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Current standard of care in treatment of bladder pain syndrome/interstitial cystitis

Bladder pain syndrome/interstitial cystitis (BPS/IC) is a debilitating, systemic pain syndrome with a cardinal symptom of bladder related pain with associated systemic symptoms. It is characterized by an inflammation that partially or completely destroys the mucus membrane and can extend into the mu...

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Autores principales: Lopez, Sabela Rodriguez, Mangır, Naşide
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8202321/
https://www.ncbi.nlm.nih.gov/pubmed/34178118
http://dx.doi.org/10.1177/17562872211022478
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author Lopez, Sabela Rodriguez
Mangır, Naşide
author_facet Lopez, Sabela Rodriguez
Mangır, Naşide
author_sort Lopez, Sabela Rodriguez
collection PubMed
description Bladder pain syndrome/interstitial cystitis (BPS/IC) is a debilitating, systemic pain syndrome with a cardinal symptom of bladder related pain with associated systemic symptoms. It is characterized by an inflammation that partially or completely destroys the mucus membrane and can extend into the muscle layer; however, the etiology and pathogenesis is still enigmatic. It has been suggested that mast cell activation, defects in the glycosaminoglycan layer, non-functional proliferation of bladder epithelial cells, neurogenic inflammation, microvascular abnormalities in the submucosal layer, autoimmunity and infectious causes may cause BPS/IC. Available treatment options include general relaxation techniques, patient education, behavioral treatments, physical therapy, multimodal pain therapy, oral (amitriptyline, cimetidine, hydroxyzine) and intravesical treatments (heparin, lidocaine, hyaluronic acid and chondroitin sulfate), hydrodistension and other more invasive treatments. Available treatments are mostly not based on a high level of evidence. Lack of understanding of disease mechanisms has resulted in lack of targeted therapies on this area and a wealth of empirical approaches with usually inadequate efficacy. The aim of this article is to review the available evidence on the pathophysiological mechanisms of BPS/IC as they relate to available treatment options.
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spelling pubmed-82023212021-06-24 Current standard of care in treatment of bladder pain syndrome/interstitial cystitis Lopez, Sabela Rodriguez Mangır, Naşide Ther Adv Urol Review Bladder pain syndrome/interstitial cystitis (BPS/IC) is a debilitating, systemic pain syndrome with a cardinal symptom of bladder related pain with associated systemic symptoms. It is characterized by an inflammation that partially or completely destroys the mucus membrane and can extend into the muscle layer; however, the etiology and pathogenesis is still enigmatic. It has been suggested that mast cell activation, defects in the glycosaminoglycan layer, non-functional proliferation of bladder epithelial cells, neurogenic inflammation, microvascular abnormalities in the submucosal layer, autoimmunity and infectious causes may cause BPS/IC. Available treatment options include general relaxation techniques, patient education, behavioral treatments, physical therapy, multimodal pain therapy, oral (amitriptyline, cimetidine, hydroxyzine) and intravesical treatments (heparin, lidocaine, hyaluronic acid and chondroitin sulfate), hydrodistension and other more invasive treatments. Available treatments are mostly not based on a high level of evidence. Lack of understanding of disease mechanisms has resulted in lack of targeted therapies on this area and a wealth of empirical approaches with usually inadequate efficacy. The aim of this article is to review the available evidence on the pathophysiological mechanisms of BPS/IC as they relate to available treatment options. SAGE Publications 2021-06-12 /pmc/articles/PMC8202321/ /pubmed/34178118 http://dx.doi.org/10.1177/17562872211022478 Text en © The Author(s), 2021 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Review
Lopez, Sabela Rodriguez
Mangır, Naşide
Current standard of care in treatment of bladder pain syndrome/interstitial cystitis
title Current standard of care in treatment of bladder pain syndrome/interstitial cystitis
title_full Current standard of care in treatment of bladder pain syndrome/interstitial cystitis
title_fullStr Current standard of care in treatment of bladder pain syndrome/interstitial cystitis
title_full_unstemmed Current standard of care in treatment of bladder pain syndrome/interstitial cystitis
title_short Current standard of care in treatment of bladder pain syndrome/interstitial cystitis
title_sort current standard of care in treatment of bladder pain syndrome/interstitial cystitis
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8202321/
https://www.ncbi.nlm.nih.gov/pubmed/34178118
http://dx.doi.org/10.1177/17562872211022478
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