Multimodal therapies and strategies for the treatment of interstitial cystitis/bladder pain syndrome in Taiwan

IF 1.5 4区 医学 Q3 UROLOGY & NEPHROLOGY
Wan-Ru Yu, Hann-Chorng Kuo
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引用次数: 0

Abstract

Interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic disease characterized by bladder pain, frequency, and nocturia. The most common pathologies include chronic inflammation and bladder urothelium dysfunction. According to the bladder condition with or without Hunner's lesions, IC/BPS can be divided into “IC” in patients with Hunner's lesion (HIC) and “BPS” in those without Hunner's lesion (NHIC). Previous studies have reported greater central sensitization and interorgan cross-talk in patients with NHIC. Multimodal treatments have been recommended in clinical guidelines under the biopsychosocial model. The bladder–gut–brain axis has also been speculated, and multimodal therapies are necessary. Unfortunately, currently, no treatment has been reported durable for IC/BPS. Patients with IC/BPS usually experience anxiety, depression, holistic physical responses, and even threats to social support systems. The lack of durable treatment outcomes might result from inadequate diagnostic accuracy and differentiation of clinical phenotypes based on the underlying pathophysiology. Precision assessment and treatment are essential for optimal therapy under definite IC/BPS phenotype. This article reviewed currently available literature and proposed a diagnosis and treatment algorithm. Based on bladder therapy combined with suitable physical and psychological therapies, a well-grounded multimodal therapy and treatment algorithm for IC/BPS following a diagnostic protocol are indispensable.

台湾间质性膀胱炎/膀胱疼痛综合征的多模式治疗与策略。
间质性膀胱炎/膀胱疼痛综合征(IC/BPS)是一种以膀胱疼痛、尿频和夜尿为特征的慢性疾病。最常见的病理包括慢性炎症和膀胱尿路上皮功能障碍。根据有无Hunner's病变的膀胱情况,IC/BPS可分为有Hunner's病变的“IC”(HIC)和无Hunner's病变的“BPS”(NHIC)。先前的研究报道了NHIC患者更大的中枢致敏和器官间串扰。在生物心理社会模型下的临床指南中推荐了多模式治疗。膀胱-肠-脑轴也被推测,多模式治疗是必要的。不幸的是,目前还没有关于IC/BPS持久治疗的报道。IC/BPS患者通常会经历焦虑、抑郁、整体身体反应,甚至对社会支持系统构成威胁。缺乏持久的治疗结果可能是由于诊断准确性不足和基于潜在病理生理学的临床表型分化。精确的评估和治疗对于确定IC/BPS表型的最佳治疗至关重要。本文回顾了现有文献,提出了一种诊断和治疗算法。在膀胱治疗的基础上,结合适当的物理和心理治疗,一种基于诊断方案的IC/BPS多模式治疗和治疗算法是必不可少的。
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来源期刊
LUTS: Lower Urinary Tract Symptoms
LUTS: Lower Urinary Tract Symptoms UROLOGY & NEPHROLOGY-
CiteScore
3.00
自引率
7.70%
发文量
52
审稿时长
>12 weeks
期刊介绍: LUTS is designed for the timely communication of peer-reviewed studies which provides new clinical and basic science information to physicians and researchers in the field of neurourology, urodynamics and urogynecology. Contributions are reviewed and selected by a group of distinguished referees from around the world, some of whom constitute the journal''s Editorial Board. The journal covers both basic and clinical research on lower urinary tract dysfunctions (LUTD), such as overactive bladder (OAB), detrusor underactivity, benign prostatic hyperplasia (BPH), bladder outlet obstruction (BOO), urinary incontinence, pelvic organ prolapse (POP), painful bladder syndrome (PBS), as well as on other relevant conditions. Case reports are published only if new findings are provided. LUTS is an official journal of the Japanese Continence Society, the Korean Continence Society, and the Taiwanese Continence Society. Submission of papers from all countries are welcome. LUTS has been accepted into Science Citation Index Expanded (SCIE) with a 2011 Impact Factor.
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