[Non-bacterial cystitis: principles, diagnostics and etiogenic therapy options]

Aktuelle Urol. 2010 Nov;41(6):361-8. doi: 10.1055/s-0030-1262615. Epub 2010 Nov 16.
[Article in German]

Abstract

The therapy for non-bacterial cysitides is often based on purely symptom-oriented measures which in many cases relieve the patient's symptoms but cannot stop the chronic progression of the disease. The present article summarises the most common forms of non-bacterial cystitis (interstitial, radiogenic, chemotherapy-induced) with their common pathophysiology and then introduces the most common therapeutic procedures. With regard to radiogenic and chemotherapy-induced cystitis it must be considered that optimal preventative measures can often markedly delay or even prevent the development of the inflammatory processes. The preventative therapeutic measures mentioned in this article should thus constitute a fixed part of the accompanying therapy within the framework of tumour-related treatment. As alternatives or supplements to symptomatic therapy, causal therapy options show good response rates. Besides successful hyperbaric oxygen therapy, this also holds for hyalurane that is instilled with the aim of repairing the damaged glycosamine layer in the endothelium of the urinary bladder and so opens new curative options in cases that were previously considered as therapy resistant. A prior potassium-sensitivity test is recommended as this allows the putative success of the therapy to be predicted with a high probability. However. It is equally important, especially in cases of interstitial cystitis, that the diagnosis is made as early as possible which was often not done in the past.

Publication types

  • English Abstract
  • Review

MeSH terms

  • Administration, Intravesical
  • Antineoplastic Agents / adverse effects*
  • Antineoplastic Agents / therapeutic use
  • Combined Modality Therapy
  • Cystitis / chemically induced
  • Cystitis / diagnosis
  • Cystitis / etiology*
  • Cystitis / therapy*
  • Cystitis, Interstitial / diagnosis
  • Cystitis, Interstitial / etiology*
  • Cystitis, Interstitial / therapy*
  • Glycosaminoglycans / metabolism
  • Humans
  • Hyaluronic Acid / administration & dosage
  • Hyperbaric Oxygenation
  • Prognosis
  • Radiation Injuries / diagnosis*
  • Radiation Injuries / therapy*
  • Urinary Bladder / radiation effects*
  • Urothelium / drug effects
  • Urothelium / radiation effects

Substances

  • Antineoplastic Agents
  • Glycosaminoglycans
  • glycosaminoglucuronates
  • Hyaluronic Acid