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Interstitielle Zystitis

Aktuelle Aspekte in der Diagnostik und Therapie

Interstitial cystitis

New aspects in diagnosis and therapy

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Zusammenfassung

Die interstitielle Zystitis (IC) ist eine chronisches, heterogenes Syndrom, das mit den klassischen Symptomen „Nykturie, Pollakisurie und Blasenschmerzen“ einhergeht. Populationsstudien zeigen ansteigende Prävalenz- und Inzidenzraten. Von den unterschiedlichen Hypothesen zur Pathogenese und Ätiologie werden die der epithelialen Dysfunktion und der neurourothelialen Wechselwirkung am häufigsten zur Erklärung genutzt. Es empfiehlt sich eine individuelle und flexible Anwendung der offiziellen Diagnosekriterien des NIDDK (National Institute of Diabetes, Digestive and Kidney Disease), um gut therapierbare Frühformen nicht zu übersehen. Da ein pathognomonischer Marker noch fehlt, beruht die Diagnose v. a. auf klinischen Befunden und dem Ausschluss von Differenzialdiagnosen. Blasenspiegelung und Probebiopsie sind nicht beweisend, machen die Diagnose jedoch wahrscheinlicher und können wichtige Informationen über den Ausprägungsgrad, auch in Hinblick auf eine angepasste Therapie, liefern. Die elektromotorische Medikamentenapplikation (EMDA) in der Instillationstherapie hat in den letzten Jahren die Erfolgsraten der konservativen Therapie deutlich verbessert.

Abstract

Interstitial cystitis is a chronic, heterogeneous syndrome that is characterized by the classic symptoms of bladder pain, nycturia, and pollakiuria. Population studies have shown an increase in prevalence and incidence. Different hypotheses exist about the etiology and pathogenesis. Epithelial dysfunction and neuro-urothelial interaction are the most frequently used causal models. Utilization of the official diagnosis criteria of the NIDDK (National Institute of Diabetes, Digestive and Kidney Disease) should be flexible and individual in order not to overlook early forms of IC. Since there is no pathognomonic marker, diagnosis of IC is a combination of typical patient history and exclusion of differential diagnoses. Cystoscopy and biopsies are not specific; however, they can provide useful information on extent and aid in treatment choice. The effectiveness of conservative therapy has been increased by using electromotive drug administration (EMDA) in instillation therapy.

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Authors and Affiliations

  1. Universitätsklinik und Poliklinik für Urologie, Homburg/Saar

    A. Loch

  2. Universitätsklinik für Pathologie, Homburg/Saar

    U. Stein

  3. Universitätsklinik und Poliklinik für Urologie, Oscar-Orth-Straße, 66421, Homburg/Saar

    A. Loch

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  1. A. Loch
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  2. U. Stein
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Correspondence to A. Loch.

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Loch, A., Stein, U. Interstitielle Zystitis. Urologe [A] 43, 1135–1146 (2004). https://doi.org/10.1007/s00120-004-0664-9

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  • DOI: https://doi.org/10.1007/s00120-004-0664-9

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