Ciprofloxacin
M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson in Kucers’ The Use of Antibiotics, 2017
Interstitial cystitis is a chronic condition of unknown etiology characterized by bladder pain, urinary urgency, and urinary frequency. An infectious etiology has not been clearly documented, but various organisms can be cultured from urine specimens, and some patients report symptomatic improvement in association with antibiotic use. In an open pilot study involving 50 women with this condition who received sequential therapy with 3 weeks each of doxycycline, erythromycin, metronidazole, clindamycin, amoxicillin, and ciprofloxacin, all in conjunction with rifampicin, there was no significant improvement in symptoms in comparison with placebo (Warren et al., 2000). Perhaps not surprisingly, there was a significant increase in adverse effects among patients receiving active agents. This study suggests that antibiotics do not have a role to play in this condition.
Chronic Prostatitis/Chronic Pelvic Pain Syndrome—A Urologist’s Perspective
Gary W. Jay in Practical Guide to Chronic Pain Syndromes, 2016
One example would be differentiating between CP/CPPS and interstitial cystitis in the male. A detailed review of the diagnosis of interstitial cystitis is presented thoroughly in the chapter on interstitial cystitis. The distinction between CP/CPPS and interstitial cystitis is particularly challenging in that both conditions are diagnoses of exclusion, that is, two separate “wastebasket” diagnoses. No diagnostic test can be used to definitively establish or to exclude the diagnosis of CP/CPPS or interstitial cystitis. In fact, there is at least the theoretical possibility that a given patient could actually have both conditions concurrently. Cystoscopy under anesthesia may include a bladder biopsy and possible bladder hydrodistension when there is a high index of suspicion to confirm the diagnosis (1,2).
Chronic abdominal, groin, and perineal pain of visceral origin
Peter R Wilson, Paul J Watson, Jennifer A Haythornthwaite, Troels S Jensen in Clinical Pain Management, 2008
At present, there is no agreed upon etiology or pathophysiology for interstitial cystitis (IC). The only defining pathology is the presence of mucosal ulcers or “glomerulations” (small submucosal petechial hemorrhages) viewed cystoscopically after hydrodistension (sustained distension of the bladder). The presence of Hunner’s (mucosal) ulcers, so named after the first clinician to describe them, separates IC patients into those with ulcerative versus nonulcerative types. Glomerulations are not unique to IC, but occur in other forms of cystitis (e.g. radiation cystitis). Theories related to the development of IC have centered around four primary hypotheses: that a disruption of the normal urothelial barrier has occurred and bladder sensory nerves are being activated by urinary constituents;that a systemic autoimmune disease is presenting as a local manifestation;that abnormal mast cell activity occurs within the bladder; andthat alterations in peripheral and/or central nervous system structures have led to a neuropathic type of pain.
Using the UPOINT system to manage men with chronic pelvic pain syndrome
Published in Arab Journal of Urology, 2021
Darren J. Bryk, Daniel A. Shoskes
Once the physical examination is complete, the next step is laboratory tests or other diagnostic tools [9,15]. Urine analysis and urine culture should be obtained. During the DRE, prostate massage can be performed to obtain expressed prostate secretions (EPS), which can be cultured, or to obtain a post-massage urine for culture. Pre- and post-massage urine cultures, also known as the ‘two-glass’ test can aid in diagnosis of chronic bacterial prostatitis with similar accuracy as the historical ‘four-glass’ test [17]. As antibiotics can persist in the prostate fluid, cultures should ideally be obtained after being off antibiotics for ≥2 weeks. If appropriate by history, testing for sexually transmitted infections should be included [8]. We routinely measure a post-void residual in all men with pelvic pain or LUTS. The PSA level should be measured as appropriate for age and physical examination. Cystoscopy is indicated if other pathology is suspected (e.g. haematuria, interstitial cystitis) but does not need to be part of the routine evaluation [5]. The key features in men to suggest interstitial cystitis are severe LUTS and pain that worsens with bladder filling and improves with emptying [18].
Delayed Urinary Symptoms Induced by Ketamine
Published in Journal of Psychoactive Drugs, 2018
María Robles-Martínez, Alfonso C. Abad, Violeta Pérez-Rodríguez, Elena Ros-Cucurull, Abderraman Esojo, Carlos Roncero
After excluding venereal diseases and the persistence of the urinary symptomatology, the patient was referred to the Urology Service. The patient was doing up to 6 micturitions per hour. Visual examination with a cystoscope revealed bladder inflammation and biopsies verified that the patient had lesions compatible with interstitial cystitis with areas of denuded mucosa, superficial edema, and abundant vascularization. Neutrophilic leukocyte infiltrates were observed. Ultrasonography study of the upper urinary tract revealed small bladder capacity and unilateral hydronephrosis. Given the medical history, the urologist asked him about ketamine consumption and the patient declared a daily use of 50 milligrams of ketamine intranasally from age 15 to age 17. The patient was diagnosed with ketamine-associated cystitis.
Comments to Editorial by J. Curtis Nickel. It is premature to categorize Hunner lesion interstitial cystitis as a distinct disease entity. Scandinavian Journal of Urology 2020, Vol. 54, No. 2, 99–100; https://doi.org/10.1080/21681805.2020.1744714
Published in Scandinavian Journal of Urology, 2020
Magnus Fall, Jørgen Nordling, Mauro Cervigni, Paulo Dinis Oliveira, Jennifer Fariello, Philip Hanno, Christina Kabjörn-Gustafsson, Yr Logadottir, Jane Meijlink, Robert Moldwin, Loredana Nasta, Jorgen Quaghebeur, Jukka Sairanen, Rajesh Taneja, Hikaru Tomoe, Tomohiro Ueda, Gjertrud Egge Wennevik, Jean Jacques Wyndaele, Andrew Zaitcev
We disagree with him vehemently. It has been 33 years since Fall and coworker’s paper ‘Chronic interstitial cystitis: a heterogeneous syndrome’ which described ‘marked clinical differences between ulcerative and nonulcerative interstitial cystitis’ [1] appeared in the literature. This was the first publication to call for evaluating these conditions separately in clinical studies and noted the different clinical pathways for treatment. Much literature has been published to support this concept. Failure to act earlier is a major reason that no new treatments have been found effective enough to warrant FDA approval since the 1996 approval of sodium pentosan polysulfate (Elmiron), which itself has failed two subsequent phase-four clinical efficacy trials.
Related Knowledge Centers
- Bladder
- Chronic Pain
- Irritable Bowel Syndrome
- Quality of Life
- Urination
- Depression
- Dyspareunia
- Fibromyalgia
- Frequent Urination
- Urologic Chronic Pelvic Pain Syndrome
- Quality of Life