Clinical Relevance of Bladder Histopathological Findings and Their Impact on Treatment Outcomes among Patients with Interstitial Cystitis/Bladder Pain Syndrome: An Investigation of the European Society for the Study of Interstitial Cystitis Histopathological Classification

No AccessJournal of UrologyAdult Urology1 Jan 2021Clinical Relevance of Bladder Histopathological Findings and Their Impact on Treatment Outcomes among Patients with Interstitial Cystitis/Bladder Pain Syndrome: An Investigation of the European Society for the Study of Interstitial Cystitis Histopathological ClassificationThis article is commented on by the following:Editorial CommentEditorial Comment Jia-Fong Jhang, Yung-Hsiang Hsu, Yuan-Hong Jiang, Han-Chen Ho, and Hann-Chorng Kuo Jia-Fong JhangJia-Fong Jhang Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, and Tzu Chi University, Hualien, Taiwan Equal study contribution. More articles by this author , Yung-Hsiang HsuYung-Hsiang Hsu Department of Pathology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, and Tzu Chi University, Hualien, Taiwan Equal study contribution. More articles by this author , Yuan-Hong JiangYuan-Hong Jiang Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, and Tzu Chi University, Hualien, Taiwan More articles by this author , Han-Chen HoHan-Chen Ho Department of Anatomy, Tzu Chi University, Hualien, Taiwan More articles by this author , and Hann-Chorng KuoHann-Chorng Kuo †Correspondence: Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, and Tzu Chi University, Hualien, Taiwan, 707 Chung-Yang Rd., Section 3, Hualien970, Taiwan telephone: +88638651825, ext. 2113; E-mail Address: [email protected] Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, and Tzu Chi University, Hualien, Taiwan More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001334AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We investigate the clinical significance of European Society for the Study of Interstitial Cystitis (ESSIC) bladder histopathological classification and its impact on treatment outcomes among patients with interstitial cystitis/bladder pain syndrome. Materials and Methods: Bladder biopsy specimens obtained from severe, treatment refractory interstitial cystitis/bladder pain syndrome cases were analyzed by a single pathologist blinded to clinical data. Inflammatory cell infiltration and urothelium denudation, eosinophil infiltration, plasma cell infiltration, lamina propria hemorrhage and granulation in specimens were evaluated separately. Patients with at least 1 histopathological finding were classified as ESSIC type C, with the rest being classified as ESSIC type A. Current overall treatment outcomes were determined via telephone interview. Results: Bladder specimens were obtained from 352 patients with interstitial cystitis/bladder pain syndrome. Bladder inflammation, urothelium denudation, eosinophil and plasma cell infiltration, lamina propria hemorrhage and granulation were present in 69.6%, 44.6%, 9.1%, 15.3%, 4.8% and 5.1% of the bladder specimens, respectively. Approximately 78.7% of the patients included were ESSIC type C and had a smaller cystometric bladder capacity and higher bladder pain compared to ESSIC type A. Although individual histopathological findings were not associated with treatment outcome, a higher proportion of ESSIC type A patients had worse, unchanged or less than 25% improvement outcomes compared to ESSIC type C (43.1% vs 25.8%, p=0.025). Conclusions: Bladder histopathological findings were associated with clinical parameters and differences in patient reported treatment outcomes. Accordingly, patients with interstitial cystitis/bladder pain syndrome who had no remarkable bladder histopathological findings had less favorable treatment outcomes compared to those who did. References 1. : Role of inflammation in bladder function and interstitial cystitis. Ther Adv Urol 2011; 3: 19. Google Scholar 2. ; Diagnosis and treatment of interstitial cystitis/bladder pain syndrome: AUA guideline amendment. J Urol 2015; 193: 1545. 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Link, Google Scholar No direct or indirect commercial, personal, academic, political, religious or ethical incentive is associated with publishing this article. © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byShin J, Kang B and Choo M (2021) Features of Various Bladder Lesions and Their Impact on Clinical Symptoms and Recurrence in Interstitial CystitisJournal of Urology, VOL. 206, NO. 3, (669-678), Online publication date: 1-Sep-2021.Related articlesJournal of Urology12 Nov 2020Editorial CommentJournal of Urology12 Nov 2020Editorial Comment Volume 205Issue 1January 2021Page: 226-235Supplementary Materials Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.Keywordstreatment outcomepathologyurotheliumurodynamicsMetricsAuthor Information Jia-Fong Jhang Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, and Tzu Chi University, Hualien, Taiwan Equal study contribution. More articles by this author Yung-Hsiang Hsu Department of Pathology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, and Tzu Chi University, Hualien, Taiwan Equal study contribution. More articles by this author Yuan-Hong Jiang Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, and Tzu Chi University, Hualien, Taiwan More articles by this author Han-Chen Ho Department of Anatomy, Tzu Chi University, Hualien, Taiwan More articles by this author Hann-Chorng Kuo Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, and Tzu Chi University, Hualien, Taiwan †Correspondence: Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, and Tzu Chi University, Hualien, Taiwan, 707 Chung-Yang Rd., Section 3, Hualien970, Taiwan telephone: +88638651825, ext. 2113; E-mail Address: [email protected] More articles by this author Expand All No direct or indirect commercial, personal, academic, political, religious or ethical incentive is associated with publishing this article. Advertisement PDF downloadLoading ...