nach oben

Erschienen in:

25.08.2020 | Schmerzsyndrome | CME

Interstitielle Zystitis/Blasenschmerzsyndrom (IC/BPS)

verfasst von: Prof. Dr. med. Dr. phil. Thomas Bschleipfer, F.E.B.U.

Erschienen in: Die Urologie | Ausgabe 9/2020

Einloggen, um Zugang zu erhalten

Zusammenfassung

Die interstitielle Zystitis/Blasenschmerzsyndrom (IC/BPS) ist als seltene Erkrankung eine häufig unterdiagnostizierte, vielfach auch erst nach Jahren adäquat behandelte Erkrankung der Harnblase. Aufgrund bisher ungeklärter Ätiopathogenese, variabler Symptomatik, fehlender Biomarker und eines schleichenden Beginns stellt sie als reine Ausschlussdiagnose eine besondere Herausforderung für Arzt und Patienten dar. Neben konventionellen und komplementärmedizinischen Therapien stehen insbesondere oral-medikamentöse, intravesikale bzw. transurethrale Verfahren als Behandlungsoptionen zur Verfügung. Interventionelle/operative Verfahren sollten aufgrund der Invasivität bzw. Unumkehrbarkeit dagegen nur nach genauer Abwägung bzw. als Ultima Ratio zum Einsatz kommen. Um eine passende, individuelle Therapie zu finden, kann daher eine Klassifizierung der Patienten entsprechend der Schwere und Art der Symptomatik von Vorteil sein.

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: 14.06.2020

Bschleipfer T, Doggweiler R, Schultz-Lampel D et al (2019) Diagnosis and treatment of interstitial cystitis (IC/PBS) : S2k guideline of the German Society of Urology. Urologe A 58:1313–1323PubMed

Homma Y (2014) Hypersensitive bladder: a solution to confused terminology and ignorance concerning interstitial cystitis. Int J Urol 21(Suppl 1):43–47PubMed

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

Berry SH, Elliott MN, Suttorp M et al (2011) Prevalence of symptoms of bladder pain syndrome/interstitial cystitis among adult females in the United States. J Urol 186:540–544PubMedPubMedCentral

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

Tseng-Rogenski S, Liebert M (2009) Interleukin‑8 is essential for normal urothelial cell survival. Am J Physiol Renal Physiol 297:F816–821PubMedPubMedCentral

Parsons CL (2011) The role of a leaky epithelium and potassium in the generation of bladder symptoms in interstitial cystitis/overactive bladder, urethral syndrome, prostatitis and gynaecological chronic pelvic pain. BJU Int 107:370–375PubMed

Maeda D, Akiyama Y, Morikawa T et al (2015) Hunner-type (classic) interstitial cystitis: a distinct inflammatory disorder characterized by pancystitis, with frequent expansion of clonal B‑cells and epithelial denudation. PLoS ONE 10:e143316PubMedPubMedCentral

10.

Schwalenberg T, Stolzenburg JU, Ho TP et al (2012) Enhanced urothelial expression of human chorionic gonadotropin beta (hCGbeta) in bladder pain syndrome/interstitial cystitis (BPS/IC). World J Urol 30:411–417PubMed

11.

Logadottir Y, Delbro D, Fall M et al (2014) Cytokine expression in patients with bladder pain syndrome/interstitial cystitis ESSIC type 3C. J Urol 192:1564–1568PubMed

12.

Tyagi P, Killinger K, Tyagi V et al (2012) Urinary chemokines as noninvasive predictors of ulcerative interstitial cystitis. J Urol 187:2243–2248PubMedPubMedCentral

13.

Colaco M, Koslov DS, Keys T et al (2014) Correlation of gene expression with bladder capacity in interstitial cystitis/bladder pain syndrome. J Urol 192:1123–1129PubMed

14.

Gamper M, Viereck V, Eberhard J et al (2013) Local immune response in bladder pain syndrome/interstitial cystitis ESSIC type 3C. Int Urogynecol J 24:2049–2057PubMedPubMedCentral

15.

Kim SW, Im YJ, Choi HC et al (2014) Urinary nerve growth factor correlates with the severity of urgency and pain. Int Urogynecol J 25:1561–1567PubMed

16.

Homma Y, Nomiya A, Tagaya M et al (2013) Increased mRNA expression of genes involved in pronociceptive inflammatory reactions in bladder tissue of interstitial cystitis. J Urol 190:1925–1931PubMed

17.

Lai HH, Gardner V, Ness TJ et al (2014) Segmental hyperalgesia to mechanical stimulus in interstitial cystitis/bladder pain syndrome: evidence of central sensitization. J Urol 191:1294–1299PubMed

18.

Kiuchi H, Tsujimura A, Takao T et al (2009) Increased vascular endothelial growth factor expression in patients with bladder pain syndrome/interstitial cystitis: its association with pain severity and glomerulations. BJU Int 104:826–831 (discussion 831)PubMed

19.

Özçağlayan Ö, Akgül M, Yazıcı C et al (2019) Is bladder blood flow an etiologic factor for the bladder pain syndrome? Neurourol Urodyn 38:1135–1141PubMed

20.

Shan H, Zhang EW, Zhang P et al (2019) Differential expression of histamine receptors in the bladder wall tissues of patients with bladder pain syndrome/interstitial cystitis—significance in the responsiveness to antihistamine treatment and disease symptoms. BMC Urol 19:115PubMedPubMedCentral

21.

Nickel JC, Stephens A, Landis JR et al (2016) Assessment of the lower urinary tract microbiota during symptom flare in women with urologic chronic pelvic pain syndrome: a MAPP network study. J Urol 195:356–362PubMed

22.

Engeler DS, Baranowski AP, Dinis-Oliveira P et al (2013) The 2013 EAU guidelines on chronic pelvic pain: is management of chronic pelvic pain a habit, a philosophy, or a science? 10 years of development. Eur Urol 64:431–439PubMed

23.

Wu CC, Chung SD, Lin HC (2018) Endometriosis increased the risk of bladder pain syndrome/interstitial cystitis: A population-based study. Neurourol Urodyn 37:1413–1418PubMed

24.

Warren JW, Morozov V, Howard FM et al (2014) Before the onset of interstitial cystitis/bladder pain syndrome, the presence of multiple non-bladder syndromes is strongly associated with a history of multiple surgeries. J Psychosom Res 76:75–79PubMed

25.

Jhang JF, Birder LA, Jiang YH et al (2019) Dysregulation of bladder corticotropin-releasing hormone receptor in the pathogenesis of human interstitial cystitis/bladder pain syndrome. Sci Rep 9:19169PubMedPubMedCentral

26.

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

27.

Wen JY, Lo TS, Chuang YC et al (2019) Risks of interstitial cystitis among patients with systemic lupus erythematosus: a population-based cohort study. Int J Urol 26:897–902PubMed

28.

Braundmeier-Fleming A, Russell NT, Yang W et al (2016) Stool-based biomarkers of interstitial cystitis/bladder pain syndrome. Sci Rep 6:26083PubMedPubMedCentral

29.

Abernethy MG, Rosenfeld A, White JR et al (2017) Urinary microbiome and cytokine levels in women with interstitial cystitis. Obstet Gynecol 129:500–506PubMed

30.

Magistro G, Stief CG (2019) The urinary tract microbiome: the answer to all our open questions? Eur Urol Focus 5:36–38PubMed

31.

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

32.

Kaftan BT, Wiedemann A (2018) Aktuelle Urol 49:e92PubMed

33.

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

34.

Tonyali S, Ates D, Akbiyik F et al (2018) Urine nerve growth factor (NGF) level, bladder nerve staining and symptom/problem scores in patients with interstitial cystitis. Adv Clin Exp Med 27:159–163PubMed

35.

Furuta A, Yamamoto T, Suzuki Y et al (2018) Comparison of inflammatory urine markers in patients with interstitial cystitis and overactive bladder. Int Urogynecol J 29:961–966PubMed

36.

Niimi A, Igawa Y, Aizawa N et al (2018) Diagnostic value of urinary CXCL10 as a biomarker for predicting Hunner type interstitial cystitis. Neurourol Urodyn 37:1113–1119PubMed

37.

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

38.

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

39.

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

40.

Neuhaus J, Schulte-Baukloh H, Stolzenburg JU 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

41.

Shoskes DA, Nickel JC (2013) Classification and treatment of men with chronic prostatitis/chronic pelvic pain syndrome using the UPOINT system. World J Urol 31:755–760PubMed

42.

Crane A, Lloyd J, Shoskes DA (2018) Improving the utility of clinical phenotyping in interstitial cystitis/painful bladder syndrome: from UPOINT to INPUT. Can J Urol 25:9250–9254PubMed

43.

Whitmore KE (2002) Complementary and alternative therapies as treatment approaches for interstitial cystitis. Rev Urol 4(Suppl 1:):S28–S35PubMedPubMedCentral

44.

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

45.

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

46.

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

47.

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

48.

Jain N, Li AL, Yu Y et al (2019) Association of macular disease with long-term use of pentosan polysulfate sodium: findings from a US cohort. Br J Ophthalmol. https://doi.org/10.1136/bjophthalmol-2019-314765CrossRefPubMed

49.

Lyons RJ, Ahmad S, Ansari S et al (2020) Pentosan polysulfate-associated macular disease in patients with interstitial cystitis. Obstet Gynecol 135:1091–1094PubMed

50.

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

51.

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

52.

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

53.

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

54.

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

55.

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

56.

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

57.

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

58.

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

59.

Rosamilia A, Dwyer PL, 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

Titel: Interstitielle Zystitis/Blasenschmerzsyndrom (IC/BPS)
verfasst von: Prof. Dr. med. Dr. phil. Thomas Bschleipfer, F.E.B.U.
Publikationsdatum: 25.08.2020
Verlag: Springer Medizin
Schlagwörter: Schmerzsyndrome
Zystitis
Zystitis
Urologie
Erschienen in: Die Urologie / Ausgabe 9/2020
Print ISSN: 2731-7064
Elektronische ISSN: 2731-7072
DOI: https://doi.org/10.1007/s00120-020-01309-3

Die Geschichte der THE MANNHEIM UROBAND

Urologie
Übersichtsartikel

Technik und Pflege – eine ambivalente Beziehung

Pflege
Praxis konkret

Berufspolitik BvDU

Berufspolitik BvDU

Urologie 2020 – es ist Zeit

Künstliche Intelligenz
Editorial

Künstliche Intelligenz

Prostatakarzinom
Leitthema

Termine

Termine