间质性膀胱炎和下尿路综合征进展学习资料

IC来自百度文库and LUTD
IC is a diagnosis of exclusion, but exclusion of OAB is usually difficult to do.
On one hand, because almost 60% of the patients regarded by experienced clinicians as suffering from IC/PBS failed to meet the criteria, so it is likely that the prevalence of IC/PBS is much higher than traditionally believed.
IC and LUTD
Functional classification is very important to neurogenic or non-neurogenic LUTD.
EAU lanched a classification system 2008 and proposed it for clinical practice. And we think its principle suited to nonneurogenic LUTD too.
prolapse (SUI/POP) 4. interstitial cystitis (IC) 5. geriatric incontinence (GI)
Supplement
According to the following description, two entities should be added into LUTD, i.e.
There are five entities of lower urinary tract dysfunction (LUTD) underlined together for establishing clinical practice guidelines
1. LUTS/BPH 2. overactive bladder (OAB) 3. stress urinary incontinence/pelvic floor
6. detrusor underactivity (DN) 7. sphincter overactivity (SO), formerly
dysfunctional voiding (DV)
IC and LUTD
Among the five entities, functional disorder dominated in OAB, SUI, and GI, pathological or mechanical factors may dominate in BPH and IC. Functional disorder may also result from BPH and IC. We should always take attention to organic as well as functional elements in the diagnosis and treatment of LUTD.
Diagnosis method
As the new century dawned, there was much confusion as to how to define this 100-year-old syndrome, and the need for a clinically useful, universally accepted way to characterize IC took to the forefront.
Old standard for interstitial cystitis (1988)
New name (PBS/IC）and its definition (confirmed in May 2007).
PBS/IC would be diagnosed on the basis of chronic pelvic pain, pressure or discomfort perceived to be related to the urinary bladder accompanied by at least one other urinary symptoms like persistent urge to void or urinary frequency. Confusable diseases as the cause of the symptoms must be excluded. Further documentation and classification of PBS/IC might be performed according to findings at cystoscopy with hydrodistention and morphological findings in bladder biopsies.
Changes of name and meaning
Diagnosis method
The potassium chloride test, an intravesical challenge comparing the sensory nerve provocative ability of saline versus potassium chloride using a 0.4M-KCl solution, has not gained acceptance as a diagnostic test for a variety of reasons.
The last two ones were marked as “sphincter only”, meaning the original lesion is subtle or unknown. Sphincter overactivity or underactivity in non-neurogenic LUTD, i.e., dysfunctional voiding (DV) or intrinsic sphincter deficiency （ISD）, have the same meaning.