What are the clinical and pathologic features needed for the diagnosis of interstitial cystitis? What are the most important entities that should be considered in the differential diagnosis?
Although called “cystitis” for years, interstitial cystitis currently is regarded as a painful bladder syndrome because it does not always demonstrate an inflammatory picture microscopically. It is an enigmatic condition of unknown etiology and pathogenesis. The diagnosis is established based on clinical features, which consist of irritative voiding symptoms including urgency, frequency, pain, and absence of objective evidence of other disease (including negative urine culture and cytology) as well as characteristic endoscopic findings, which generally are demonstrated after overdistension of the bladder. Because the presenting symptoms of interstitial cystitis are suggestive of an inflammatory process, infectious disease, or a urothelial neoplasm, especially carcinoma in situ must be excluded by urine culture and microscopic examination of urine sediment/biopsy specimens. The etiology and pathogenesis and therapy are discussed under Questions 6 and 7, respectively.
KeywordsMast Cell Lamina Propria Interstitial Cystitis Detrusor Muscle Urethral Diverticulum
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