膀胱药物灌注联合心理护理在间质性膀胱炎/膀胱疼痛综合征治疗中的应用

目的探讨膀胱内药物膀胱灌注联合心理护理在间质性膀胱炎/膀胱疼痛综合征(IC/BPS)患者治疗中的疗效,以指导临床治疗。方法 2015年11月至2019年5月,泌尿外科共收治IC/BPS患者71例。其中女61例,男10例。年龄21～76岁,平均(43±11)岁。病程6～242个月,平均(63±21)个月。IC/BPS患者症状评估采用O'Leary-Sant调查表和盆腔疼痛和尿频尿急症状评分表(PUF评分表),IC/BPS患者焦虑评估采用焦虑自评量表(SAS),抑郁评估采用贝克抑郁量表(BDI-Ⅱ)。所有患者均行麻醉下膀胱镜检查及水扩张。对水扩张后所有患者均行膀胱内透明质酸钠灌注,根据是否进行心理护理及指导分为两组,比较两组治疗前及治疗后(1个月、3个月、6个月)的疗效情况。结果与治疗前相比,两组患者治疗后第1、3、6个月时的各项观察指标均得以改善(P0.05)。治疗1个月后各项观察指标两组间比较差异无统计学意义(P0.05);但治疗后3个月与治疗后6个月,各项观察指标两组间比较差异均具有统计学意义(P0.05)。结论膀胱内透明质酸钠灌注可有效缓解IC/BPS患者的症状,而在长期疗效中膀胱内药物灌注联合心理护理优于单纯进行膀胱内药物灌注。     

间质性膀胱炎/膀胱疼痛综合征尿动力学检查价值分析

目的:探讨间质性膀胱炎/膀胱疼痛综合征(interstitial cystitis/bladder pain syndrome,IC/BPS)尿动力学特征及鉴别诊断价值.方法:回顾性分析2019年06月-2019年12月就诊于我院40例女性IC/BPS患者与40例女性单纯压力性尿失禁(stress urinary in...     

肉毒素A联合透明质酸钠治疗间质性膀胱炎的疗效观察

目的 探讨肉毒素A膀胱内注射联合透明质酸钠膀胱灌注治疗间质性膀胱炎(IC/PBS)的有效性和安全性.方法 53例IC/PBS患者,其中行肉毒素A膀胱内注射联合透明质酸钠膀胱灌注28例(A组),单纯行透明质酸钠膀胱灌注25例(B组).观察并记录患者治疗前及治疗2周、1、3、6个月的临床症状(每日排尿次数、最大排尿容量、VAS疼痛评分)和O'Leary-Sant IC问卷表评分情况,治疗完成后进行疗效评估,并记录不良反应发生情况.结果 A组患者治疗各时间点的每日排尿次数、最大排尿容量、VAS疼痛评分、O' Leary-Sant评分与治疗前相比差异均有统计学意义(P＜0.05);B组患者治疗2周和治疗前比较差异无统计学意义(P＞0.05),其余治疗的各时间点和治疗前比较均有统计学意义(P＜0.05).治疗完成后,两组患者下腹酸胀/疼痛改善率分别为82.1％ (23/28)和68.0％(17/25),夜尿次数多改善率分别为78,6％(22/28)和64.0％ (16/25),尿频尿急改善分别为60.1％ (17/28)和28.0％(7/25),组间疗效评估结果差异均有统计学意义(P ＜0.05,其中尿频尿急改善率差异P＜0.01).A、B两组各有5例在膀胱灌注后出现尿路感染,口服抗生素后缓解.所有患者均完成治疗及随访.结论 肉毒素A膀胱内注射联合透明质酸钠膀胱灌注治疗IC/PBS能够迅速有效的缓解患者临床症状,较单纯透明质酸灌注能更好地改善IC/PBS所造成的下腹酸胀/疼痛、夜尿次数多和尿频尿急,提高患者生活质量,为治疗IC/PBS提供了一种新的有效方法.     

2022版美国泌尿外科学会间质性膀胱炎/膀胱疼痛综合征指南更新解读

2022年美国泌尿外科学会更新了间质性膀胱炎/膀胱疼痛综合征(IC/BPS)的诊断和治疗指南, 本次更新在治疗推荐方面做了大幅改动, 不再推荐一线至六线治疗, 而将目前已有的治疗方案分为五大类, 包括行为和非药物治疗、口服药物、膀胱药物灌注、经尿道手术和骶神经调节, 以及尿路重建手术。这种改变强调了IC/BPS患者的异质性及个体化治疗的重要性, 打破了长期以来层级递进式的治疗观念, 并且鼓励患者参与治疗方案的决策。同时, 专家委员会强调了IC/BPS病程早期进行膀胱镜检查的重要性, 也指出应用戊聚糖多硫酸盐导致视网膜色素性黄斑病的风险, 并且认为尿路重建手术仅作为治疗IC/BPS的最后手段, 且收益风险比不明确。更新后的指南就IC/BPS的诊断和治疗为医师提供了新的认识和决策依据, 但需要注意的是, 实践中需考虑中国患者的临床特征, 做到指南应用本土化。     

膀胱镜随机活检及麻醉下水扩张对膀胱疼痛综合征/间质性膀胱炎诊治的价值

目的 探讨膀胱镜随机活检及麻醉下水扩张对诊断和治疗膀胱疼痛综合征/间质性膀胱炎(bladder pain syndrome/interstitial cystitis,BPS/IC)的临床意义. 方法 回顾性分析2005年至2010年我院因膀胱疼痛等下尿路症状入院的119例患者的临床资料.男32例,年龄47～ 64岁,平均56岁;女87例,年龄23 ～ 67岁,平均49岁.初步诊断均为BPS/IC.入院后行排尿日记、疼痛及症状评分、QOL、尿细菌学培养、尿找肿瘤细胞、尿找抗酸杆菌等检查.全麻后行膀胱镜检膀胱黏膜随机活检,然后进行膀胱镜麻醉下水扩张,对水扩张前后IC患者每日排尿次数、最大排尿量、疼痛评分、O 'Leary-Sant问卷症状评分、QOL等指标进行比较. 结果 119例经膀胱镜随机活检及麻醉下水扩张,确诊为IC患者102例,治疗前每日排尿次数为(42.1±5.6)次,最大排尿量为(141.0 ±8.3)ml,疼痛评分为(7.6±3.0)分,O'Leary-Sant问卷症状评分为(27.7±4.2)分,QOL为(7.6±2.4)分.治疗后每日排尿次数为(23.3±3.4)次,最大排尿量为(352.0±1.7)ml,疼痛评分为(3.3±4.3)分,O 'Leary-Sant问卷症状评分为(12.5±7.3)分,QOL为(3.2±5.1)分,与治疗前比较差异均有统计学意义(P＜0.05).非IC患者17例,确诊为膀胱尿路上皮癌8例,其中原位癌4例、低级别非浸润性膀胱癌l例、高级别浸润性膀胱癌3例,其中4例无血尿症状,膀胱疼痛症状出现至确诊的平均时间为10.8个月.确诊为结核性膀胱炎3例,嗜酸性膀胱炎1例,化学性膀胱炎3例,放射性膀胱炎2例.结论 BPS仍需采用排除性诊断才能确诊为IC.膀胱镜随机活检及麻醉下水扩张对BPS的诊疗有重要意义.     

内镜下电灼术治疗溃疡型膀胱疼痛综合征/间质性膀胱炎患者临床研究

目的:探讨内镜下电灼术治疗溃疡型膀胱疼痛综合征/间质性膀胱炎患者(bladder pain syndrome/interstitial cystitis;BPS/IC)的临床有效性和安全性。方法:所有患者在膀胱镜检+水扩张后,病理回报明确为非特异性炎症者,排除恶性肿瘤疾病,明确为BPS/IC诊断后,分为溃疡型和非溃疡型。随机选取32例溃疡型BPS/IC患者行膀胱溃疡内镜下电灼术治疗。观察手术治疗前后(术后随访1、3、6个月)病情变化如:临床症状情况(每日排尿次数、最大排尿容量、膀胱区疼痛程度评分)和O’Leary-Sant间质性膀胱炎问卷表评分及生活质量评分(QOL)情况。结果:32例溃疡型BPS/IC患者,男5例,女27例,年龄36～60岁,平均(47.0±6.2)岁;病程1～5年,平均(3.5±1.2)年。本组患者症状改善总有效率78.1%(25/32),其中完全缓解率为53.1%(17/32),部分缓解率为25%(8/32),治疗无效率为21.9%(7/32)。手术治疗后患者平均每日排尿次数、每次排尿量、疼痛程度、O’Leary-Sant评分、生活质量评分与治疗前相比均存在显著改善(P<0.01)。结论:内镜下电灼术治疗溃疡型BPS/IC患者能够有效缓解临床症状和改善生活质量。     

Eur Urol:Certolizumab Pegol治疗女性难治性间质性膀胱炎/膀胱疼痛综合征的有效性及安全性研究——单中心随机,双盲,安慰剂对照试验

间质性膀胱炎/膀胱疼痛综合征(interstitial cystitis/bladder pain syndrome,IC/BPS)是基于与膀胱相关的慢性盆腔疼痛、压迫感或不适感而诊断出的,同时至少伴有一种其他尿路症状(如持续急迫排尿感或尿频),需排除混淆疾病。美国泌尿外科学会将之定义为“一种与膀胱充盈相关的不适感(憋胀、疼痛、压迫感),病史大于6周,合并下尿路症状,排除其他疾病,其中尿频和疼痛是两大要素”IC/BPS的病因和病理生理学基础尚不确定,目前没有普遍有效的治疗方法。     

间质性膀胱炎与女性激素失调的临床相关性研究

目的 探讨间质性膀胱炎(interstitial cystitis,IC)与女性激素失调的临床相关性.方法 回顾性分析2006年1月至2012年4月收治的58例女性IC患者的临床资料.年龄21～76岁,平均(40.2±12.4)岁.病程9～120个月,平均(64.3±55.7)个月.记录患者月经周期第1、12、22天的O'Leary-Sant评分、盆腔疼痛与尿急/尿频(PUF)评分,探讨女性IC患者尿频、尿急、膀胱疼痛等症状与月经周期的关系,以及未绝经患者与绝经患者各项评分的差异,调查女性IC患者伴发性激素失调病的发病情况. 结果51例未绝经患者月经周期第1天膀胱疼痛和尿频、尿急症状发生率最高,分别为54.9％(28/51)和60.8％(31/51)；7例绝经患者症状加重无明显规律性.月经周期第1、12、22天O'Leary-Sant评分分别为26.60±2.37、21.62±1.98、22.40±2.68,第1天与第12、22天比较差异均有统计学意义(P＜0.05),第12天与第22天比较差异无统计学意义(P＞0.05)；PUF评分分别为25.20±1.81、19.95±2.01、20.80±3.01,第1天与第12、22天比较差异均有统计学意义(P＜0.05),第12天与第22天比较差异无统计学意义(P＞0.05).7例绝经患者的O'Leary-Sant评分和PUF评分的平均值均低于未绝经患者,差异均有统计学意义(P＜0.05).本组58例中,子宫肌瘤、乳腺增生、卵巢囊肿、子宫内膜异位症的发病率分别为48.3％(28/58)、41.4％(24/58)、5.2％(3/58)、13.8％(8/58),均高于国内一般人群的发病率30.0％、40.0％、0.3％、7.0％,除乳腺增生外,其他3种疾病的发病率与国内一般人群比较差异均有统计学意义(P＜0.05). 结论 女性IC患者的尿频、尿急和膀胱疼痛等症状主要在月经期加重,且未绝经患者的症状比绝经患者严重；女性IC患者伴发性激素失调病的发病率高于国内一般人群,说明性激素失调可能是女性IC的致病因素之一.     

TLR4在间质性膀胱炎/膀胱疼痛综合征中表达增加

目的探究TLR4在间质性膀胱炎/膀胱疼痛综合征(IC/BPS)中的表达。方法分别在动物样本和临床样本中检测TLR4表达。动物样本:将24只雌性大鼠随机分为实验组和对照组,每组各12只,实验组大鼠通过向膀胱内灌注1mL硫酸鱼精蛋白(PS)和1mL脂多糖(LPS)建立IC/BPS大鼠模型,对照组膀胱灌注2mL生理盐水;模型建立4周后处死大鼠,采用苏木精-伊红染色法(HE染色)、甲苯胺蓝(TB)染色、免疫组织化学染色、免疫印迹、实时定量PCR等检测实验组及对照组大鼠膀胱组织的炎症浸润、肥大细胞脱颗粒程度及TLR4的蛋白、mRNA表达水平变化。临床样本:本研究共纳入60例临床样本,30例女性IC/BPS患者,30例膀胱癌患者。采用HE染色、TB染色及免疫组织化学染色检测两组受试者膀胱组织中炎症细胞、肥大细胞、TLR4阳性染色细胞的数目。结果动物样本:与正常大鼠相比,IC/BPS大鼠膀胱组织中炎症及肥大细胞浸润加剧,TLR4的蛋白及mRNA表达水平显著升高。临床样本:与癌旁健康膀胱组织相比,IC/BPS患者的膀胱组织中炎症细胞、肥大细胞及TLR4阳性染色细胞数目显著增多(P0.05)。结论 TLR4在雌性IC/BPS大鼠及女性IC/BPS患者膀胱组织中的表达量较高,且具有明显的升高趋势,提示TLR4在IC/BPS发病过程中具有一定作用。     

女性膀胱疼痛综合症/间质性膀胱炎患者发生抑郁症和惊恐发作的人群研究

目的:本文报道了患有膀胱疼痛综合症/间质性膀胱炎(BPS/IC)女性中抑郁症和惊恐发作的患病率,并描述其特点及护理。方法 :电话筛选了146231名家庭主妇并电话采访了有BPS/IC症状的女性,并用加权概率抽样确定了1469名符合BPS/IC诊断标准的女性。     

Urinary nerve growth factor level is increased in patients with interstitial cystitis/bladder pain syndrome and decreased in responders to treatment

OBJECTIVE

To measure urinary nerve growth factor (NGF) levels in patients with interstitial cystitis/bladder pain syndrome (IC/BPS), and to evaluate the role of urinary NGF in predicting the response to treatment, as the clinical diagnosis of IC/BPS is based on subjective symptoms and recent investigations suggest that urinary NGF is increased in patients with IC/BPS.

PATIENTS, SUBJECTS AND METHODS

Urine samples from 122 patients with IC/BPS and 28 normal controls were measured for NGF levels using an enzyme‐linked immunosorbent assay. The diagnosis of IC/BPS was based on bladder pain symptoms and the results of cystoscopic hydrodistension. Patients’ perception of pain was assessed by a visual analogue scale (VAS) and a ‘global’ response assessment after treatment. Urinary NGF levels were further normalized to the concentration of urinary creatinine (NGF/Cr) and compared between control and IC/BPS subgroups at diagnosis and after treatment.

RESULTS

Urinary NGF/Cr levels were very low when the bladder was not distended and significantly elevated with a full bladder in patients with IC/BPS. However, urinary NGF/Cr levels were not correlated with VAS scores or cystometric bladder capacity at diagnosis, or maximum bladder capacity during hydrodistension. Patients who responded to treatment and had an improvement in VAS pain score of ≥2 had significantly lower NGF/Cr levels than nonresponders who had a VAS improvement of <2.

CONCLUSIONS

Patients with IC/BPS had greater urinary NGF/Cr levels than controls. A decrease of urinary NGF level was associated with greater pain reduction and a successful response, suggesting that urinary NGF levels can be a useful biomarker for detecting the severity of the bladder condition in patients with IC/BPS.     

Childhood sexual trauma in women with interstitial cystitis/bladder pain syndrome: a case control study

Background:

The impact of early lifetime trauma on symptom severity and quality of life of patients with interstitial cystitis/bladder pain syndrome (IC/BPS) has not been fully elucidated. We wanted to determine and compare the prevalence and impact of childhood traumatic events, with an emphasis on childhood sexual abuse, on patient symptoms, quality of life and other biopsychosocial parameters.

Methods:

Subjects (female patients with IC/BPS and controls without IC/BPS) completed psychosocial phenotyping questionnaires, including a demographics/history form, and validated questionnaires focused on presenting symptoms (IC symptom indices, pain), psychosocial parameters (depression, anxiety, pain catastrophizing, sexual functioning, social support) and quality of life. Participants also completed the Childhood Traumatic Events Scale.

Results:

Questionnaires were completed by 207 IC/BPS patients and 117 controls matched for age, partner status and education. It was found that before 17 years of age, the IC/BPS cases reported higher prevalence of “raped or molested” compared to controls (24.0% vs. 14.7%; p = 0.047). Within the IC/BPS group, cases reporting previous sexual abuse endorsed greater sensory pain, depression and poorer physical quality of life at the present time compared to IC cases without a sexual abuse history. In the controls only, those reporting previous sexual abuse endorsed more depression, anxiety, stress, social maladjustment poorer mental quality of life in the present time. When the analysis was corrected for potential multiple comparison error, none of the findings remained significant in either the IC/BPS or control groups.

Interpretation:

Childhood traumatic events, in particular sexual abuse and extreme illness, are reported as more common in IC/BPS patients than controls. Early trauma, such as the occurrence of sexual abuse, is associated with some differences in patient adjustment (e.g., pain, quality of life, depression) but this impact appears to be, at most, very modest.     

An urgent case for sensory urgency: A patient perspective

Interstitial cystitis/bladder pain syndrome (IC/BPS) patients around the world are all too familiar with the immense stress and anxiety caused by an urgent and frequent need to void, leading to many patients with IC/BPS staying at home in social isolation since they are afraid that they will not find a public toilet when they urgently need it. It is therefore of great concern that for almost two decades the “sensory” type of urgency due to intolerable pain or unpleasant sensation as typically experienced by this group of patients has no longer been officially recognized, researched or treated as a symptom of IC/BPS. This official misrepresentation of IC/BPS symptoms needs to be addressed and rectified for the sake of patients and to ensure medical accuracy in research.     

Dyspareunia and chronic pelvic pain in patients with interstitial cystitis/bladder pain syndrome

ObjectiveA previous study established that interstitial cystitis/bladder pain syndrome (IC/BPS) patients had significantly more dyspareunia and fear of pain than healthy controls. We evaluated the relationships between lower urinary tract symptoms and dyspareunia in IC/BPS patients.Materials and methodsA total of 156 IC/BPS female patients were included in this study. The diagnosis was made on the consensus of IC/PBS proposed by the Society for Urodynamics and Female Urology criteria in 2008. All women completed measures of pain severity (visual analog scale) and bladder symptom severity [IC Symptom Index, IC Problem Index, and the Pelvic Pain and Urinary/Frequency (PUF) scale]. Respondents were asked to recall if they experienced any sexual pain during or after sexual intercourse in the past 1 year. Cystoscopic hydrodistension during general anesthesia was performed for 5 minutes and maximal bladder capacity was also measured. Bivariate analyses were performed using chi-square and independent Student t tests.ResultsOf the women with a current sexual partner, 61% (96/156) reported dyspareunia during or after sexual intercourse. Of the 96 dyspareunia respondents, 46% (44/96) reported pain in the bladder only, 43% (41/96) in the vagina only, and 11% (11/96) in both the bladder and the vagina. Patients with dyspareunia complained of more severe urological pain (p = 0.02), a higher PUF scale score (p < 0.01), and larger anesthetic maximal bladder capacity (p = 0.04) than patients without dyspareunia. However, patients with dyspareunia at the bladder only had more severe urgency sensation (p < 0.01) but no differences in pain, PUF scale, severity of glomerulation, and maximal bladder capacity than those with dyspareunia at the vagina only.ConclusionIC/BPS women with dyspareunia have significantly more severe urological pain and a higher PUF scale score than women without dyspareunia. Physicians should consider sexual pain disorder in the management of patients with IC/BPS and use the PUF scale to evaluate not only IC-specific lower urinary tract symptoms, but also sexual pain disorder.     

Mapping of Pain Phenotypes in Female Patients with Bladder Pain Syndrome/Interstitial Cystitis and Controls

Background

Many bladder pain syndrome/interstitial cystitis (BPS/IC) patients report multiple pain locations outside the pelvis. No research has examined pain using a whole-body diagram, pain-associated adjustment factors, or the impact of pain in multiple body areas on patients’ quality of life (QoL).

Objective

Compare and contrast pain in BPS/IC patients and controls using a whole-body diagram (visible body areas). Examine the association between patient adjustment factors and greater number of body pain areas (pain phenotypes).

Design, setting, and participants

Validated questionnaires were collected from diagnosed, tertiary-care, outpatient, female BPS/IC patients (n = 193) and age-matched controls (n = 115). Scales included a body pain area diagram, demographics/history, pain severity, BPS/IC symptoms, pain, depression, catastrophizing, and QoL.

Outcome measurements and statistical analysis

Cross-tabulation and analysis of variance models addressed the patient and control differences.

Results and limitations

Patients reported more pain than controls in all reported body areas. Four pain phenotypes were created based on increasing counts of body locations (BPS/IC only, BPS/IC + plus 1–3 additional locations, BPS/IC plus 4–9, BPS/IC ≥10). Patients reported more body pain locations, pain, urinary symptoms, depression, catastrophizing, and diminished QoL than controls. The increased-pain phenotype was associated with poorer psychosocial adjustment and diminished physical QoL, but catastrophizing and low scores for mental QoL remained stable across all patient groups. This study was cross-sectional, relying on correlation-based analyses, thus causality cannot be established.

Conclusions

Patients reported numerous systemic pain symptoms outside the areas associated with the bladder/pelvic region, and increased numbers of body pain sites were associated with poorer patient outcomes (ie, pain severity, depression). This study illustrates the significant negative impact of pain on patient adjustment in BPS/IC. These findings suggest that clinicians carefully consider pain location distributions and the potential impact of body pain phenotypes during patient evaluation and treatment planning.     

Relationship among symptoms,mood, and personality traits in patients with interstitial cystitis/bladder pain syndrome

ObjectiveWe have proposed an analysis of personality traits to classify patients with interstitial cystitis/bladder pain syndrome (IC/BPS) to determine the association between symptoms, mood, and personality traits in IC/BPS patients.Materials and methodsA total of 57 patients (7 males and 50 females) diagnosed according to the National Institute of Diabetes and Digestive and Kidney Diseases criteria were recruited from December 2005 to June 2006. All of these patients were newly diagnosed cases of IC/BPS, and the evaluation was made during the admission after hydrodistension. This study used the O'Leary–Sant Symptom Index and Problem Index (interstitial cystitis system index and interstitial cystitis problem index) to record the clinical symptoms of all IC/BPS patients. Basic Personality Inventory and Back Anxiety Inventory were used to analyze personality traits and mood status.ResultsIC/BPS patients have personality traits of depression and hypochondriasis, and show moderate anxiety mood. The duration of the symptoms is longer in depressive IC/BPS patients. Significant positive correlations were found among pain and anxiety mood, symptoms and interpersonal problems, and problem index and depression, respectively. Patients with severe anxiety mood status have abnormal personality traits such as depression, anxiety, self-depreciation, and others.ConclusionsIC/BPS patients frequently exhibit several mental health disorders and negative personality traits. Therefore, in addition to targeting the bladder pathological condition, psychological intervention focusing on personality traits and anxiety mood status should be provided to improve quality of life of IC/BPS patients.     

The Chinese approach to complementary and alternative medicine treatment for interstitial cystitis/bladder pain syndrome

Management of interstitial cystitis/bladder pain syndrome (IC/BPS) remains a challenge due to poor understanding on its etiology. Complementary and alternative medicine (CAM), as an optional treatment, has been widely used, because no definitive conventional therapy is available. The different domain of CAM provides miscellaneous treatments for IC/BPS, which mainly include dietary modification, nutraceuticals, bladder training, biofeedback, yoga, massage, physical therapy, Qigong, traditional Chinese medicine and acupuncture. Clinical evidence has shown that each therapy can certainly benefit a portion of IC/BPS patients. However, the target patient group of each therapy has not been well studied and randomized, controlled trials are needed to further confirm the efficacy and reliability of CAM on managing IC/BPS. Despite these limitations, CAM therapeutic characteristics including non-invasive and effectiveness for specific patients allow clinicians and patients to realize multimodal and individualized therapy for IC/BPS.     

Bladder pain syndrome/interstitial cystitis in a Danish population: a study using the 2008 criteria of the European Society for the Study of Interstitial Cystitis

Study Type – Symptom prevalence (prospective cohort)
Level of Evidence 1b

OBJECTIVE

To characterize and evaluate a Danish patient population with bladder pain syndrome/interstitial cystitis (BPS/IC), using a working definition for BPS/IC incorporating six variables, and a set of criteria defined by the European Society for the Study of Interstitial Cystitis (ESSIC); to describe the clinical course and treatment intensity in relation to these variables.

PATIENTS AND METHODS

Clinical data were obtained retrospectively from medical records for 349 consecutive patients with IC referred to the Department of Urology, Copenhagen University Hospital Herlev, Denmark between 1966 and 2008. The median (range) age at diagnosis was 53 (16–88) years; 64% were followed for at least 2 years. The outcome was expressed in terms of treatment intensity and was correlated with clinical data (pain, nocturnal frequency, bladder capacity, mucosal glomerulations, detrusor mastocytosis, detrusor intrafascicular fibrosis, IFF).

RESULTS

All patients had pain and 75% had nocturia at least twice. The bladder capacity estimated under general anaesthesia was <500 mL in 42%; 53% presented with detrusor mastocytosis (≥28 mast cells/mm²) and 50% with IFF. The detrusor mast cell count (P < 0.001), IFF (P = 0.004) and nocturnal frequency (P = 0.043) had statistically significant prognostic value for treatment intensity, whereas bladder capacity and glomerulations were not significant.

CONCLUSION

Nocturia, detrusor mastocytosis and IFF are associated with multiple treatments and presumed failure of standard urological therapy in patients with BPS/IC, while bladder capacity and glomerulations are not. Valid conclusions cannot be drawn because of numerous limitations to the study.     

微波热疗联合三联药物膀胱灌注治疗膀胱疼痛综合征/间质性膀胱炎的临床研究

目的探讨微波热疗联合三联药物膀胱灌注治疗膀胱疼痛综合征/间质性膀胱炎（BPS/IC）的临床效果与安全性。 方法回顾性分析2014年2月至2017年9月收治的51例BPS/IC患者的临床资料,其中女44例,男7例,平均年龄36岁,平均病程32个月。对照组采用单纯三联药物膀胱灌注,治疗组在膀胱灌注的基础上运用微波热疗治疗。所有患者治疗前后均行O'Leary-Sant间质性膀胱炎症状指数和问题指数评分（ICSI/ICPI）,盆腔疼痛及尿频评分（PUF）和VAS疼痛评分以评估疗效。 结果经治疗后,治疗组患者ICSI、ICPI、PUF及VAS评分均优于对照组[（7.3±3.3） vs（10.7±2.5）、（5.2±3.5）vs（7.5±3.5）、（19.6±3.4）vs（22.3±4.7）、（5.0±0.7）vs（5.8±1.1）,P值均<0.05）],且两组患者治疗后各项评分均优于治疗前（P<0.05）,治疗组患者有效率为91.7%,所有患者均未发生严重不良反应。 结论微波热疗联合药物膀胱灌注治疗BPS/IC的疗效肯定,适合广泛开展,为临床治疗BPS/IC提供了一种有效方法。