Holm-Bentzen M, Larsen S, Hainau B, Hald T
Scand J Urol Nephrol. 1985;19(1):21-6. doi: 10.3109/00365598509180217.
Chronic abacterial cystitis is clinically and pathoanatomically an ill-defined condition, presenting with a variety of urologic symptoms and often nonspecific histology. A retrospective histologic analysis of bladder biopsies from 101 patients with chronic abacterial cystitis revealed degenerative changes in the detrusor muscle cells (detrusor myopathy) in 25 of them. The changes were often very severe, and even fatty replacement of muscle tissue was seen. Retrospective analysis of the symptoms, urodynamics and cystoscopic findings in these patients showed that none had haematuria, but five (all women) had had urinary retention requiring catheterization. Significant residual urine was found in nine patients, and the cystometrograms showed a shift to the right. No patient had infravesical obstruction. At cystoscopy less than half of the patients had petechial bleeding after bladder distension. The aetiology and pathogenesis of the degenerative changes are unknown, despite theoretic speculation. The authors conclude that careful histologic examination can identify different clinical types of chronic abacterial cystitis. Such studies may assist future research into the nature of the problem and also the search for more rational therapy.
慢性非细菌性膀胱炎在临床和病理解剖学上是一种定义不明确的病症，表现为多种泌尿系统症状，且组织学表现往往不具有特异性。对101例慢性非细菌性膀胱炎患者的膀胱活检进行回顾性组织学分析发现，其中25例患者的逼尿肌细胞出现退行性改变（逼尿肌肌病）。这些改变通常非常严重，甚至可见肌肉组织的脂肪替代。对这些患者的症状、尿动力学和膀胱镜检查结果进行回顾性分析发现，无一例患者有血尿，但有5例（均为女性）出现尿潴留需要导尿。9例患者发现有大量残余尿，膀胱压力容积测定显示曲线右移。无患者存在膀胱以下梗阻。膀胱镜检查时，不到一半的患者在膀胱扩张后有瘀点性出血。尽管有理论推测，但退行性改变的病因和发病机制尚不清楚。作者得出结论，仔细的组织学检查可以识别慢性非细菌性膀胱炎的不同临床类型。此类研究可能有助于未来对该问题本质的研究，也有助于寻找更合理的治疗方法。
