Interstitial Cystitis: Clinical and Immunological Findings

Abstract

Fifty-four female patients were treated for interstitial cystitis. The age range was 16 to 80 and the mean age 59 years. The average duration of symptoms before diagnosis was six years.

Antinuclear antibodies were demonstrated in 85 per cent of the patients. Allergy of reagin type was present in 13 per cent and hypersensitivity reactions to drugs had occurred in 35 per cent. The series included a pair of monozygotic twins. These observations suggest that interstitial cystitis closely resembles connective tissue disease. The diagnosis must be based on the history in the case together with urinalysis, cystoscopy, biopsy and the response to treatment. The demonstration of anti-nuclear antibodies is an important diagnostic aid. The biopsy specimens in this series showed that interstitial cystitis always involves the whole of the bladder, though the macroscopic changes often are local.

The patients were classified in three groups according to the severity of the symptoms, the capacity of the bladder and the response to treatment. Dilatation of the bladder sufficed in the mild cases and was combined with intramural injections of prednisolone in the moderately severe cases. Subtotal cystectomy and colocystoplasty seemed to give the best results in severe cases. Neurosurgical procedures also seemed to be helpful.

As a result of the apparent similarity between interstitial cystitis and connective tissue disease, therapeutic trials with antimalarial agents and salicylates have been begun.