Does mast cell density predict the outcome after transurethral resection of Hunner's lesions in patients with type 3C bladder pain syndrome/interstitial cystitis?

Abstract

Objective. This study aimed to assess mast cell density in the lamina propria for possible correlation with duration of symptom amelioration after transurethral resection of the bladder (TURB). Material and methods. Twelve patients (eight women and four men) referred to the tertiary referral facility, treated between June 2003 and June 2009, were included in the study. All had undergone three consecutive complete TURB procedures, where the first one was also diagnostic. All patients fulfilled the NIH-NIDDK criteria and the ESSIC bladder pain syndrome/interstitial cystitis type 3C criteria; they had Hunner's lesions and biopsy findings with inflammatory infiltrates, granulation tissue and mastocytosis. Bladder biopsies were evaluated for mast cell density by immunochemistry and symptom amelioration was recorded by self-report of symptom relapse. Results. Median mast cell density in the lamina propria at the first, second and third TURB was high. No statistically significant correlation between mast cell density in the urothelium, lamina propria or detrusor, and duration of symptom amelioration could be seen after the first, second or third TURB. Conclusion. Mast cell density does not appear to correlate with duration of symptom amelioration after complete transurethral resection of Hunner's lesions, either in the lamina propria or in the urothelium or detrusor.

Key Words::

• Interstitial cystitis
• mast cells
• TURB

Acknowledgements

We would like to express our sincere thanks to Chief Engineer Ulric Pedersen for technical assistance with photographs of the microscopic pictures. This study was supported by Märtha and Gustaf Ågrens Research Foundation and Sahlgrenska University Hospital (project no. ALF 7582).

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.