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BPS and CONFUSABLE DISEASES:  
literature on benign prostate obstruction (hypertrophy) relevant for BPS
 
The ESSIC obtained consensus on a new classification of IC and to replace the name IC by BPS (bladder pain syndrome) followed by a type indication. Click here for more details.
 
  • Glomerulation observed during transurethral resection of the prostate for patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia is a common finding but no predictor of clinical outcome.
    Furuya R, Masumori N, Furuya S, et al. Urology 2007;70:922-6
    • 197 patients aged 50 years or older who were considered to be appropriate candidates to undergo TURP for LUTS/BPH were investigated in this study
    • just before beginning resection, the bladder was filled to a water pressure of 80 cm and the capacity was measured
    • after evacuation of the fluid, careful inspection was conducted for glomerulation during refilling
    • glomerulation was observed in 40 of the 197 patients (20.3%)
    • there was no difference in bladder capacity between the glomerulation and nonglomerulation groups, although the glomerulation group was younger with lighter resected weight and a higher baseline IC problem index than the nonglomerulation group
    • the authors conclude that glomerulation observed during transurethral resection of the prostate for patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia is a common finding but no predictor of clinical outcome
  • Is benign prostatic hyperplasia (BPH) an immune inflammatory disease?
    Kramer G, Mitteregger D, Marberger M. Eur Urol 2006 Dec 11; [Epub ahead of print]
    • almost all BPH specimens showed inflammatory infiltrates consisting predominantly of CD4+ T-lymphocytes
    • according to the authors, their data strongly suggest that BPH is an immune inflammatory disease

  • Interstitial cystitis in men.
    Novicki DE, Larson TR, Swanson SK. Urology. 1998 Oct;52(4):621-4.
    • a chart review of 29 men diagnosed with IC was performed and IC was diagnosed at a mean age of 67.3 years
    • there was a 4-year diagnostic lag between presentation and diagnosis
    • the most common prior erroneous diagnoses were prostatitis in 48% and benign prostatic hypertrophy (BPH) in 38% of the men
    • ulcers were encountered cystoscopically in about 70% and biopsy specimens uniformly showed nonspecific chronic cystitis at the time of diagnosis. • • the authors conclude that
    a) IC should be considered in the differential diagnosis of voiding disorders accompanied by irritative symptoms and pelvic pain in older men
    b) the diagnosis should be especially considered in men who are refractory to the usual treatments for BPH and prostatitis
    c) cystoscopy and bladder distention under anesthesia provided the most useful objective information in our hands
    d) biopsy is useful to rule out inflammatory cancer but adds little to the diagnosis of IC
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
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