Holm-Bentzen M, Jacobsen F, Nerstrøm B, Lose G, Kristensen J K, Pedersen R H, Krarup T, Feggetter J, Bates P, Barnard R
J Urol. 1987 Sep;138(3):500-2. doi: 10.1016/s0022-5347(17)43240-x.
The diagnostic criteria for interstitial cystitis considered as a subgroup of painful bladder disease (that is sensory bladder disease and chronic abacterial cystitis) are not well established. Some urologists rely on symptoms, while others rely on cystoscopic appearance or pathological findings. Among 115 patients with painful bladder disease we compared symptoms, and cystoscopic and urodynamic findings in those with and without detrusor mastocytosis (28 or more mast cells per mm.2) and attempted to elucidate possible differences between the groups. We chose the pathological anatomical criterion of detrusor mastocytosis to be diagnostic for interstitial cystitis. A total of 43 patients had detrusor mastocytosis and other pathological anatomical signs of interstitial cystitis, and 72 had no mastocytosis but the pathological diagnoses of chronic unspecific cystitis, fibrosis of the bladder, detrusor myopathy, intestinal metaplasia and normal findings. When the 2 groups of patients were compared we found no differences in regard to symptoms (pain, dysuria, frequency, nocturia and urgency), frequency of allergy and hysterectomy, duration of symptoms, petechial bleeding during cystoscopy with bladder distension and cystometric findings. The patients with mastocytosis differed from those without mastocytosis in that they were older, and had a higher frequency of hematuria, a higher frequency of a red, scarred and richly vascularized bladder at cystoscopy before distension, and a smaller cystoscopic bladder capacity. We conclude that by dividing patients with painful bladder into 2 groups according to the mast cell counts in the detrusor, certain differences in the clinical findings in the groups can be ruled out. However, in individual patients one cannot note with certainty to which pathological anatomical group the patient belongs, since great overlapping between the groups exists. Whether only patients with detrusor mastocytosis have interstitial cystitis depends on definitions and still remains an open question.
作为疼痛性膀胱疾病（即感觉性膀胱疾病和慢性非细菌性膀胱炎）一个亚组的间质性膀胱炎的诊断标准尚未完全确立。一些泌尿科医生依靠症状，而另一些则依靠膀胱镜检查结果或病理发现。在115例疼痛性膀胱疾病患者中，我们比较了有和没有逼尿肌肥大细胞增多症（每平方毫米28个或更多肥大细胞）患者的症状、膀胱镜检查和尿动力学检查结果，并试图阐明两组之间可能存在的差异。我们选择逼尿肌肥大细胞增多症的病理解剖学标准来诊断间质性膀胱炎。共有43例患者有逼尿肌肥大细胞增多症及间质性膀胱炎的其他病理解剖学体征，72例没有肥大细胞增多症，但病理诊断为慢性非特异性膀胱炎、膀胱纤维化、逼尿肌肌病、肠化生及正常表现。当比较这两组患者时，我们发现他们在症状（疼痛、排尿困难、尿频、夜尿和尿急）、过敏和子宫切除频率、症状持续时间、膀胱扩张时膀胱镜检查时的瘀点出血及膀胱测压结果方面没有差异。有肥大细胞增多症的患者与没有肥大细胞增多症的患者不同之处在于，他们年龄较大，血尿频率较高，扩张前膀胱镜检查时膀胱发红、瘢痕化且血管丰富的频率较高，膀胱镜检查时膀胱容量较小。我们得出结论，根据逼尿肌中的肥大细胞计数将疼痛性膀胱患者分为两组，可以排除两组临床发现中的某些差异。然而，对于个体患者，由于两组之间存在很大重叠，无法确定该患者属于哪个病理解剖学组。仅逼尿肌肥大细胞增多症的患者是否患有间质性膀胱炎取决于定义，仍然是一个悬而未决的问题。
