|
|
|
|
- Providers for Midlife Patients Get IC Education
Dasgupta J, Tincello DG. Interstitial cystitis/bladder pain syndrome: An update. Maturitas. 2009 Oct 16. [Epub ahead of print]
This update on the latest ideas about the cause, the terminology, and the treatments for IC appeared in a journal aimed at a broad cross-section healthcare professionals who take care of patients at midlife. The article noted that the mainstays of treatment are bladder instillations and oral drugs.
- Review Helps Educate Kidney Specialists Worldwide
Moutzouris DA, Falagas ME. Interstitial Cystitis: An Unsolved Enigma. Clin J Am Soc Nephrol. 2009 Oct 1. [Epub ahead of print]
This review article in an international journal for kidney specialists informs them about IC and reminds them to keep the IC diagnosis in mind when they see patients with chronic urinary symptoms. The article pointed out that the diagnosis is still one made after ruling out other more common conditions and that “supportive” therapies (psychosocial, behavioral, and physical), instillations, and oral medications are the mainstays of treatment. Neuromodulation and surgery are reserved for difficult cases that don’t respond to other treatment.
- Recognition of IC as Potential Cause of Pelvic Pain Growing Worldwide
Siedentopf F. Chronic pelvic pain in women from a gynecologic viewpoint. [Article in German] Urologe A. 2009 Oct;48(10):1193-4,1196-8.
This article by a gynecologist in a German urology journal shows that awareness of IC is growing among gynecologists worldwide. Chronic pelvic pain has a number of possible gynecologic causes, but the author also included irritable bowel syndrome, IC, and fibromyalgia as potential causes.
- Spasm of Pelvic Floor Muscle Can Cause Pelvic Pain
Hull M, Corton MM. Evaluation of the levator ani and pelvic wall muscles in levator ani syndrome. Urol Nurs. 2009 Jul-Aug;29(4):225-31.
This article encourages nurses to learn about pelvic floor muscles and how to identify spasm, which can cause pelvic pain. Specifically, levator ani (one of the pelvic floor muscles) spasm syndrome is discussed in the article.
- Article Raises Awareness, Reviews Skills for Pelvic Floor Dysfunction Practice
Prather H, Dugan S, Fitzgerald C, Hunt D. Review of anatomy, evaluation, and treatment of musculoskeletal pelvic floor pain in women. PM R. 2009 Apr;1(4):346-58.
This article is a review of skills for physical therapists who treat musculoskeletal dysfunction of the pelvic floor and a resource for physical therapists who are interested in expanding their practice to pelvic floor disorders. If healthcare providers can recognize pelvic floor dysfunction better, impairment and disability for women with pelvic floor pain will be reduced. Further research, awareness, and care are needed, said the authors.
- Gynecologists Urge Colleagues to Consider IC
Dell JR, Mokrzycki ML, Jayne CJ. Differentiating interstitial cystitis from similar conditions commonly seen in gynecologic practice. Eur J Obstet Gynecol Reprod Biol. 2009 Jun;144(2):105-9. Epub 2009 May 5.
IC looks similar to many other conditions gynecologists see in women, so consider IC as a diagnosis when patients have urinary symptoms or pelvic pain, said these gynecologists. Their review pointed out that IC has similarities with recurrent urinary tract infections, endometriosis, chronic pelvic pain, vulvodynia, and overactive bladder and that IC may exist along with these conditions. Patients need a correct diagnosis to get treated appropriately.
- Helping GYNs Recognize IC
Dell JR, Mokrzycki ML, Jayne CJ. Differentiating interstitial cystitis from similar conditions commonly seen in gynecologic practice. Eur J Obstet Gynecol Reprod Biol. 2009 Apr 29. [Epub ahead of print]
This article is a lesson in how to tell IC apart from other conditions gynecologists see. These gynecologists let their colleagues know that diagnosing IC correctly is critical for their patients’ well-being. IC shares features with many conditions gynecologists commonly see, including recurrent urinary tract infections, endometriosis, chronic pelvic pain, vulvodynia, and overactive bladder, and can often coexist with these conditions. Gynecologists should consider an IC diagnosis when patients have bothersome voiding symptoms and/or pelvic pain. Tools to aid diagnosis and effective therapies are available, the authors emphasized.
- APF Has Potential for IC, Cancer
Barchi JJ Jr, Kaczmarek P. Short and sweet: evolution of a small glycopeptide from a bladder disorder to an anticancer lead. Mol Interv. 2009 Feb;9(1):14-7.
This review article in a journal for basic medical scientists describes the glycopeptide antiproliferative factor (APF) and its role in IC. APF is unusual because small glycopeptides secreted in the body rarely play a role in the progression of a disease. APF dramatically inhibits normal bladder cell proliferation and is thought to cause some of the characteristic pathological changes in the bladders of IC patients. APF also strongly inhibits the growth of certain tumor cells. How APF interacts with cellular receptors and the structural features critical for its activity are beginning to be understood. This interesting molecule is a powerful model for the design of new treatments and diagnostic tests for IC, as well as an unprecedented lead agent for novel anticancer drugs, said the authors.
- Japanese Society Develops Guidelines for IC Diagnosis, Treatment
Homma Y, Ueda T, Ito T, Takei M, Tomoe H. Japanese guideline for diagnosis and treatment of interstitial cystitis. Int J Urol. 2009 Jan;16(1):4-16.
The need for standardized interstitial cystitis guidelines for diagnosing and treating IC has become very apparent over the past few years and has generated a lot of heated debates. There has been much discussion surrounding what exactly IC is, what are its causes, what to call it, how to best diagnose it, and what treatments are most effective. Several countries and professional medical associations are now in the process of developing their own IC Guidelines, including Japan.
- IC Experts See Disappointments But Also Promise
Theoharides TC, Whitmore K, Stanford E, Moldwin R, O'Leary MP. Interstitial cystitis: bladder pain and beyond. Expert Opin Pharmacother. 2008 Dec;9(17):2979-94.
These IC experts looked for trends in research and treatment in the literature and found no new effective treatments but promise for finding causes and treatment targets from the growing evidence of connections with other conditions, nerve-generated inflammation, and stress. Oral pentosan polysulfate (Elmiron), amitriptyline (Elavil), hydroxyzine (Atarax, Vistaril), and quercetin as well as heparin, bicarbonate, and lidocaine instillations are being used with variable success. Although many promising treatments have not withstood more rigorous testing, some pilot studies of new treatments are nevertheless encouraging.
- IC Experts Inform through Global Clinical Journal
Forrest JB, Moldwin R. Diagnostic options for early identification and management of interstitial cystitis/painful bladder syndrome. Int J Clin Pract. 2008 Dec;62(12):1926-34.
For a worldwide readership of clinicians, these two IC experts discussed the pros and cons of different diagnostic methods and laid out treatment options, including oral medication, bladder instillation, dietary modification, and physical therapy. The authors emphasized early diagnosis and treatment as well good follow-up. Early diagnosis and treatment, they said, can bring better outcomes, and follow-up can be an opportunity to educate and empower patients to participate in their treatment. They also argued that multimodal therapy with an emphasis on patient education can help ensure success in treating IC. This paper is available free-of-charge online.
- Medical Student Urges Training in IC
Hazzard MA. A medical student perspective on interstitial cystitis: a view from the womb. Int J Clin Pract. 2008 Dec;62(12):1825-6.
In this editorial, a fourth-year medical student describes his experience studying IC and the stark contrast with his medical education, in which IC was barely mentioned. He said it would be like not noticing the elephant sitting in your living room. Polling his fellow students from other medical schools showed that his experience wasn’t unique. One student asked, “Isn’t that some type of lung disease?” He stated, “As long as medical educators fail to stress the importance and prevalence of IC in the general population, students will continue to advance through their graduate medical training, be deployed onto the front lines of our nation’s medical fields, and millions of patients with IC will continue to suffer needlessly mis- or undiagnosed.” Medical students, he believes, should know what a average bladder capacity, rate of urine production, and, therefore, normal number of voids per day are, just as they know what normal blood pressure is. Although he noted that review articles, like the one above, to educate practicing physicians are good, they are not enough, and that IC leaders should teach medical students, at the very least, to recognize IC. He, like the authors of the educational article above, believe that early diagnosis and treatment is the key to the best outcomes for patients.
Revised October 27, 2009
|
|
|