Background:Radiation cystitis is a well-known complication resulting from radiotherapy for pelvic malignancies.It remains a challenging condition to treat and is associated with significant morbidity for patients.We a...Background:Radiation cystitis is a well-known complication resulting from radiotherapy for pelvic malignancies.It remains a challenging condition to treat and is associated with significant morbidity for patients.We aimed to establish the economic cost burden of presentations and investigations associated with radiation cystitis over a two-year period to a tertiary referral hospital in Ireland.Materials and Methods:A retrospective review of patient charts was performed for radiation cystitisrelated presentations and investigations over 24 months.Costs were estimated in consultation with the hospital finance department and using Health Service Executive data on diagnostic-related groups and average inpatient bed day costs.Results:A total of 56 individual patients were identified over 2 years.91%male,9%female.The mean age was 72 years.Twenty-three patients(41%)required inpatient care.Radiation cystitis accounted for 621 inpatient bed days.Median length of stay was 7.5 days.The inpatient care cost was approximately e545,238(801,908 Canadian dollars(CA$))over 2 years.Conclusion:Radiation cystitis accounts for a significant amount of inpatient bed days.A conservative estimate of the overall cost burden for inpatient care and outpatient investigations exceeds e280,000(CA$411,810)per year.展开更多
BACKGROUND The advanced first-line regimen for advanced gastric cancer is based on a combination of fluoropyrimidine and platinum and/or paclitaxel(PTX),forming a two-or three-drug regimen.Compared to conventional PTX...BACKGROUND The advanced first-line regimen for advanced gastric cancer is based on a combination of fluoropyrimidine and platinum and/or paclitaxel(PTX),forming a two-or three-drug regimen.Compared to conventional PTX,nanoparticle albumin-bound PTX(Nab-PTX)has better therapeutic effects and fewer adverse effects reported in studies.Nab-PTX is a great option for patients presenting with advanced gastric cancer.Herein,we highlight an adverse event(hemorrhagic cystitis)of Nab-PTX in advanced gastric cancer.CASE SUMMARY A 55-year-old male was diagnosed with lymph node metastasis after a laparo-scopic-assisted radical gastrectomy for gastric cancer that was treated by Nab-PTX and S-1(AS).On the 15th day after treatment with AS,he was diagnosed with hemorrhagic cystitis.CONCLUSION Physicians should be aware that hemorrhagic cystitis is a potential adverse event associated with Nab-PTX treatment.展开更多
BACKGROUND Interstitial cystitis/bladder pain syndrome(IC/BPS)is an at least 6-mo noninfectious bladder inflammation of unknown origin characterized by chronic suprapubic,abdominal,and/or pelvic pain.Although the term...BACKGROUND Interstitial cystitis/bladder pain syndrome(IC/BPS)is an at least 6-mo noninfectious bladder inflammation of unknown origin characterized by chronic suprapubic,abdominal,and/or pelvic pain.Although the term cystitis suggests an inflammatory or infectious origin,no definite cause has been identified.It occurs in both sexes,but women are twice as much affected.AIM To systematically review evidence of psychiatric/psychological changes in persons with IC/BPS.METHODS Hypothesizing that particular psychological characteristics could underpin IC/BPS,we investigated in three databases the presence of psychiatric symptoms and/or disorders and/or psychological characteristics in patients with IC/BPS using the following strategy:("interstitial cystitis"OR"bladder pain syndrome")AND("mood disorder"OR depressive OR antidepressant OR depression OR depressed OR hyperthymic OR mania OR manic OR rapid cyclasterisk OR dysthymiasterisk OR dysphoriasterisk).RESULTS On September 27,2023,the PubMed search produced 223 articles,CINAHL 62,and the combined PsycLIT/PsycARTICLES/PsycINFO/Psychology and Behavioral Sciences Collection search 36.Search on ClinicalTrials.gov produced 14 studies,of which none had available data.Eligible were peer-reviewed articles reporting psychiatric/psychological symptoms in patients with IC/BPS,i.e.63 articles spanning from 2000 to October 2023.These studies identified depression and anxiety problems in the IC/BPS population,along with sleep problems and the tendency to catastrophizing.CONCLUSION Psychotherapies targeting catastrophizing and life stress emotional awareness and expression reduced perceived pain in women with IC/BPS.Such concepts should be considered when implementing treatments aimed at reducing IC/BPS-related pain.展开更多
Emphysematous cystitis is a rare complication of lower urinary tract infection whose prognosis is conditioned by the delay in treatment. The predisposition of diabetic patients to urinary infections caused by gas-prod...Emphysematous cystitis is a rare complication of lower urinary tract infection whose prognosis is conditioned by the delay in treatment. The predisposition of diabetic patients to urinary infections caused by gas-producing bacteria is considered one of the most common factors in the occurrence of emphysematous cystitis. The currently recommended diagnostic test is CT scanning, which has definite value in assessing gas accumulation in the bladder wall and lumen. The authors report the observations of two patients aged 68 and 80 who were treated for emphysematous cystitis complicating diabetes mellitus. The evolution was favorable under treatment with antibiotic therapy, insulin therapy and bladder drainage.展开更多
BACKGROUND Encrusted cystitis(EC)is a chronic inflammation of the bladder associated with mucosal encrustations.Early diagnosis and optimal treatment are not well established.Here,we report a case of EC successfully t...BACKGROUND Encrusted cystitis(EC)is a chronic inflammation of the bladder associated with mucosal encrustations.Early diagnosis and optimal treatment are not well established.Here,we report a case of EC successfully treated with com-bination therapy.CASE SUMMARY A 27-year-old man presented with frequency,urgency,dysuria,gross hematuria and suprapubic pain for 2 mo.He was diagnosed with EC based on characteristic calcifications of the bladder wall(most of them were struvite),cystoscopy and histopathological examination.He was cured after combined therapy of elimination of encrustations,bladder instillation of hyaluronic acid and injection of botulinum-A neurotoxin into bladder submucosal tissue.CONCLUSION Bladder instillation of hyaluronic acid and injection of botulinum-A neurotoxin into the bladder submucosal tissue can be used for treatment of EC.展开更多
Interstitial cystitis/bladder pain syndrome(IC/BPS)is a debilitating,chronic condition characterized by chronic pelvic pain,urinary urgency,and frequency and is well-known to be associated with a decrease in work prod...Interstitial cystitis/bladder pain syndrome(IC/BPS)is a debilitating,chronic condition characterized by chronic pelvic pain,urinary urgency,and frequency and is well-known to be associated with a decrease in work productivity,emotional changes,sleep,sexual dysfunction,and mobility.Many metrics of quality of life(QoL)in this patient population have been developed;however,a unified,standardized approach to QoL in these patients has not been determined.The effects of IC/BPS and co-morbid conditions on QoL are described using current validated metrics.Next,data regarding successful treatment of IC/BPS in terms of QoL improvement are reviewed.While QoL is the single most important clinical measure of success in the treatment of patients suffering from IC/BPS,addressing QoL in this patient population remains a significant challenge,as its effects on QoL are highly variable and unable to be differentiated from the effects of comorbid conditions on QoL,including depression,poor sleep,and inability to work.Future studies will need to address treatment efficacy on the basis of IC/BPS specific QoL metrics,and multi-modal assessment and therapy to address comorbid disease will also play an important role in the future to ensure comprehensive management of these patients.展开更多
Background: Radiotherapy is one of the most popular treatments for pelvic malignancy, which causes patients suffering from the adverse effect such as cystitis, hematuria, proctitis, hematochezia and distal ureteric st...Background: Radiotherapy is one of the most popular treatments for pelvic malignancy, which causes patients suffering from the adverse effect such as cystitis, hematuria, proctitis, hematochezia and distal ureteric stricture. The hematuria condition from radiation-induced hemorrhagic cystitis is the most common adverse event suffering the patients, losing properties, wasting time, and deteriorating quality of life. One of the most effective treatments for radiation-induced hemorrhagic cystitis is the hyperbaric oxygen therapy with no necessity for patients to be hospitalized, no need of anesthesia use, and also non-invasion. However, it requires that patients spend 90 - 120 minutes a day for 40 days administered out-patient treatment session. The transportation cost as well as the accommodation one will greatly burden the self-pay health care patients. In addition, there is still no definite standardized number of HBOT treatment session assignment at present. Objectives: To compare the treatment outcome (bladder mucosal characteristics, red blood cells in urine) between 30 and 40 sessions of HBOT for treatment of radiation-induced hemorrhagic cystitis. Methods: Prospective cohort observational study of patients (n = 15) who were diagnosed with radiation-induced hemorrhagic cystitis that were treated with hyperbaric oxygen therapy in Somdechprapinklao Hospital between October 2020 and September 2021. We compared the parameter about hemoglobin concentration, red blood cell number in urine during the course of HBOT treatment every 10 sessions and cystoscopic finding severity as EORTC/RTOG classification for radiation-induced hemorrhagic cystitis in Table 1 before treatment, and after 30 and 40 sessions of treatment. Results: From 15 of treated patients, 93.3% of patients had evidence of posterior wall lesion. The mean duration from radiotherapy (radiation and brachytherapy) to the first episode gross hematuria is 112 months. This study shows no statistically different cystoscopic findings as EORTC/RTOG classification for radiation-induced hemorrhagic cystitis after 30 and 40 sessions of HBOT (p = 0.653) and statistically significant improvement after the treatment of more than 30 sessions (p = 0.008). No relationship was found with the hemoglobin concentration and red blood cell number in urine during the course of HBOT. Conclusions: Radiation-induced hemorrhagic cystitis can be treated with HBOT. There is no different treatment outcome between 30 and 40 sessions of HBOT.展开更多
Cystitis often appears even in absence of bacteria colonization. Trigonitis and interstitial inflammation are the most common morphological features of abacterial cystitis in young and post menopausal women. Arterial ...Cystitis often appears even in absence of bacteria colonization. Trigonitis and interstitial inflammation are the most common morphological features of abacterial cystitis in young and post menopausal women. Arterial obstructive disease and bladder ischemia might play an important role in bladder dysfunction. Activated inflammatory cells produce ROS （radicals of oxygen）, NF kB seems involved in ROS synthesis. Clinical studies have indicated that high CO2 levels can impact upon peripheral tissue, reducing ischaemia, responsible of recurrent inflammation and consequently reducing oxydative phenomena. PRP （platelet-rich plasma） is a volume of fractionated plasma from the patient＇s own blood that contains platelet concentrate rich of alpha granules. PRP interacts tissue repair mechanisms by placing supra-physiological concentrations of autologous platelets at the site of tissue damage. This study proposes a single PRP transvaginal injection followed by 10 weekly applications of carboxytherapy, using subcutaneous injections of sterile CO2 gas. We have selected 6 Women （50-75 years）, affected by recurrent abacterial cystitis with Pain and urge incontinence. All patients showed a subjective sensible reduction of symptoms. After 2 months all patients have neither inflammatory symptoms nor endoscopic evidence of trigonitis. Preliminary qualitative results could encourage the use of carboxytherapy and PRP in treatment of abacterial and interstitial cystitis.展开更多
Summary: In order to study the association between lower urinary tract infection and cystitis glandularis (CG), 120 cases of CG were diagnosed by cystoscopic biopsy in the suspicious foci of the bladder. Among them, 7...Summary: In order to study the association between lower urinary tract infection and cystitis glandularis (CG), 120 cases of CG were diagnosed by cystoscopic biopsy in the suspicious foci of the bladder. Among them, 72 cases were subjected to bacterial counting culture of urine and microscopic examination of urinary sediment, and 60 cases to fluorescence quantitative polymerase chain reaction (FQ-PCR) assay to detect HPV, CMV and HSV DNA in urine samples. In the 72 cases of CG, the positive rate of bacterial counting culture of urine was 15.3 % (11/72), and gray zone rate was 18.1 % (13/72). 31.9 % (23/72) patients were positive in bacterioscopy of urinary sediment. There was statistically significant difference as compared with the control group (P<0.01). Only 4 of 60 urine samples were positive by FQ-PCR in detection of the three viruses mentioned above with the positive rate being 6.67 %. Compared with the control group, there was no significant difference (P>0.05). It was concluded that the genesis of CG was closely correlated with the chronic lower urinary tract infection, especially caused by Esch coli.展开更多
Eosinophilic gastroenteritis(EG) is a rare,distinct clinical entity,and EG associated with eosinophilic cystitis(EC) is extremely rare and has not been well documented.Here,we report two cases of EG and coexistent EC ...Eosinophilic gastroenteritis(EG) is a rare,distinct clinical entity,and EG associated with eosinophilic cystitis(EC) is extremely rare and has not been well documented.Here,we report two cases of EG and coexistent EC along with findings from computed tomography(CT) and magnetic resonance imaging(MRI).An 18-year-old male with a history of hematuria,urgency and occasional urodynia for two weeks and a 34-year-old male with a history of abdominal distention for one week were admitted to our hospital.Abdominal contrast-enhanced CT in both patients revealed wall thickening in different parts of the gastrointestinal tract with inhomogeneous reinforcement,coexistent with local or diffuse bladder wall thickening with progressive enhancement,and also showed that the bladder mucosal lining was nondestructive.Pelvic MRI showed that the local or diffuse thickened bladder wall was iso-intense on T1-weighted images,hypointense on T2-weighted images,and slightly restricted on diffusion weighted imaging(DWI) in one case.After therapy,the thickened wall of the gastrointestinal tract and urinary bladder had improved markedly in the two cases.To the best of our knowledge,this is the first report on the radiological imaging of EG and coexistent EC by both CT and MRI and the first with DWI findings.展开更多
To study the relationship between bacterial infection and the etiology of cystitis glandularis, 36 female Wistar rats were divided into 3 groups. No intervention was given to the rats in the blank group. NS was infuse...To study the relationship between bacterial infection and the etiology of cystitis glandularis, 36 female Wistar rats were divided into 3 groups. No intervention was given to the rats in the blank group. NS was infused into the bladder of the rats of the control group, and solution containing E. coil was injected into the bladder of experimental group. Three months later, tissue samples of bladder were collected and observed visually and under light microscope. The results showed that tissues of the blank group were normal＇, one sample in the control group showed Brunn＇s nests and cystitis cystica, and 10 in the experimental group had the change of cystitis glandularis. Compared to the blank and control group, samples in the experimental group showed significant change （P〈0.05）. There were no significant difference between blank group and control group （P〉0.05）. It is concluded that bladder instillation of E. coil can induce cystitis glandularis, which confirms that infection is the cause of cystitis glandularis.展开更多
To examine the expression of human telomere reverse transcriptase （hTERT）, p53 and proliferating cell nuclear antigen （PCNA） in cystitis glandulafis, 38 patients were divided into two grouips： group A （including...To examine the expression of human telomere reverse transcriptase （hTERT）, p53 and proliferating cell nuclear antigen （PCNA） in cystitis glandulafis, 38 patients were divided into two grouips： group A （including 18 cases of papillary cystitis glandularis） and group B （including 20 subjects with normal bladder mucosa）. All the cases were immunohistochemically examined by using antibodies specifically against p53 and PCNA, and hTERT was determined by in situ hybridization. hTERT was found in 6 cases （33.3%） and p53 was detected in 4 cases （22.2%） in group A, while they were not detected in group B. There were significant differences in hTERT and p53 expression between groups A and B （P〈0.05 for both）. PCNA was detected in 7 cases （38.9%） in group A and 1 case （5.0%） in group B, and significant difference in PCNA expression was found between the two groups （P〈0.05）. The expressions of hTERT, p53 and PCNA were significantly higher in group A than in group B, suggesting that papillary cystitis glandularis is predisposed to cancerous change, and p53, PCNA, hTERT may be related to the malignant alteration.展开更多
BACKGROUND Pelvic lipomatosis(PL)is a rare benign condition with characteristic overgrowth of histologically benign fat and invasion and compression of pelvic organs,often leading to non-specific lower urinary tract s...BACKGROUND Pelvic lipomatosis(PL)is a rare benign condition with characteristic overgrowth of histologically benign fat and invasion and compression of pelvic organs,often leading to non-specific lower urinary tract symptoms(LUTS).Approximately 40%of patients with PL have cystitis glandularis(CG).The cause of PL combined with CG is poorly understood,and there is currently no effective treatment.Refractory CG with upper urinary tract obstruction even requires partial or radical bladder resection.CASE SUMMARY In this case,a patient suffering from PL with CG was treated by transurethral resection of bladder tumour(TUR-BT)and oral administration of celecoxib,a selective cyclooxygenase-2(COX-2)inhibitor.The LUTS were alleviated,and the cystoscopy results improved significantly.Immunohistochemistry showed upregulated COX-2 expression in the epithelium of TUR-BT samples,suggesting that COX-2 may participate in the pathophysiological process of PL combined with CG.CONCLUSION We report for the first time that celecoxib may be an effective treatment strategy for PL combined with refractory CG.展开更多
Abelmoschus manihot(L.)Medik.(A.manihot)is a traditional Chinese herbal medicine with a variety of pharmacological properties.It was first recorded in Jiayou Materia Medica dating back to the Song dynasty to eliminate...Abelmoschus manihot(L.)Medik.(A.manihot)is a traditional Chinese herbal medicine with a variety of pharmacological properties.It was first recorded in Jiayou Materia Medica dating back to the Song dynasty to eliminate urinary tract irritation by clearing away heat and diuretic effect.However,its pharmacological action on urinary tract infections has not been investigated.The present study aims to evaluate the anti-inflammatory activity of A.manihot on a mouse model of lipopolysaccharide(LPS)-induced cystitis.The results showed that A.manihot decreased white blood cell(WBC)count in urine sediments of the cystitis mice,alleviated bladder congestion,edema,as well as histopathological damage,reduced the expression levels of tumor necrosis factor-α,interleukin-6,and interleukin-1βsimultaneously.Moreover,A.manihot administration significantly downregulated the expression levels of TLR4,MYD88,IκBα,p-IκBα,NF-κB p65,and p-NF-κB p65 in LPS-induced cystitis mice.These findings demonstrated the protective effect of A.manihot against LPS-induced cystitis,which is attributed to its anti-inflammatory profile by suppressing TLR4/MYD88/NF-κB pathways.Our results suggest that A.manihot could be a potential candidate for cystitis treatment.展开更多
Introduction:Recurrent cystitis,defined as at least two episodes within six months or three episodes within one year,presented among about one fifth to one-third of women with history of cystitis or urinary tract infe...Introduction:Recurrent cystitis,defined as at least two episodes within six months or three episodes within one year,presented among about one fifth to one-third of women with history of cystitis or urinary tract infection(UTI) according to previous studies.However,the use of antibiotics can only resolve the urinary symptoms but not reduce the frequency of urinary symptoms recurrence,and meanwhile increasing rates of adverse effect of repetitive antimicrobial therapy and bacterial antimicrobial resistance became clinical concerns.This case report aims to present a case of recurrent cystitis treated by electroacupuncture(EA) in reducing recurrent frequency,amount of antibiotics used and urinary symptoms.Case presentation:A 42-year-old woman diagnosed with recurrent cystitis for five years presented mainly with recurrent dysuria,urine frequency and urgency.She received EA treatment 3 to 5 sessions a week and 30 min per session from August 2019 to August 2020 with 3-month suspension due to Coronavirus Disease 2019(COVID-19).During the treatment,both the frequency of recurrent urinary episode and symptoms were reduced.Although there was some fluctuation,the mean frequencies of daytime voiding reduced dramatically from 17.7 to 8.3,and night-time voiding from 4 to 1,and the number of voiding with moderate urgency was reduced from 17.7 to 2.3,and severe urgency dropped from 2.7 to 0.The patient’s scores of overactive bladder symptom score(OABSS) and overactive bladder questionnaire short form(OAB-q SF) were also improved.The postvoid residual urine volume(PVR) reduced from 42 mL to less than 10 mL Conclusion:This case of individual effect of EA for a woman with frequent recurrent cystitis suggested a plausible benefit of EA on reducing frequency,amount of antibiotics used and symptoms of recurrent cystitis,but further research is necessary to proof the efficacy and effectiveness among a wider population.展开更多
Purpose: The effectiveness of daily or weekly instillation of non-alkalinized lidocaine for patients suffering interstitial cystitis and/or bladder pain syndrome was evaluated retrospectively. Patients and methods: Fi...Purpose: The effectiveness of daily or weekly instillation of non-alkalinized lidocaine for patients suffering interstitial cystitis and/or bladder pain syndrome was evaluated retrospectively. Patients and methods: Five female patients (40 - 71 years old) diagnosed as interstitial cystitis by cystoscopic findings and a 68 year-old bladder pain syndrome patient were enrolled. All patients, having interstitial cystitis, had undergone hydrodistention therapy previously and had not improved their symptoms by empirical therapies. Daily or weekly (upon their severity of symptoms) intravesical instillation of 20 ml of 4% non-alkalinized (pH 6.0 - 7.0) lidocaine solution was performed for several times, and patients were asked to keep them in the bladder as long as two hours each time. Previous medications such as anti-cholinergic drugs and analgesics were continued according to patient's requirements and symptoms. The treatment effect was evaluated comparing O'Leary-Sant Symptom Index for interstitial cystitis patients and visual analog pain scale before and after the series of lidocaine therapies. Results: Instillation was made 6 to 16 times. Patients with interstitial cystitis improved their symptoms from O'Leary-Sant Symptom Index 17.5 to 10, Problem Index from 14.8 to 6 in an average. Crouching pain disappeared in all these patients after the instillation therapy. Severe interstitial cystitis findings on cystoscopy disappeared completely in one patient after the therapy. One patient having bladder pain syndrome reduced her analgesics use, and bladder-filling pain decreased from 7 to 3 as a visual analog scale score. One patient complained palpitation at 11th instillation and abandoned treatment thereafter, otherwise, none of these patients showed side effect concerning lidocaine toxicity. Conclusions: Intravesical non-alkalinized lidocaine instillation therapy for interstitial cystitis/bladder pain syndrome patients were an easy, safe and effective treatment.展开更多
Purpose: Since intravesically administered steroid therapy may treat bladder pain syndrome/interstitial cystitis (BPS/IC) with fewer side effects than the current treatment of orally administered steroids, we investig...Purpose: Since intravesically administered steroid therapy may treat bladder pain syndrome/interstitial cystitis (BPS/IC) with fewer side effects than the current treatment of orally administered steroids, we investigated whether the intravesical infusion of budesonide foam can effectively treat BPS/IC symptoms in a rat model of tranilast-induced BPS/IC. Methods: There were 6 rat treatment groups (n = 8 per group): control + single or daily saline infusion, tranilast + single or daily saline infusion, and tranilast + single or daily budesonide infusion. All groups except for the controls were fed a tranilast supplemented diet for 5 weeks. Budesonide and saline were infused intravesically. After the BPS/IC rat model underwent single infusion treatments, we measured the paw pain threshold using the von Frey test and continuous cystometry was taken. After two weeks of daily intravesical infusions, we measured locomotor activity and serum cortisol levels;harvested bladders underwent histological analysis. Results: Both pain threshold and locomotor activity were significantly lower in the saline-infused groups receiving the tranilast diet, but there were no differences between the budesonide-infused groups and the controls. The interval between bladder contractions was significantly shorter in the tranilast group than the control or tranilast + budesonide infusion groups. The serum cortisol levels did not change. Hematoxylin-Eosin stainings of the bladder showed thickening of the bladder muscle layer and mucosal edema in the tranilast group, while the tranilast + budesonide infusion group showed only mild changes. Conclusion: Intravesical infusion of budesonide effectively treated BPS/IC symptoms in a rat model of BPS/IC.展开更多
A 56-year-old female patient with interstitial cystitis was treated with umbilical moxibustion combined with acupuncture.The doctor prepared the wheat flour-made bowl and the herbal powder for umbilical moxibustion.Th...A 56-year-old female patient with interstitial cystitis was treated with umbilical moxibustion combined with acupuncture.The doctor prepared the wheat flour-made bowl and the herbal powder for umbilical moxibustion.The bowl was put on the patient's umbilicus with a small hole in the middle of the bowl directly facing the navel,in which,the herbal powder was filled.The moxa cone was put on the bowl and ignited.Totally,3 cones were used.During umbilical moxibustion,acupuncture was adopted at Guanyuan(关元CV12),Zhongji(中极CV3),Dahe(大赫KI12),etc.The above treatment was given twice a week and 2-week treatment was as one course.After 4 courses of treatment,the clinical symptoms basically disappeared.The cystoscopic examination results were recovered to be normal.展开更多
Follicular cystitis is a non-specific inflammatory condition of the bladder where the aetiology is unknown.The extent of the disease can be mild or proliferative and bulky.Antibiotics,steroids,therapies used for inter...Follicular cystitis is a non-specific inflammatory condition of the bladder where the aetiology is unknown.The extent of the disease can be mild or proliferative and bulky.Antibiotics,steroids,therapies used for interstitial cystitis,palliative cystectomy and radiotherapy have been reported as successful treatment options.We report a case of follicular cystitis that responded to a course of oral diethyl carbamazine.展开更多
BACKGROUND Nearly-complete labial adhesions diagnosed with repetitive cystitis in postmenopausal women:A case report CASE SUMMARY The case of an 83-year-old woman who presented with dysuria,urination disorders,recurre...BACKGROUND Nearly-complete labial adhesions diagnosed with repetitive cystitis in postmenopausal women:A case report CASE SUMMARY The case of an 83-year-old woman who presented with dysuria,urination disorders,recurrent cystitis,and bacteriuria and was admitted to a private hospital after 1 mo of antibiotic treatment without improvement of her symptoms.Upon examination,labial adhesions were observed with nearly-complete labial fusion with a pinpoint opening.Bacteriuria was detected in urine analysis,and the urine culture test was positive for Escherichia coli.Therefore,a parenteral antibiotic(Fosfomycin)and topical estrogen cream were administered.However,since the adhesion did not separate after 2 wk of treatment,surgical correction was performed.First,adhesiolysis was conducted with a blunt instrument.Then,hysteroscopy and cystoscopy were performed.Hysteroscopic findings showed no abnormalities of the endometrium and endocervix,and the cystoscopic results were also normal.Finally,labiaplasty was completed to prevent adhesion recurrence.One month after the surgery,the discomfort while urinating was eliminated and the adhesion did not recur.CONCLUSION Labial adhesions in postmenopausal women cannot be successfully treated with estrogen creams,and surgical treatment should be considered.展开更多
文摘Background:Radiation cystitis is a well-known complication resulting from radiotherapy for pelvic malignancies.It remains a challenging condition to treat and is associated with significant morbidity for patients.We aimed to establish the economic cost burden of presentations and investigations associated with radiation cystitis over a two-year period to a tertiary referral hospital in Ireland.Materials and Methods:A retrospective review of patient charts was performed for radiation cystitisrelated presentations and investigations over 24 months.Costs were estimated in consultation with the hospital finance department and using Health Service Executive data on diagnostic-related groups and average inpatient bed day costs.Results:A total of 56 individual patients were identified over 2 years.91%male,9%female.The mean age was 72 years.Twenty-three patients(41%)required inpatient care.Radiation cystitis accounted for 621 inpatient bed days.Median length of stay was 7.5 days.The inpatient care cost was approximately e545,238(801,908 Canadian dollars(CA$))over 2 years.Conclusion:Radiation cystitis accounts for a significant amount of inpatient bed days.A conservative estimate of the overall cost burden for inpatient care and outpatient investigations exceeds e280,000(CA$411,810)per year.
文摘BACKGROUND The advanced first-line regimen for advanced gastric cancer is based on a combination of fluoropyrimidine and platinum and/or paclitaxel(PTX),forming a two-or three-drug regimen.Compared to conventional PTX,nanoparticle albumin-bound PTX(Nab-PTX)has better therapeutic effects and fewer adverse effects reported in studies.Nab-PTX is a great option for patients presenting with advanced gastric cancer.Herein,we highlight an adverse event(hemorrhagic cystitis)of Nab-PTX in advanced gastric cancer.CASE SUMMARY A 55-year-old male was diagnosed with lymph node metastasis after a laparo-scopic-assisted radical gastrectomy for gastric cancer that was treated by Nab-PTX and S-1(AS).On the 15th day after treatment with AS,he was diagnosed with hemorrhagic cystitis.CONCLUSION Physicians should be aware that hemorrhagic cystitis is a potential adverse event associated with Nab-PTX treatment.
文摘BACKGROUND Interstitial cystitis/bladder pain syndrome(IC/BPS)is an at least 6-mo noninfectious bladder inflammation of unknown origin characterized by chronic suprapubic,abdominal,and/or pelvic pain.Although the term cystitis suggests an inflammatory or infectious origin,no definite cause has been identified.It occurs in both sexes,but women are twice as much affected.AIM To systematically review evidence of psychiatric/psychological changes in persons with IC/BPS.METHODS Hypothesizing that particular psychological characteristics could underpin IC/BPS,we investigated in three databases the presence of psychiatric symptoms and/or disorders and/or psychological characteristics in patients with IC/BPS using the following strategy:("interstitial cystitis"OR"bladder pain syndrome")AND("mood disorder"OR depressive OR antidepressant OR depression OR depressed OR hyperthymic OR mania OR manic OR rapid cyclasterisk OR dysthymiasterisk OR dysphoriasterisk).RESULTS On September 27,2023,the PubMed search produced 223 articles,CINAHL 62,and the combined PsycLIT/PsycARTICLES/PsycINFO/Psychology and Behavioral Sciences Collection search 36.Search on ClinicalTrials.gov produced 14 studies,of which none had available data.Eligible were peer-reviewed articles reporting psychiatric/psychological symptoms in patients with IC/BPS,i.e.63 articles spanning from 2000 to October 2023.These studies identified depression and anxiety problems in the IC/BPS population,along with sleep problems and the tendency to catastrophizing.CONCLUSION Psychotherapies targeting catastrophizing and life stress emotional awareness and expression reduced perceived pain in women with IC/BPS.Such concepts should be considered when implementing treatments aimed at reducing IC/BPS-related pain.
文摘Emphysematous cystitis is a rare complication of lower urinary tract infection whose prognosis is conditioned by the delay in treatment. The predisposition of diabetic patients to urinary infections caused by gas-producing bacteria is considered one of the most common factors in the occurrence of emphysematous cystitis. The currently recommended diagnostic test is CT scanning, which has definite value in assessing gas accumulation in the bladder wall and lumen. The authors report the observations of two patients aged 68 and 80 who were treated for emphysematous cystitis complicating diabetes mellitus. The evolution was favorable under treatment with antibiotic therapy, insulin therapy and bladder drainage.
文摘BACKGROUND Encrusted cystitis(EC)is a chronic inflammation of the bladder associated with mucosal encrustations.Early diagnosis and optimal treatment are not well established.Here,we report a case of EC successfully treated with com-bination therapy.CASE SUMMARY A 27-year-old man presented with frequency,urgency,dysuria,gross hematuria and suprapubic pain for 2 mo.He was diagnosed with EC based on characteristic calcifications of the bladder wall(most of them were struvite),cystoscopy and histopathological examination.He was cured after combined therapy of elimination of encrustations,bladder instillation of hyaluronic acid and injection of botulinum-A neurotoxin into bladder submucosal tissue.CONCLUSION Bladder instillation of hyaluronic acid and injection of botulinum-A neurotoxin into the bladder submucosal tissue can be used for treatment of EC.
文摘Interstitial cystitis/bladder pain syndrome(IC/BPS)is a debilitating,chronic condition characterized by chronic pelvic pain,urinary urgency,and frequency and is well-known to be associated with a decrease in work productivity,emotional changes,sleep,sexual dysfunction,and mobility.Many metrics of quality of life(QoL)in this patient population have been developed;however,a unified,standardized approach to QoL in these patients has not been determined.The effects of IC/BPS and co-morbid conditions on QoL are described using current validated metrics.Next,data regarding successful treatment of IC/BPS in terms of QoL improvement are reviewed.While QoL is the single most important clinical measure of success in the treatment of patients suffering from IC/BPS,addressing QoL in this patient population remains a significant challenge,as its effects on QoL are highly variable and unable to be differentiated from the effects of comorbid conditions on QoL,including depression,poor sleep,and inability to work.Future studies will need to address treatment efficacy on the basis of IC/BPS specific QoL metrics,and multi-modal assessment and therapy to address comorbid disease will also play an important role in the future to ensure comprehensive management of these patients.
文摘Background: Radiotherapy is one of the most popular treatments for pelvic malignancy, which causes patients suffering from the adverse effect such as cystitis, hematuria, proctitis, hematochezia and distal ureteric stricture. The hematuria condition from radiation-induced hemorrhagic cystitis is the most common adverse event suffering the patients, losing properties, wasting time, and deteriorating quality of life. One of the most effective treatments for radiation-induced hemorrhagic cystitis is the hyperbaric oxygen therapy with no necessity for patients to be hospitalized, no need of anesthesia use, and also non-invasion. However, it requires that patients spend 90 - 120 minutes a day for 40 days administered out-patient treatment session. The transportation cost as well as the accommodation one will greatly burden the self-pay health care patients. In addition, there is still no definite standardized number of HBOT treatment session assignment at present. Objectives: To compare the treatment outcome (bladder mucosal characteristics, red blood cells in urine) between 30 and 40 sessions of HBOT for treatment of radiation-induced hemorrhagic cystitis. Methods: Prospective cohort observational study of patients (n = 15) who were diagnosed with radiation-induced hemorrhagic cystitis that were treated with hyperbaric oxygen therapy in Somdechprapinklao Hospital between October 2020 and September 2021. We compared the parameter about hemoglobin concentration, red blood cell number in urine during the course of HBOT treatment every 10 sessions and cystoscopic finding severity as EORTC/RTOG classification for radiation-induced hemorrhagic cystitis in Table 1 before treatment, and after 30 and 40 sessions of treatment. Results: From 15 of treated patients, 93.3% of patients had evidence of posterior wall lesion. The mean duration from radiotherapy (radiation and brachytherapy) to the first episode gross hematuria is 112 months. This study shows no statistically different cystoscopic findings as EORTC/RTOG classification for radiation-induced hemorrhagic cystitis after 30 and 40 sessions of HBOT (p = 0.653) and statistically significant improvement after the treatment of more than 30 sessions (p = 0.008). No relationship was found with the hemoglobin concentration and red blood cell number in urine during the course of HBOT. Conclusions: Radiation-induced hemorrhagic cystitis can be treated with HBOT. There is no different treatment outcome between 30 and 40 sessions of HBOT.
文摘Cystitis often appears even in absence of bacteria colonization. Trigonitis and interstitial inflammation are the most common morphological features of abacterial cystitis in young and post menopausal women. Arterial obstructive disease and bladder ischemia might play an important role in bladder dysfunction. Activated inflammatory cells produce ROS （radicals of oxygen）, NF kB seems involved in ROS synthesis. Clinical studies have indicated that high CO2 levels can impact upon peripheral tissue, reducing ischaemia, responsible of recurrent inflammation and consequently reducing oxydative phenomena. PRP （platelet-rich plasma） is a volume of fractionated plasma from the patient＇s own blood that contains platelet concentrate rich of alpha granules. PRP interacts tissue repair mechanisms by placing supra-physiological concentrations of autologous platelets at the site of tissue damage. This study proposes a single PRP transvaginal injection followed by 10 weekly applications of carboxytherapy, using subcutaneous injections of sterile CO2 gas. We have selected 6 Women （50-75 years）, affected by recurrent abacterial cystitis with Pain and urge incontinence. All patients showed a subjective sensible reduction of symptoms. After 2 months all patients have neither inflammatory symptoms nor endoscopic evidence of trigonitis. Preliminary qualitative results could encourage the use of carboxytherapy and PRP in treatment of abacterial and interstitial cystitis.
文摘Summary: In order to study the association between lower urinary tract infection and cystitis glandularis (CG), 120 cases of CG were diagnosed by cystoscopic biopsy in the suspicious foci of the bladder. Among them, 72 cases were subjected to bacterial counting culture of urine and microscopic examination of urinary sediment, and 60 cases to fluorescence quantitative polymerase chain reaction (FQ-PCR) assay to detect HPV, CMV and HSV DNA in urine samples. In the 72 cases of CG, the positive rate of bacterial counting culture of urine was 15.3 % (11/72), and gray zone rate was 18.1 % (13/72). 31.9 % (23/72) patients were positive in bacterioscopy of urinary sediment. There was statistically significant difference as compared with the control group (P<0.01). Only 4 of 60 urine samples were positive by FQ-PCR in detection of the three viruses mentioned above with the positive rate being 6.67 %. Compared with the control group, there was no significant difference (P>0.05). It was concluded that the genesis of CG was closely correlated with the chronic lower urinary tract infection, especially caused by Esch coli.
文摘Eosinophilic gastroenteritis(EG) is a rare,distinct clinical entity,and EG associated with eosinophilic cystitis(EC) is extremely rare and has not been well documented.Here,we report two cases of EG and coexistent EC along with findings from computed tomography(CT) and magnetic resonance imaging(MRI).An 18-year-old male with a history of hematuria,urgency and occasional urodynia for two weeks and a 34-year-old male with a history of abdominal distention for one week were admitted to our hospital.Abdominal contrast-enhanced CT in both patients revealed wall thickening in different parts of the gastrointestinal tract with inhomogeneous reinforcement,coexistent with local or diffuse bladder wall thickening with progressive enhancement,and also showed that the bladder mucosal lining was nondestructive.Pelvic MRI showed that the local or diffuse thickened bladder wall was iso-intense on T1-weighted images,hypointense on T2-weighted images,and slightly restricted on diffusion weighted imaging(DWI) in one case.After therapy,the thickened wall of the gastrointestinal tract and urinary bladder had improved markedly in the two cases.To the best of our knowledge,this is the first report on the radiological imaging of EG and coexistent EC by both CT and MRI and the first with DWI findings.
基金the Hubei Prov-ince Natural Sciences Foundation (No.2005ABA164).
文摘To study the relationship between bacterial infection and the etiology of cystitis glandularis, 36 female Wistar rats were divided into 3 groups. No intervention was given to the rats in the blank group. NS was infused into the bladder of the rats of the control group, and solution containing E. coil was injected into the bladder of experimental group. Three months later, tissue samples of bladder were collected and observed visually and under light microscope. The results showed that tissues of the blank group were normal＇, one sample in the control group showed Brunn＇s nests and cystitis cystica, and 10 in the experimental group had the change of cystitis glandularis. Compared to the blank and control group, samples in the experimental group showed significant change （P〈0.05）. There were no significant difference between blank group and control group （P〉0.05）. It is concluded that bladder instillation of E. coil can induce cystitis glandularis, which confirms that infection is the cause of cystitis glandularis.
基金This project was supported by a grant from the Hubei Pro-vincial Natural Sciences Foundation (No 2005ABA164)
文摘To examine the expression of human telomere reverse transcriptase （hTERT）, p53 and proliferating cell nuclear antigen （PCNA） in cystitis glandulafis, 38 patients were divided into two grouips： group A （including 18 cases of papillary cystitis glandularis） and group B （including 20 subjects with normal bladder mucosa）. All the cases were immunohistochemically examined by using antibodies specifically against p53 and PCNA, and hTERT was determined by in situ hybridization. hTERT was found in 6 cases （33.3%） and p53 was detected in 4 cases （22.2%） in group A, while they were not detected in group B. There were significant differences in hTERT and p53 expression between groups A and B （P〈0.05 for both）. PCNA was detected in 7 cases （38.9%） in group A and 1 case （5.0%） in group B, and significant difference in PCNA expression was found between the two groups （P〈0.05）. The expressions of hTERT, p53 and PCNA were significantly higher in group A than in group B, suggesting that papillary cystitis glandularis is predisposed to cancerous change, and p53, PCNA, hTERT may be related to the malignant alteration.
基金The Grant from the Medical Science and Technology Project of Zhejiang Province,No.2020KY354.
文摘BACKGROUND Pelvic lipomatosis(PL)is a rare benign condition with characteristic overgrowth of histologically benign fat and invasion and compression of pelvic organs,often leading to non-specific lower urinary tract symptoms(LUTS).Approximately 40%of patients with PL have cystitis glandularis(CG).The cause of PL combined with CG is poorly understood,and there is currently no effective treatment.Refractory CG with upper urinary tract obstruction even requires partial or radical bladder resection.CASE SUMMARY In this case,a patient suffering from PL with CG was treated by transurethral resection of bladder tumour(TUR-BT)and oral administration of celecoxib,a selective cyclooxygenase-2(COX-2)inhibitor.The LUTS were alleviated,and the cystoscopy results improved significantly.Immunohistochemistry showed upregulated COX-2 expression in the epithelium of TUR-BT samples,suggesting that COX-2 may participate in the pathophysiological process of PL combined with CG.CONCLUSION We report for the first time that celecoxib may be an effective treatment strategy for PL combined with refractory CG.
基金supported by the“Double First-Class”University project(CPU2018GF06).
文摘Abelmoschus manihot(L.)Medik.(A.manihot)is a traditional Chinese herbal medicine with a variety of pharmacological properties.It was first recorded in Jiayou Materia Medica dating back to the Song dynasty to eliminate urinary tract irritation by clearing away heat and diuretic effect.However,its pharmacological action on urinary tract infections has not been investigated.The present study aims to evaluate the anti-inflammatory activity of A.manihot on a mouse model of lipopolysaccharide(LPS)-induced cystitis.The results showed that A.manihot decreased white blood cell(WBC)count in urine sediments of the cystitis mice,alleviated bladder congestion,edema,as well as histopathological damage,reduced the expression levels of tumor necrosis factor-α,interleukin-6,and interleukin-1βsimultaneously.Moreover,A.manihot administration significantly downregulated the expression levels of TLR4,MYD88,IκBα,p-IκBα,NF-κB p65,and p-NF-κB p65 in LPS-induced cystitis mice.These findings demonstrated the protective effect of A.manihot against LPS-induced cystitis,which is attributed to its anti-inflammatory profile by suppressing TLR4/MYD88/NF-κB pathways.Our results suggest that A.manihot could be a potential candidate for cystitis treatment.
基金Supported by the"13th five-year"National Key Re-search and Development Program:2017YFC1703602。
文摘Introduction:Recurrent cystitis,defined as at least two episodes within six months or three episodes within one year,presented among about one fifth to one-third of women with history of cystitis or urinary tract infection(UTI) according to previous studies.However,the use of antibiotics can only resolve the urinary symptoms but not reduce the frequency of urinary symptoms recurrence,and meanwhile increasing rates of adverse effect of repetitive antimicrobial therapy and bacterial antimicrobial resistance became clinical concerns.This case report aims to present a case of recurrent cystitis treated by electroacupuncture(EA) in reducing recurrent frequency,amount of antibiotics used and urinary symptoms.Case presentation:A 42-year-old woman diagnosed with recurrent cystitis for five years presented mainly with recurrent dysuria,urine frequency and urgency.She received EA treatment 3 to 5 sessions a week and 30 min per session from August 2019 to August 2020 with 3-month suspension due to Coronavirus Disease 2019(COVID-19).During the treatment,both the frequency of recurrent urinary episode and symptoms were reduced.Although there was some fluctuation,the mean frequencies of daytime voiding reduced dramatically from 17.7 to 8.3,and night-time voiding from 4 to 1,and the number of voiding with moderate urgency was reduced from 17.7 to 2.3,and severe urgency dropped from 2.7 to 0.The patient’s scores of overactive bladder symptom score(OABSS) and overactive bladder questionnaire short form(OAB-q SF) were also improved.The postvoid residual urine volume(PVR) reduced from 42 mL to less than 10 mL Conclusion:This case of individual effect of EA for a woman with frequent recurrent cystitis suggested a plausible benefit of EA on reducing frequency,amount of antibiotics used and symptoms of recurrent cystitis,but further research is necessary to proof the efficacy and effectiveness among a wider population.
文摘Purpose: The effectiveness of daily or weekly instillation of non-alkalinized lidocaine for patients suffering interstitial cystitis and/or bladder pain syndrome was evaluated retrospectively. Patients and methods: Five female patients (40 - 71 years old) diagnosed as interstitial cystitis by cystoscopic findings and a 68 year-old bladder pain syndrome patient were enrolled. All patients, having interstitial cystitis, had undergone hydrodistention therapy previously and had not improved their symptoms by empirical therapies. Daily or weekly (upon their severity of symptoms) intravesical instillation of 20 ml of 4% non-alkalinized (pH 6.0 - 7.0) lidocaine solution was performed for several times, and patients were asked to keep them in the bladder as long as two hours each time. Previous medications such as anti-cholinergic drugs and analgesics were continued according to patient's requirements and symptoms. The treatment effect was evaluated comparing O'Leary-Sant Symptom Index for interstitial cystitis patients and visual analog pain scale before and after the series of lidocaine therapies. Results: Instillation was made 6 to 16 times. Patients with interstitial cystitis improved their symptoms from O'Leary-Sant Symptom Index 17.5 to 10, Problem Index from 14.8 to 6 in an average. Crouching pain disappeared in all these patients after the instillation therapy. Severe interstitial cystitis findings on cystoscopy disappeared completely in one patient after the therapy. One patient having bladder pain syndrome reduced her analgesics use, and bladder-filling pain decreased from 7 to 3 as a visual analog scale score. One patient complained palpitation at 11th instillation and abandoned treatment thereafter, otherwise, none of these patients showed side effect concerning lidocaine toxicity. Conclusions: Intravesical non-alkalinized lidocaine instillation therapy for interstitial cystitis/bladder pain syndrome patients were an easy, safe and effective treatment.
文摘Purpose: Since intravesically administered steroid therapy may treat bladder pain syndrome/interstitial cystitis (BPS/IC) with fewer side effects than the current treatment of orally administered steroids, we investigated whether the intravesical infusion of budesonide foam can effectively treat BPS/IC symptoms in a rat model of tranilast-induced BPS/IC. Methods: There were 6 rat treatment groups (n = 8 per group): control + single or daily saline infusion, tranilast + single or daily saline infusion, and tranilast + single or daily budesonide infusion. All groups except for the controls were fed a tranilast supplemented diet for 5 weeks. Budesonide and saline were infused intravesically. After the BPS/IC rat model underwent single infusion treatments, we measured the paw pain threshold using the von Frey test and continuous cystometry was taken. After two weeks of daily intravesical infusions, we measured locomotor activity and serum cortisol levels;harvested bladders underwent histological analysis. Results: Both pain threshold and locomotor activity were significantly lower in the saline-infused groups receiving the tranilast diet, but there were no differences between the budesonide-infused groups and the controls. The interval between bladder contractions was significantly shorter in the tranilast group than the control or tranilast + budesonide infusion groups. The serum cortisol levels did not change. Hematoxylin-Eosin stainings of the bladder showed thickening of the bladder muscle layer and mucosal edema in the tranilast group, while the tranilast + budesonide infusion group showed only mild changes. Conclusion: Intravesical infusion of budesonide effectively treated BPS/IC symptoms in a rat model of BPS/IC.
基金Supported by grant of Shandong Key Research and Development Program:2015GSF119020
文摘A 56-year-old female patient with interstitial cystitis was treated with umbilical moxibustion combined with acupuncture.The doctor prepared the wheat flour-made bowl and the herbal powder for umbilical moxibustion.The bowl was put on the patient's umbilicus with a small hole in the middle of the bowl directly facing the navel,in which,the herbal powder was filled.The moxa cone was put on the bowl and ignited.Totally,3 cones were used.During umbilical moxibustion,acupuncture was adopted at Guanyuan(关元CV12),Zhongji(中极CV3),Dahe(大赫KI12),etc.The above treatment was given twice a week and 2-week treatment was as one course.After 4 courses of treatment,the clinical symptoms basically disappeared.The cystoscopic examination results were recovered to be normal.
文摘Follicular cystitis is a non-specific inflammatory condition of the bladder where the aetiology is unknown.The extent of the disease can be mild or proliferative and bulky.Antibiotics,steroids,therapies used for interstitial cystitis,palliative cystectomy and radiotherapy have been reported as successful treatment options.We report a case of follicular cystitis that responded to a course of oral diethyl carbamazine.
文摘BACKGROUND Nearly-complete labial adhesions diagnosed with repetitive cystitis in postmenopausal women:A case report CASE SUMMARY The case of an 83-year-old woman who presented with dysuria,urination disorders,recurrent cystitis,and bacteriuria and was admitted to a private hospital after 1 mo of antibiotic treatment without improvement of her symptoms.Upon examination,labial adhesions were observed with nearly-complete labial fusion with a pinpoint opening.Bacteriuria was detected in urine analysis,and the urine culture test was positive for Escherichia coli.Therefore,a parenteral antibiotic(Fosfomycin)and topical estrogen cream were administered.However,since the adhesion did not separate after 2 wk of treatment,surgical correction was performed.First,adhesiolysis was conducted with a blunt instrument.Then,hysteroscopy and cystoscopy were performed.Hysteroscopic findings showed no abnormalities of the endometrium and endocervix,and the cystoscopic results were also normal.Finally,labiaplasty was completed to prevent adhesion recurrence.One month after the surgery,the discomfort while urinating was eliminated and the adhesion did not recur.CONCLUSION Labial adhesions in postmenopausal women cannot be successfully treated with estrogen creams,and surgical treatment should be considered.
