Interstitial Cystitis

An update of the basic and clinical research on a urologic disorder now considered common.

Section 1 Introduction.- 1 Interstitial Cystitis: An Introduction to the Problem.- Summary of the National Institute of Arthritis, Diabetes, Digestive and Kidney Diseases Workshops on Interstitial Cystitis, National Institutes of Health, Bethesda, Maryland 28-29 August, 1987 and 22 November, 1988.- 2 Historical Perspectives.- Section 2 Epidemiology and Etiology.- 3 Epidemiology of Interstitial Cystitis: 1.- Prevalence.- Incidence.- Sex.- Age.- Severity Grades.- Interstitial Cystitis in Urological Practice.- 4 Epidemiology of Interstitial Cystitis: 2.- Prevalence and Incidence of Interstitial Cystitis.- Diagnosis.- Patient Reports on Diagnosis of IC.- Patient Demographics.- Social and Economic Cost of IC.- Discussion.- Appendix: IC Screening Criteria.- 5 Interstitial Cystitis: Animal Models.- Current Research Strategies.- Experimental Models.- Mucin Extraction.- Studies.- Acute Administration of Nitrofurantoin.- Chronic Administration of Nitrofurantoin.- What Constitutes an Experimental Animal Model of Interstitial Cystitis?.- 6 Etiology: Etiologic and Pathogenic Theories in Interstitial Cystitis.- General Remarks on Etiology and Pathogenesis.- The Etiologic Agent.- The GAG Layer and Urothelium in the Pathogenetic Processes.- The Inflammatory Processes in the Bladder Wall.- Neurogenic and Psychiatric Aspects of Etiology and Pathogenesis.- Conclusions.- Editorial Comment Etiologic Theories: Deficiency of the Bladder Lining.- Section 3 Diagnosis.- 7 Light Microscopic Findings in Bladders of Patients with Interstitial Cystitis.- 8 Pathology of Interstitial Cystitis.- 9 Mast Cells and Interstitial Cystitis.- Mucosal Mast Cells in the Rat.- Mucosal Mast Cells in Man.- Proliferation and Intraepithelial Distribution of MMCs.- Mast Cells in Interstitial Cystitis.- Implications.- 10 Diagnosis of Interstitial Cystitis: A Clinical, Endoscopc and Pathologic Approach.- Symptomatology.- Diagnosis.- Pathologic Features.- Bladder "Mastocytosis".- Summary.- 11 Neurourologic Evaluation in Interstitial Cystitis.- Urgency and Frequency.- Cystometrograms and Other Urodynamic Tests and Uncomfortable Bladder Symptoms.- Urethral Activity and Uncomfortable Bladder Symptoms.- Assessment of Bladder Compliance (Ability to Tolerate Volume Increments) and Interstitial Cystitis.- Urodynamic Testing and Physical Volume Restriction.- 12 Hydrodistension and Intraoperative Urodynamics.- History of Intravesical Hydrodistension.- Helmstein's Techniques.- Diagnosis.- Complications.- Intraoperative Urodynamics During Hydrodistension.- Conclusion.- Editorial Comment The Clinical Evaluation of Patients with Painful Bladder Disease.- Interstitial Cystitis.- Section 4 Management.- 13 Pharmacotherapeutic Goals in Interstitial Cystitis.- Corticosteroids.- Immunosuppressive Drugs.- Anti-Inflammatory Drugs.- Antihistamines.- Sodium Pentosanpolysulfate.- Heparin.- Amitriptyline.- Dimethyl Sulfoxide (DMSO).- Oxychlorosene Sodium (Clorpactin WCS 90).- Silver Nitrate.- Disodium Cromoglycate.- 14 Intravesical Therapy of Interstitial Cystitis.- Silver Nitrate.- Clorpactin WCS 90.- Dimethyl Sulfoxide (DMSO).- 15 Subcutaneous Heparin in the Treatment of Interstitial Cystitis.- Administration and Dose.- Comments.- 16 Urine Eosinophil Cationic Protein in Painful Bladder Disease.- Eosinophil Cationic Protein (ECP).- ECP and IC.- Comments.- 17 Use of Pentosanpolysulfate in the Management of Interstitial Cystitis.- Materials and Methods.- Patients.- Oral Study.- Subcutaneous Therapy.- Results.- Comments.- 18 Use of Transcutaneous Electrical Nerve Stimulation in the Management of Chronic Interstitial Cystitis.- Clinical Trials.- Intravaginal Versus Suprapubic Stimulation.- Long-Term Follow-Up of Suprapubic Stimulation.- Suprapubic Stimulation in Classic and Non-Ulcer IC.- Common Peroneal or Posterior Tibial Nerve Stimulation.- Comment.- 19 Reappraisal of Transurethral Resection in Classic Interstitial Cystitis.- Update on the Author's Own Experience.- Comments.- 20 Treatment of Interstitial Cystitis with the Neodymium:YAG Laser.- Materials and Methods.- Results and Conclusions.- 21 Partial Bladder Denervation in the Treatment of Interstitial Cystitis in Women.- Indications.- Selection of Patients.- Operative Techniques.- Post-Operative Management.- Results.- 22 Surgical Therapy of Interstitial Cystitis.- Surgical Treatment.- Augmentation Cystoplasty.- Objectives and Goals.- Indications and Patient Selection.- Historical Perspective.- Principles and Caveats.- Choice of Bowel Segment.- Our Technique.- Series Review.- Risks and Complications.- Cystectomy and Total Bladder Substitution.- Surgical Technique.- Results and Complications.- Editorial Comment Substitution Cystoplasty in the Management of Interstitial Cystitis.- Addendum. Summary of the 1989 AUA Podium Section on Genitourinary Infection: Interstitial Cystitis.