Argüelles Rojas Sofía, Oviedo Ortega José G, Velasco Sordo Roberto
Obstetrics and Gynecology, Centro Médico ABC (American British Cowdray), Mexico City, MEX.
Cureus. 2021 Apr 18;13(4):e14549. doi: 10.7759/cureus.14549.
Interstitial cystitis or painful bladder syndrome is a chronic condition characterized by severe and acyclic pelvic pain lasting for a period of at least six weeks. Although this condition is not accompanied by urinary infection, the patient's daily activities are impeded. The most common symptoms are urinary frequency, dysuria, suprapubic pain, nycturia, and dyspareunia. The etiology of interstitial cystitis is unclear, and its diagnosis is infrequent because of the low number of cases. A definitive diagnosis is based on cystoscopic findings and typical histopathological evidence, such as Hunner's ulcers. Herein, we describe the diagnosis and treatment of a clinical case of interstitial cystitis in a patient who started presenting symptoms during pregnancy. A 42-year-old woman at 27.2 weeks of pregnancy began showing symptoms at 10 weeks of gestation. She presented with dysuria and hypogastric pain with an intensity of 9/10, which hindered her daily activities. Physical examination revealed tenderness to deep and superficial hypogastric palpation. Routine urinalysis and urine culture test yielded negative results. She was started on symptomatic treatment from 10 weeks of gestation, but it did not result in any improvement. Therefore, intraoperative diagnostic cystoscopy was performed to obtain biopsy samples. Histopathological analysis of the samples showed evidence of interstitial cystitis. Accordingly, she was started on intravesical instillation of hyaluronic acid, which improved her condition. On the basis of the case findings, we recommend that interstitial cystitis should be considered a differential diagnosis in patients with pelvic pain and urinary symptoms unrelated to a urinary infection.
间质性膀胱炎或膀胱疼痛综合征是一种慢性疾病，其特征为严重且无周期性的盆腔疼痛，持续时间至少六周。尽管该疾病不伴有泌尿系统感染，但患者的日常活动受到影响。最常见的症状是尿频、尿痛、耻骨上疼痛、夜尿症和性交困难。间质性膀胱炎的病因尚不清楚，由于病例数量较少，其诊断并不常见。明确诊断基于膀胱镜检查结果和典型的组织病理学证据，如Hunner溃疡。在此，我们描述了一名在孕期开始出现症状的间质性膀胱炎临床病例的诊断和治疗。一名怀孕27.2周的42岁女性在妊娠10周时开始出现症状。她表现为尿痛和下腹部疼痛，疼痛强度为9/10，这妨碍了她的日常活动。体格检查发现下腹部深浅触诊均有压痛。常规尿液分析和尿培养检查结果均为阴性。她从妊娠10周开始接受对症治疗，但没有任何改善。因此，进行了术中诊断性膀胱镜检查以获取活检样本。样本的组织病理学分析显示有间质性膀胱炎的证据。据此，她开始接受膀胱内注射透明质酸治疗，病情得到改善。根据病例结果，我们建议对于有盆腔疼痛和与泌尿系统感染无关的泌尿系统症状的患者，应将间质性膀胱炎作为鉴别诊断。
