therapie. Aktuelle Urol 49:e92PubMed

40.

Kanter G, Komesu YM, Qaedan F et al (2016) Mindfulness-based stress reduction as a novel treatment for interstitial cystitis/bladder pain syndrome: a randomized controlled trial. Int Urogynecol J 27:1705–1711PubMedPubMedCentral

41.

Kirkemo A, Miles B, Peters J (1990) Use of amitriptyline in interstitial cystitis. J Urol 143:279A

42.

Kuo H‑C (2003) Urodynamic study and potassium sensitivity test for women with frequency-urgency syndrome and interstitial cystitis. Urol Int 71:61–65PubMed

43.

Kuo HC (2001) Urodynamic results of intravesical heparin therapy for women with frequency urgency syndrome and interstitial cystitis. J Formos Med Assoc 100:309–314PubMed

44.

Kuo HC, Jiang YH, Tsai YC et al (2016) Intravesical botulinum toxin‑A injections reduce bladder pain of interstitial cystitis/bladder pain syndrome refractory to conventional treatment—a prospective, multicenter, randomized, double-blind, placebo-controlled clinical trial. Neurourol Urodyn 35:609–614PubMed

45.

Kuo YC, Kuo HC (2012) Potential factors that can be used to differentiate between interstitial cystitis/painful bladder syndrome and bladder oversensitivity in women. Int J Clin Pract 66:146–151PubMed

46.

Kutlar A, Ataga KI, McMahon L et al (2012) A potent oral P‑selectin blocking agent improves microcirculatory blood flow and a marker of endothelial cell injury in patients with sickle cell disease. Am J Hematol 87:536–539PubMed

47.

Lampel A (2014) Oral Presentation: Optionen bei refraktärer interstitieller Zystitis (Schwarzwald-Baar Klinikum Villingen-Schwenningen)

48.

Lampel A (2017) Zystektomie, Augmentation und Harnableitung (ICA-Deutschland)

49.

Layer P, Andresen V, Pehl C et al (2011) Irritable bowel syndrome: German consensus guidelines on definition, pathophysiology and management. Z Gastroenterol 49:237–293PubMed

50.

Lee CL, Kuo HC (2013) Intravesical botulinum toxin a injections do not benefit patients with ulcer type interstitial cystitis. Pain Physician 16:109–116PubMed

51.

Leppilahti M, Hellstrom P, Tammela TL (2002) Effect of diagnostic hydrodistension and four intravesical hyaluronic acid instillations on bladder ICAM‑1 intensity and association of ICAM‑1 intensity with clinical response in patients with interstitial cystitis. Urology 60:46–51PubMed

52.

Lewi H (1995) Cimetidine in treatment of interstitial cystitis. Urology 45:1088PubMed

53.

Lewi H (2001) Medical therapy in interstitial cystitis: the essex experience. Urology 57:120PubMed

54.

Liu J, Farmer JD Jr, Lane WS et al (1991) Calcineurin is a common target of cyclophilin-cyclosporin A and FKBP-FK506 complexes. Cell 66:807–815PubMed

55.

Loch A, Stein U (2004) Interstitielle Zystitis. Urologe 43:1135–1146PubMed

56.

Loving S, Nordling J, Jaszczak P et al (2012) Does evidence support physiotherapy management of adult female chronic pelvic pain? A systematic review. Scand J Pain 3:70–81PubMed

57.

Mayson BE, Teichman JM (2009) The relationship between sexual abuse and interstitial cystitis/painful bladder syndrome. Curr Urol Rep 10:441–447PubMed

58.

Minaglia S, Özel B, Nguyen JN et al (2005) Validation of Spanish version of pelvic pain and urgency/frequency (PUF) patient symptom scale. Urology 65:664–669PubMed

59.

Muendner-Hensen BBJT, Wagenlehner FME, Matsumoto T, Cho YH, Krieger JN, Shoskes D, Naber KG (Hrsg) (2017) Patient contributions to treatment decisions in BPS/IC. Urogenital infections and inflammations

60.

Mutschler E, Ruth P, Geisslinger G et al (2016) Pharmakologie kompakt; Allgemeine und Klinische Pharmakologie, Toxikologie Bd. 1. Wissenschaftliche Verlagsgesellschaft Stuttgart, Stuttgart

61.

Neuhaus J, Schulte-Baukloh H, Stolzenburg J‑U et al (2012) Individual receptor profiling as a novel tool to support diagnosis of bladder pain syndrome/interstitial cystitis (BPS/IC). World J Urol 30:693–700PubMed

62.

Nickel JC, Barkin J, Forrest J et al (2005) Randomized, double-blind, dose-ranging study of pentosan polysulfate sodium for interstitial cystitis. Urology 65:654–658PubMed

63.

Nickel JC, Kaufman DM, Zhang HF et al (2008) Time to initiation of pentosan polysulfate sodium treatment after interstitial cystitis diagnosis: effect on symptom improvement. Urology 71:57–61PubMed

64.

Nickel JC, Tripp DA, Pontari M et al (2011) Childhood sexual trauma in women with interstitial cystitis/bladder pain syndrome: a case control study. Can Urol Assoc J 5:410–415PubMedPubMedCentral

65.

Niimi A, Nomiya A, Yamada Y et al (2015) Hydrodistension with or without fulguration of hunner lesions for interstitial cystitis: long-term outcomes and prognostic predictors. Neurourol Urodynam 35:965–969

66.

Nomiya A, Naruse T, Niimi A et al (2013) On-and post-treatment symptom relief by repeated instillations of heparin and alkalized lidocaine in interstitial cystitis. Int J Urol 20:1118–1122PubMed

67.

Nordling J, van Ophoven A (2008) Intravesical glycosaminoglycan replenishment with chondroitin sulphate in chronic forms of cystitis. Arzneimittelforschung 58:328–335PubMed

68.

O’Hare PG 3rd, Hoffmann AR, Allen P et al (2013) Interstitial cystitis patients’ use and rating of complementary and alternative medicine therapies. Int Urogynecol J 24:977–982PubMed

69.

Oemler M, Grabhorn R, Vahlensieck W et al (2006) Psychosoziale Aspekte der interstitiellen Zystitis. Urologe 45:728–733PubMed

70.

Oyama IA, Rejba A, Lukban JC et al (2004) Modified Thiele massage as therapeutic intervention for female patients with interstitial cystitis and high-tone pelvic floor dysfunction. Urology 64:862–865PubMed

71.

Park JM (2001) Is interstitial cystitis an underdiagnosed problem in children? A diagnostic and therapeutic dilemma. Urology 57:30–31PubMed

72.

Parsons CL (2009) The potassium sensitivity test: a new gold standard for diagnosing and understanding the pathophysiology of interstitial cystitis. J Urol 182:432–434PubMed

73.

Parsons CL (2003) Prostatitis, interstitial cystitis, chronic pelvic pain, and urethral syndrome share a common pathophysiology: lower urinary dysfunctional epithelium and potassium recycling. Urology 62:976–982PubMed

74.

Parsons CL, Dell J, Stanford EJ et al (2002) Increased prevalence of interstitial cystitis: previously unrecognized urologic and gynecologic cases identified using a new symptom questionnaire and intravesical potassium sensitivity. Urology 60:573–578PubMed

75.

Parsons CL, Housley T, Schmidt JD et al (1994) Treatment of interstitial cystitis with intravesical heparin. Br J Urol 73:504–507PubMed

76.

Parsons CL, Zupkas P, Proctor J et al (2012) Alkalinized lidocaine and heparin provide immediate relief of pain and urgency in patients with interstitial cystitis. J Sex Med 9:207–212PubMed

77.

Payne RA, O’Connor RC, Kressin M et al (2009) Endoscopic ablation of Hunner’s lesions in interstitial cystitis patients. Can Urol Assoc J 3:473–477PubMedPubMedCentral

78.

Peters KM, Feber KM, Bennett RC (2007) A prospective, single-blind, randomized crossover trial of sacral vs pudendal nerve stimulation for interstitial cystitis. BJU Int 100:835–839PubMed

79.

Pinto R, Lopes T, Costa D et al (2014) Ulcerative and nonulcerative forms of bladder pain syndrome/interstitial cystitis do not differ in symptom intensity or response to onabotulinum toxin A. Urology 83:1030–1034PubMed

80.

Pinto RA, Costa D, Morgado A et al (2018) Intratrigonal onabotulinumtoxinA improves bladder symptoms and quality of life in patients with bladder pain syndrome/interstitial cystitis: a pilot, single center, randomized, double-blind, placebo controlled trial. J Urol 199:998–1003PubMed

81.

Porru D, Campus G, Tudino D et al (1997) Results of treatment of refractory interstitial cystitis with intravesical hyaluronic acid. Urol Int 59:26–29PubMed

82.

Pranikoff K, Constantino G (1998) The use of amitriptyline in patients with urinary frequency and pain. Urology 51:179–181PubMed

83.

Pyo J‑S, Cho WJ (2016) Systematic review and meta-analysis of Intravesical hyaluronic acid and hyaluronic acid/chondroitin sulfate instillation for interstitial cystitis/painful bladder syndrome. Cell Physiol Biochem 39:1618–1625PubMed

84.

Ragab MM, Tawfik AM, El-enen AM et al (2015) Evaluation of Percutaneous tibial nerve stimulation for treatment of refractory painful bladder syndrome. Urology 86:707–711PubMed

85.

Regauer S, Gamper M, Fehr MK et al (2017) Sensory hyperinnervation distinguishes bladder pain syndrome/interstitial cystitis from overactive bladder syndrome. J Urol 197:159–166PubMed

86.

Riedl CR, Knoll M, Plas E et al (1998) Electromotive drug administration and hydrodistention for the treatment of interstitial cystitis. J Endourol 12:269–272PubMed

87.

Rosamilia A, Dwyer P, Gibson J (1997) Electromotive drug administration of lidocaine and dexamethasone followed by cystodistension in women with interstitial cystitis. Int Urogynecol J Pelvic Floor Dysfunct 8:142–145PubMed

88.

Rourke W, Kahn SAA, Ahmed K et al (2014) Painful bladder sydrome/interstitial cystitis: aetiology, evaluation and managment. Arch Italian Urol Androl 86:126–131

89.

Sairanen J, Forsell T, Ruutu M (2004) Long-term outcome of patients with interstitial cystitis treated with low dose cyclosporine A. J Urol 171:2138–2141PubMed

90.

Sant GR, Propert KJ, Hanno PM et al (2003) A pilot clinical trial of oral pentosan polysulfate and oral hydroxyzine in patients with interstitial cystitis. J Urol 170:810–815PubMed

91.

Seshadri P, Emerson L, Morales A (1994) Cimetidine in the treatment of interstitial cystitis. Urology 44:614–616

92.

Shorter B, Ackerman M, Varvara M et al (2014) Statistical validation of the shorter-moldwin food sensitivity questionnaire for patients with interstitial cystitis/bladder pain syndrome. J Urol 191:1793–1801PubMed

93.

Shorter B, Lesser M, Moldwin RM et al (2007) Effect of comestibles on symptoms of interstitial cystitis. J Urol 178:145–152PubMed

94.

Sönmez MG, Kozanhan B (2017) Complete response to acupuncture therapy in female patients with refractory interstitial cystitis/bladder pain syndrome. Ginekol Pol 88:61–67PubMed

95.

Stern R (2009) Hyaluronan in cancer biology. Academic Press, New York, Boston, London, Oxford

96.

Störkel S (2002) Interstitielle Cystitis aus der Sicht der Pathologen. In: Interstitielle cystits – the state of the Art. Biermann Verlag, Köln, S 43–48

97.

Tanaka T, Kawashima H, Makino T et al (2007) Hyperbaric oxygen therapy for interstitial cystitis resistant to conventional treatments. Int J Urol 14:563–565PubMed

98.

Tanaka T, Nitta Y, Morimoto K et al (2011) Hyperbaric oxygen therapy for painful bladder syndrome/interstitial cystitis resistant to conventional treatments: long-term results of a case series in Japan. BMC Urol 11:11PubMedPubMedCentral

99.

Thilagarajah R, Witherow RO, Walker MM (2001) Oral cimetidine gives effective symptom relief in painful bladder disease: a prospective, randomized, double-blind placebo-controlled trial. BJU Int 87:207–212PubMed

100.

Tutolo M, Ammirati E, Castagna G et al (2017) A prospective randomized controlled multicentre trial comparing intravesical DMSO and chondroïtin sulphate 2 % for painful bladder syndrome/interstitial cystitis. Int Braz J Urol 43:134–141PubMedPubMedCentral

101.

Ueda T, Kanemitsu N, Ukimura O et al (2016) MP72-10 Characterization of non-hunner type interstitial cystitis using narrow band imaging (NBI)-assissted cytoscopy in 1298 cases. J Urol 195:e955–e956

102.

Ueda T, Nakagawa M, Okamura M et al (2008) New cystoscopic diagnosis for interstitial cystitis/painful bladder syndrome using narrow-band imaging system. Int J Urol 15:1039–1043PubMed

103.

Andresen V, Enck P, Frieling T, Herold A, Ilgenstein P, Jesse N, Karaus M, Kasparek M, Keller J, Kuhlbusch-Zicklam R, Krammer H, Kreis M, Layer P, Madisch A, Matthes H, Mönnikes H, Müller-Lissner S, Preiss J, Sailer M, Schemann M, Schwille-Kiuntke J, Voderholzer W, van der Voort I, Wedel T, Pehl C (2011) AWMF-S2k-Leitlinie Chronische Obstipation: Definition, Pathophysiologie, Diagnostik und Therapie (Gemeinsame Leitlinie der Deutschen Gesellschaft für Neurogastroenterologie und Motilität (DGNM) und der Deutschen Gesellschaft für Verdauungs- und Stoffwechselkrankheiten (DGVS). AWMF-Registriernummer: 021/019)

104.

Vahlensieck W (2002) Interstitielle Cystitis und Diät. Interstitielle Cystitis – The State of the Art Bd. 1. Biermann Verlag, Köln

105.

Vahlensieck W, Zermann D‑H (2016) Rehabilitation der interstitiellen Zystitis. In: Die Urologie. Springer, Heidelberg, Berlin, New York

106.

van de Merwe JP, Nordling J, Bouchelouche P et al (2008) Diagnostic criteria, classification, and nomenclature for painful bladder syndrome/interstitial cystitis: an ESSIC proposal. Eur Urol 53:60–67PubMed

107.

van Ophoven A, Hertle L (2005) Long-term results of amitriptyline treatment for interstitial cystitis. J Urol 174:1837–1840PubMed

108.

van Ophoven A, Pokupic S, Heinecke A et al (2004) A prospective, randomized, placebo controlled, double-blind study of amitriptyline for the treatment of interstitial cystitis. J Urol 172:533–536PubMed

109.

van Ophoven A, Rossbach G, Pajonk F et al (2006) Safety and efficacy of hyperbaric oxygen therapy for the treatment of interstitial cystitis: a randomized, sham controlled, double-blind trial. J Urol 176:1442–1446PubMed

110.

Vij M, Srikrishna S, Cardozo L (2012) Interstitial cystitis: diagnosis and management. Eur J Obstet Gynecol Reprod Biol 161:1–7PubMed

111.

Weiss JM (2001) Pelvic floor myofascial trigger points: manual therapy for interstitial cystitis and the urgency-frequency syndrome. J Urol 166:2226–2231PubMed

112.

Welk BK, Teichman JM (2008) Dyspareunia response in patients with interstitial cystitis treated with intravesical lidocaine, bicarbonate, and heparin. Urology 71:67–70

113.

Whitmore KE (2002) Complementary and alternative therapies as treatment approaches for interstitial cystitis. Rev Urol 4:S28–S35PubMedPubMedCentral

114.

Wördehoff A (2002) Interstitielle Cystitis – The State of the Art. Die Möglichkeiten der alternativen IC-Therapie Bd. 1. Köln, Biermann Verlag

115.

Zhou SY, Gillilland M 3rd, Wu X et al (2018) FODMAP diet modulates visceral nociception by lipopolysaccharide-mediated intestinal inflammation and barrier dysfunction. J Clin Invest 128:267–280PubMed

Titel: Diagnostik und Therapie der interstitiellen Zystitis (IC/BPS)
S2k-Leitlinie der Deutschen Gesellschaft für Urologie
verfasst von: Prof. Dr. med. Dr. phil. T. Bschleipfer, F.E.B.U.
R. Doggweiler
D. Schultz-Lampel
J. de Jong
A. Gonsior
J. Hensen
E. Heßdörfer
B. T. Kaftan
A. Kuhn
U. Kunzendorf
A. Lampel
A. Landmesser
A. Loch
O. Moormann
B. Müller
J. Neuhaus
A. Reich
R. Roth
S. Schumacher
R. Stratmeyer
W. Vahlensieck
A. Wördehoff
B. Münder-Hensen
Publikationsdatum: 28.10.2019
Verlag: Springer Medizin
Schlagwörter: Zystitis
Zystitis
Erschienen in: Die Urologie / Ausgabe 11/2019
Print ISSN: 2731-7064
Elektronische ISSN: 2731-7072
DOI: https://doi.org/10.1007/s00120-019-01054-2

Passend zum Thema

Phytotherapie als Basis bei der Behandlung von PMS

Die Symptome beim Prämenstruellen Syndrom (PMS) sind vielfältig und erfordern eine differenzierte Behandlung. Welche Rolle spielen Phytopharmaka in der gynäkologischen Praxis? Und welche neuen Erkenntnisse sind für die Klinik besonders interessant? Darüber sprechen Dr. Dorothee Struck und Prof. Dr. Petra Stute im Video.

Zentraler Therapiebaustein in Praxis und Klinik

Sonderbericht

Weltweit leidet etwa die Hälfte aller Frauen im gebärfähigen Alter an Symptomen eines prämenstruellen Syndroms (PMS). An Diagnose und Therapie des PMS sind sowohl Gynäkologinnen und Gynäkologen in der Niederlassung als auch in Kliniken beteiligt. Die Wahl einer geeigneten Behandlung hängt von den vorherrschenden PMS-Symptomen, der Familienplanung, möglichen Risikofaktoren und Komorbiditäten sowie den Präferenzen der betroffenen Frau ab.

Evidenzbasierte Phytotherapie in der Frauenheilkunde

Content Hub

Ein Drittel aller menstruierender Frauen hat mit prämenstruellen Beschwerden zu kämpfen. Um Symptome, wie sie beim PMS auftreten, nicht nur symptomatisch zu therapieren, können pflanzliche Präparate mit Mönchspfefferextrakt nachhaltig helfen. Erfahren Sie mehr zur Studienlage und dem Wirkmechanismus.

Die Highlights vom Kongress des American College of Cardiology 2024

Springer Medizin

Zusammenfassung

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 11/2019

Mitteilungen der DGU

Steintherapie bei Kindern: Medikamentöse und chirurgische Ansätze

Urolithiasisforschung – Big Data und künstliche Intelligenz

Berufspolitik BvDU

Plazomicin – neues Antibiotikum bei komplizierten Harnwegsinfektionen

Kenntnisstand und Früherkennung maligner Hodentumoren unter Jugendlichen und jungen Erwachsenen

Passend zum Thema

Phytotherapie als Basis bei der Behandlung von PMS

Zentraler Therapiebaustein in Praxis und Klinik

Evidenzbasierte Phytotherapie in der Frauenheilkunde