Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0677481 (urinary frequency)
 1,126 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Thirty three patients with carcinoma in situ (CIS) or/and numerous recurrences of superficial bladder tumor were treated with intravesical BCG after transurethral resection. 63% of patients with CIS were free of recurrence after two years, two underwent cystectomy and one died because of progression. Patients with Ta and concomitant CIS responded well to BCG, while the patient with T1 tumor and CIS was free from recurrence for 15 months. Dysplasia of grade II disappeared after BCG. 62% of patients with Ta tumor were without recurrence after one year, but after two years 86% of the patients had recurrences. Patients with T1 tumor were free from recurrence for eight months, after which 25% had progression. The side effects of BCG were transient: urinary frequency in 48%, malaise in 39%, dysuria in 36%, haematuria, bladder pain and fever in 24%. 15% of the patients required isoniazid treatment. It is concluded that intravesical BCG is beneficial in CIS and superficial bladder tumors.
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PMID:[Treatment of superficial bladder tumors with intravesical BCG]. 154 71

Double-pigtail stents are placed commonly in patients before extracorporeal shock wave lithotripsy to prevent ureteral obstruction from steinstrasse. The use of double-pigtail stents in lithotripsy patients with a moderate stone burden was studied in a prospective randomized trial. Patients with unilateral renal stone(s) with at least 1 diameter between 7 and 25 mm. were eligible for the study. Fifty patients were randomized to a control or stented group. Double-pigtail stents with an attached suture were placed immediately before extracorporeal shock wave lithotripsy in the stented group. Stents were removed by the patients 1 week after lithotripsy. A survey on pain and associated symptoms was completed by patients at 1 and 14 days after treatment. There was no statistical difference in flank or abdominal pain, nausea, vomiting, temperature or use of analgesics at 1 and 14 days after extracorporeal shock wave lithotripsy in the control and stented groups. All patients in the stented groups complained of side effects attributable to the stent including urinary frequency and urgency, bladder pain, hematuria and flank pain with urination. Of 25 patients with stents 7 (27%) had early removal because of severe irritation, early migration or accidental removal. Among the patients with follow-up x-rays 1 month after treatment 17 of 21 (81%) in the control group and 12 of 19 (63%) in the stented group showed no evidence of remaining stones. The use of double-pigtail stents is not beneficial in patients with a moderate stone burden. Double-pigtail stents are associated with considerable patient discomfort but no decrease in symptomatic ureteral obstruction or final stone eradication rate.
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PMID:Use of double-pigtail stents in extracorporeal shock wave lithotripsy. 240 62

Interstitial cystitis (IC) is manifest by years of urinary frequency, urgency, and bladder pain and on cystoscopy, is diagnosed by petechial hemorrhages or ulcers. The etiology is unknown; the prominent theories are that IC is an autoimmune disease or is linked to increased permeability of the bladder mucosa. Although sought, no infectious agent has ever been identified. The disease has many characteristics of a chronic infection and the author's opinion is that an infectious disease has not been properly ruled out. To do so would require culture of bladder epithelium (not just urine) using special culture and non-culture techniques such as polymerase chain reaction. Infection can easily be integrated into the autoimmune and permeability theories of IC pathogenesis. A possible analogue for this disease is chronic gastritis in which Helicobacter pylori has been identified as an etiological agent.
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PMID:Is interstitial cystitis an infectious disease? 781 76

Interstitial cystitis is a chronic disease of unknown etiology characterized by bladder pain and urinary frequency and urgency. The epithelium may be critical in its pathogenesis; the hallmarks of the disease are visible epithelial defects (Hunner's ulcers and epithelial ruptures). Areas denuded of epithelium are commonly seen, and defects in epithelial permeability are characteristic. We report here the culture and characterization of epithelial cells from cystoscopic bladder biopsies obtained from 7 female patients with interstitial cystitis. Within 4 to 14 days cellular outgrowths appeared from explants incubated in cell medium. Monolayers reached confluence after 6 weeks. Cells of the monolayer were cytokeratin-positive and smooth muscle actin-negative, confirming their epithelial origin. They exhibited epithelial cell ultrastructure including intermediate filaments and junctional complexes. Vesicles bounded by a trilaminar plasma membrane and lateral interdigitations were also present. This is the first report of the culture of bladder epithelium from interstitial cystitis patients. Epithelial cells may be targets for initiating agents and inflammatory effects of interstitial cystitis and should be useful for studies of the pathogenesis of this disease.
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PMID:Culture of bladder epithelium from cystoscopic biopsies of patients with interstitial cystitis. 796 81

A potential pathophysiological role for the urinary kallikrein-kinin system is suggested by the prominent symptoms of bladder pain and urinary frequency in interstitial cystitis. Kallikrein activity in the urine of 84 patients with interstitial cystitis and 33 normal volunteers was determined by cleavage of the synthetic substrate Val-Leu-Arg-pNA. Interstitial cystitis patients had significantly higher levels of kallikrein activity than did the normal volunteers. Kallikrein activity was correlated with symptoms of bladder pain and voiding frequency. The percentage of total urinary kallikrein in the active form correlated with active kallikrein levels and was also increased in interstitial cystitis patients, particularly those with higher levels of pain. Patients who underwent hydrodistention and subsequently experienced relief from the bladder symptoms had a decrease in urinary kallikrein levels, whereas patients who failed to improve following hydrodistention did not.
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PMID:Activation of urinary kallikrein in patients with interstitial cystitis. 805 40

Although most cell membranes permit rapid flux of water, small nonelectrolytes, and ammonia, the apical membranes of bladder epithelial umbrella cells, which form the bladder permeability barrier, exhibit strikingly low permeabilities to these substances. In cystitis, disruption of the bladder permeability barrier may irritate the bladder wall layers underlying the epithelium, causing or exacerbating inflammation, and increasing urinary frequency, urgency, and bladder pain. To determine the effects of inflammation on the integrity of the permeability barrier, guinea pigs were sensitized with ovalbumin, and the bladders were exposed subsequently to antigen by instillation on the urinary side. Inflammation of the bladder wall markedly reduced transepithelial resistance of dissected epithelium mounted in Ussing chambers and increased water and urea permeabilities modestly at 2 h and more strikingly at 24 h after induction of the inflammation. Transmission and scanning electron microscopy of bladders at 30 min and 24 h after antigen exposure revealed disruption of tight junctions, denuding of patches of epithelium, and occasional loss of apical membrane architecture. These permeability and structural effects did not occur in nonsensitized animals in which the bladders were exposed to antigen and in sensitized animals exposed to saline vehicle rather than antigen. These results demonstrate that inflammation of the underlying muscle and lamina propria can disrupt the bladder permeability barrier by damaging tight junctions and apical membranes and causing sloughing of epithelial cells. Leakage of urinary constituents through the damaged epithelium may then exacerbate the inflammation in the underlying muscle layers.
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PMID:Disruption of guinea pig urinary bladder permeability barrier in noninfectious cystitis. 945 41

Interstitial Cystitis (IC) is a chronic disease of unknown etiology which primarily affects women aged 40-60 years. Many plausible theories for the development of IC have been postulated, and one current theory is that these patients have a quantitative and qualitative defect in the glycosaminoglycan (GAG) layer of the urothelium. Such a defect may allow toxic substances in the urine to gain access to the lamina propria and initiate a chronic inflammatory process. Pentosanpolysulphate (PPS) is a sulphated proteoglycan similar in structure to heparin sulphate, which is quantitatively the major GAG on cell surfaces. Exogenously administered PPS has been shown in several studies to decrease bladder pain and urinary frequency and to increase the voided volume. Further studies are required to evaluate the role of PPS in the management of IC patients, with particular emphasis on dosage, route of administration and combination with other compounds.
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PMID:Pentosanpolysulphate for interstitial cystitis. 955 94

To establish the safety and efficacy of low-dose oral methotrexate in treating refractory interstitial cystitis, 9 women who fulfilled internationally accepted criteria for the diagnosis of interstitial cystitis were enrolled in a prospective study. All had proven unresponsive to conventional treatment modalities. Assessment by pain score and frequency volume charts was performed pretreatment and up to 6 months during therapy. No significant adverse side effects were noted. At the end of follow-up, 4 women had noted a subjective improvement in bladder pain and wished to continue on methotrexate, 4 women noted little change and 1 woman reported a worsening of symptoms. Overall there was a significant reduction in pain score (p = 0.047) posttreatment. However, there was no significant difference in urinary frequency per 24 hours (p = 0.40), maximum voided volume (p = 0.089) or mean voided volume (p = 0.59). Methotrexate significantly improved bladder pain in women with interstitial cystitis, although no significant change was found in voiding pattern.
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PMID:Oral methotrexate in the management of refractory interstitial cystitis. 1068 66

The involvement of C-fiber afferent pathways in urinary frequency and pain associated with painful bladder syndrome raises the possibility of multiple targets for the treatment of this disease. Using an in vivo measurement of bladder activity as well as whole-cell patch clamp recording techniques to examine the properties of bladder afferent neurons in animal models of chronic cystitis, we have documented that tetrodotoxin-resistant sodium channels encoded by the Na(v) 1.8 (PN3/SNS) gene and nitric oxide acting via a cyclic guanosine monophosphate (cGMP)-dependent mechanism are important in modulating bladder pain responses. Thus, suppression of C-fiber afferent nerve activity by blocking specific sodium channels, elevating nitric oxide levels, or activating cGMP-dependent pathways might represent novel strategies for the treatment of symptoms in patients with painful bladder syndrome. Another treatment strategy is suppression of release or activity of proinflammatory agents that can cause normally unexcitable C-fiber afferents to become hyperactive or hyperexcitable. This approach to management of bladder pain was tested in patients with painful bladder syndrome by examining the effectiveness of the antiallergic agent suplatast tosilate (IPD-1151T), which suppresses urinary frequency in a rat model of cystitis. IPD-1151T is an immunoregulator that suppresses cytokine production in T-helper 2 cells and inhibits immunoglobulin E antibody formation and antigen-induced histamine release from mast cells. Preliminary data from an open-label clinical trial showed that 16 of 23 (70%) patients responded to treatment with IPD-1151T (300 mg/day orally for 12 months). The finding that expression of platelet-derived endothelial cell growth factor, which can activate mast cells, was lower in the bladder of responders than nonresponders indicates that bladder levels of platelet-derived endothelial cell growth factor may be a useful marker for this disease.
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PMID:Targeting afferent hyperexcitability for therapy of the painful bladder syndrome. 1200 24

Interstitial cystitis (IC) is a disease complex characterized by urinary frequency, urgency, and bladder pain without an identifiable cause. Essentially, IC is a diagnosis of exclusion. The lack of knowledge of pathophysiology remains the biggest hurdle in diagnosis and treatment of this puzzling and troublesome disorder. Nevertheless, several recent advances, coupled with increased public awareness of this disease, make it easier for physicians and patients to effectively deal with IC.
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PMID:Interstitial cystitis: diagnosis and treatment options. 1215 Jul 58


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