New Aspects in the Differential Diagnosis and Therapy of Bladder Pain Syndrome/Interstitial Cystitis

Author:

Neuhaus Jochen1ORCID,Schwalenberg Thilo1,Horn Lars-Christian2,Alexander Henry3,Stolzenburg Jens-Uwe1

Affiliation:

1. Department of Urology, University Hospital Leipzig, 04103 Leipzig, Germany

2. Department of Pathology, University of Leipzig, 04103 Leipzig, Germany

3. Department of Gynecology and Reproduction, University Hospital Leipzig, 04103 Leipzig, Germany

Abstract

Diagnosis of bladder pain syndrome/interstitial cystitis (BPS/IC) is presently based on mainly clinical symptoms. BPS/IC can be considered as a worst-case scenario of bladder overactivity of unknown origin, including bladder pain. Usually, patients are partially or completely resistant to anticholinergic therapy, and therapeutical options are especially restricted in case of BPS/IC. Therefore, early detection of patients prone to develop BPS/IC symptoms is essential for successful therapy. We propose extended diagnostics including molecular markers. Differential diagnosis should be based on three diagnostical “columns”: (i) clinical diagnostics, (ii) histopathology, and (iii) molecular diagnostics. Analysis of molecular alterations of receptor expression in detrusor smooth muscle cells and urothelial integrity is necessary to develop patient-tailored therapeutical concepts. Although more research is needed to elucidate the pathomechanisms involved, extended BPS/IC diagnostics could already be integrated into routine patient care, allowing evidence-based pharmacotherapy of patients with idiopathic bladder overactivity and BPS/IC.

Publisher

Hindawi Limited

Subject

Urology,Obstetrics and Gynaecology

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