Journal
JOURNAL OF UROLOGY
Volume 193, Issue 6, Pages 1994-2000Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.juro.2015.01.036
Keywords
urinary bladder, overactive; cystitis, interstitial; mast cells; pain; diagnosis
Categories
Funding
- Astellas European Foundation Prize Fund in Urology
- Functional Urology/Uro-Gynaecology Grant
- IKBT
- Cantonal Hospital Frauenfeld, Spital Thurgau AG
Ask authors/readers for more resources
Purpose: ESSIC identifies mast cell infiltrates of detrusor muscle as a diagnostic criterion for bladder pain syndrome/interstitial cystitis. However, an increased mast cell count is also characteristic of overactive bladder syndrome. The lack of uniformity in mast cell detection methods hampers data comparison. Using state-of-the-art techniques we investigated whether mast cells differ among bladder conditions. Materials and Methods: We analyzed bladder biopsies from 56 patients, including 31 with bladder pain syndrome/interstitial cystitis with (12) or without (19) Hunner lesions, 13 with overactive bladder syndrome and 12 without bladder symptoms to determine the quantity, location, distribution and activation of mast cells using immunohistochemistry with anti-mast cell tryptase. Patients were allocated to study groups by key bladder symptoms commonly used to define conditions (pain and major urgency). Results: Subepithelial mast cell localization (p < 0.001) and an increased detrusor mast cell count (p = 0.029) were characteristic of bladder pain syndrome/interstitial cystitis with Hunner lesions. The optimal cutoff of 32 detrusor mast cells per mm(2) achieved only 68% accuracy with 38% positive predictive value. No difference was observed between bladder pain syndrome/interstitial cystitis without Hunner lesions and overactive bladder syndrome. Patient groups differed in lymphocyte infiltration (p = 0.001), nodular lymphocyte aggregates (p < 0.001) and urothelium integrity (p < 0.001). Conclusions: Subepithelial mast cell distribution was characteristic of bladder pain syndrome/interstitial cystitis with Hunner lesions. Detrusor mastocytosis had poor predictive value for bladder pain syndrome/interstitial cystitis. Mast cell assessment did not distinguish bladder pain syndrome/ interstitial cystitis without Hunner lesions from overactive bladder syndrome.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available