Gå direkt till huvudinnehållet

Interstitiell cystit

Senast uppdaterad: Senast reviderad:
Sakkunnig:
Definition:
Tillståndet karaktäriseras av smärta i urinblåsa och underliv i kombination med trängningar och frekvent blåstömning både dag och natt. Kallas även "painful bladder syndrome".
Förekomst:
Prevalens i Europa är cirka 20 per 100 000 kvinnor. Förekommer 5–10 gånger oftare hos kvinnor jämfört med män. Genomsnittsåldern för debut är 30–50 år.
Symtom:
Liknande symtom som vid urinvägsinfektion. Ofta ökad smärta vid fylld urinblåsa.
Kliniska fynd:
Vanligtvis normala kliniska fynd.
Diagnostik:
Negativa urinodlingar.
Behandling:
Symtomlindrande behandling. Det finns inte en behandling som passar alla. I första hand bör patienten få utförlig information om tillståndet och dess prognos samt uppföljning.
  1. Hanno PM, Erickson D, Moldwin R, et al. Diagnosis and treatment of interstitial cystitis/bladder pain syndrome: AUA guideline amendment. J Urol 2015; 193: 1545-53. pmid:25623737 PubMed  
  2. Hanno PM et al. The diagnosis of interstitial cystitis revisited: lessons learned from the National Institutes of Health Interstitial Cystitis Database study. J Urol 1999; 161: 553. PubMed  
  3. Dawson TE, Jamison J. Intravesical treatments for painful bladder syndrome/interstitial cystitis. Cochrane Database of Systematic Reviews 2007; Issue 4: CD006113. The Cochrane Library  
  4. Clemens JQ, Meenan RT, Rosetti MC, et al. Prevalence and incidence of interstitial cystitis in a managed care population. J Urol. 2005;173:98-102. PMID: 15592041 PubMed  
  5. Curhan GC, Speizer FE, Hunter DJ, et al. Epidemiology of interstitial cystitis: a population based study. J Urol. 1999;161:549-552. PMID: 9915446 www.ncbi.nlm.nih.gov  
  6. van de Merwe JP, Nordling J, Bouchelouche P, et al. Diagnostic criteria, classification, and nomenclature for painful bladder syndrome/interstitial cystitis: an ESSIC proposal. Eur Urol. 2008;53:60-67. PMID: 17900797 www.ncbi.nlm.nih.gov  
  7. Sant GR. Etiology, pathogenesis, and diagnosis of interstitial cystitis. Rev Urol 2002; 4 (suppl 1): S9-S15.
  8. Evans RJ, Sant GR. Current diagnosis of interstitial cystitis: an evolving paradigm. Urology 2007; 69(4 suppl): 64-72.
  9. Imamura M, Scott NW, Wallace SA et al. Interventions for treating people with symptoms of bladder pain syndrome: a network meta‐analysis. Cochrane Database of Systematic Reviews 2020, Issue 7. Art. No.: CD013325. DOI: 10.1002/14651858.CD013325.pub2. www.cochranelibrary.com  
  10. Marinkovic SP, Moldwin R, Gillen LM, Stanton SL. The management of interstitial cystitis or painful bladder syndrome in women. Clinical review. BMJ 2009; 339: b2707. BMJ (DOI)  
  11. Jamison J, Dawson TE, Helfand M. Medical treatments for painful bladder syndrome (interstitial cystitis) (Protocol). Cochrane Database of Systematic Reviews 2007; Issue 3: CD006730. Cochrane (DOI)  
  12. Van Ophoven A, Pokupic C, Heinecke A, Hertle L. A prospective randomized, placebo controlled double-blind study of amitriptyline for the treatmen of interstitial cystitis. J Urol 2004; 172: 533-6. PubMed  
  13. van Ophoven A, Hertle L. Long term results of amitriptyline treatment for interstitial cystitis. J Urol. 2005;174:1837-1840. PMID: 16217303 PubMed  
  14. Sant GR, Propert KJ, Hanno PM, et al. Interstitial Cystitis Clinical Trials Group. A pilot clinical trial of oral pentosan polysulphate and oral hydroxyzine in patients with interstitial cystitis. J Urol 2003; 170: 810-5. PubMed  
  15. Nickel JC et al. Pentosan polysulfate sodium for treatment of interstitial cystitis/bladder pain syndrome: Insights from a randomized, double-blind, placebo controlled study. J Urol 2015; 193:857 DOI: 10.1016/j.juro.2014.09.036 DOI  
  16. Lewis SC, Bhattacharya S, Wu O, et al. Gabapentin for the management of chronic pelvic pain in women (GaPP1): a pilot randomised controlled trial. PLoS One. 2016;11:e0153037. PMID: 27070434 PubMed  
  17. Mayer R, Propert KJ, Peters KM, et al. Interstitial Cystitis Clinical Trials Group. A randomized controlled trial of intravesical Bacillus Calmette-Guerin for treatment of refractory interstitial cystitis. J Urol 2005; 173: 1186-91. PubMed  
  18. Barua JM, Arance I, Angulo JC, et al. A systematic review and meta-analysis on the efficacy of intravesical therapy for bladder pain syndrome/interstitial cystitis. Int Urogynecol J. 2016;27:1137-1147. PMID: 26590137 PubMed  
  19. Duthie JB, Herbison GP, Wilson DI, Wilson D. Botulinum toxin injections for adults with overactive bladder syndrome. Cochrane Database of Systematic Reviews 2007; Issue 3: CD005493. Cochrane (DOI)  
  20. Kuo HC, Jiang YH, Tsai YC, et al. Intravesical botulinum toxin-A injections reduce bladder pain of interstitial cystitis/bladder pain syndrome refractory to conventional treatment: a prospective, multicenter, randomized, double-blind, placebo-controlled clinical trial. Neurourol Urodyn. 2016;35:609-614. PMID: 25914337 PubMed  
  21. Peters K, Killinger K, Boguslawski BM, et al. Chronic pudendal neuromodulation: expanding available treatment options for refractory urologic symptoms. Neurourol Urodyn. 2010;29:1267-127. PMID: 19787710 PubMed  
  22. Geirsson G, Wang YH, Lindstrom S, et al. Traditional acupuncture and electrical stimulation of the posterior tibial nerve: a trial in chronic interstitial cystitis. Scand J Urol Nephrol. 1993;27:67-70. PMID: 8493470 PubMed  
  • Anna Nager, med dr och specialist i allmänmedicin, Karolinska institutet