Advertisement

Virchows Archiv A

, Volume 416, Issue 5, pp 447–451 | Cite as

Nerve fibre proliferation in interstitial cystitis

  • T. J. Christmas
  • J. Rode
  • C. R. Chapple
  • E. J. G. Milroy
  • R. T. Turner-Warwick
Article

Summary

The aetiology of pain in interstitial cystitis is not understood, although it has been reported to be due to release of mediators from mast cell granules. Cystolysis and intravesical instillation of dimethyl sulphoxide have been shown to relieve pain in this condition. We have studied the nerve population within the bladder wall using immunohistochemical stains for protein gene product 9.5. A group of 18 cases of chronic interstitial cystitis and 12 controls; neuropathic bladder (n=1), chronic bacterial cystitis (n=3), systemic lupus erythematosus cystitis (n=2) and normals (n=6), were investigated. There were significantly more nerve fibres within the sub-urothelial and detrusor muscle layers in chronic interstitial cystitis than there were in normals. Patients with chronic cystitis of other aetiology did not have a significant increase in nerve fibre density within the bladder wall suggesting a specific association between nerve fibre proliferation and interstitial cystitis. Cystolysis is shown to deplete selectively the submucosal nerve plexuses without altering the nerve density within detrusor muscle. This finding explains the desensitisation of the bladder without impairment of detrusor function after this procedure.

Key words

Interstitial cystitis Bladder nerves Protein gene product 9.5 cystolysis 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Alm P, Alumets J, Håkanson R, Sundler F (1977) Peptidergic (vasoactive intestinal peptide) nerves in the genito-urinary tract. Neuroscience 2:751–753Google Scholar
  2. Alm P, Alumets J, Brodin E, Håkanson R, Nilsson G, Sjöberg N-O, Sundler F (1978) Peptidergic (Substance-P) nerves in the genito-urinary tract. Neuroscience 3:419–425Google Scholar
  3. Bains RM, Miller KD (1988) Peroxidase labelling in immunohistochemistry: a critical comparison of five systems. Med Lab Sci 45:240–244Google Scholar
  4. Bohm E, Franksson C (1957) Interstitial cystitis and sacral rhizotomy. Acta Chir Scand 113:63–67Google Scholar
  5. Cornish J, Vanderwee MA, Ormrod DJ, Miller TE (1986) Mucosal mast cells as a component of the inflammatory response to lower urinary tract infection. Int Archs Allergy Appl Immunol 81:337–342Google Scholar
  6. Dixon JS, Gilpin CJ (1987) Presumptive sensory axons of the human urinary bladder: a fine structural study. J Anat 151:199–207Google Scholar
  7. Dixon JS, Hald T (1986) Morphological studies of the bladder wall in interstitial cystitis. In: George NJR, Gosling JA (eds) Sensory disorders of the bladder and urethra. Springer-Verlag, Berlin Heidelberg New York, pp 63–71Google Scholar
  8. Doran JF, Jackson PJ, Kynoch PAM, Thompson RJ (1983) Isolation of PGP 9.5, a new human neurone-specific protein detected by high resolution two-dimensional electrophoresis. J Neurochem 40:1542–1547Google Scholar
  9. Douglass HL (1934) Excision of the superior hypogastric plexus in the treatment of intractable interstitial cystitis, report of five cases. Am J Surg 25:249–257Google Scholar
  10. Gulbenkian S, Wharton J, Polak JM (1987) The visualisation of cardiovascular innervation in the guinea pig using antiserum to protein gene product 9.5 (PGP 9.5). J Auton Nerv Syst 18:235–247Google Scholar
  11. Hand JR (1949) Interstitial cystitis: report of 223 cases (204 women and 19 men). J Urol 61:291–310Google Scholar
  12. Heine H, Förster FJ (1975) Relationships between mast cells and preterminal nerve fibres. Z Mikrosk Anat Forsch 89:934–937Google Scholar
  13. Jackson PJ, Thomson VM, Thompson RJ (1985) A comparison of the evolutionary distribution of the two neuroendocrine markers, neurone-specific enolase and protein gene product 9.5. J Neurochem 45:185–190Google Scholar
  14. Jarvis LR (1986) A microcomputer system for video image analysis and microdensitometry. Anal Quant Cytol Histol 8:201–209Google Scholar
  15. Kastrup J, Hald T, Larsen S, Nielsen VG (1983) Histamine content and mast cell count of detrusor muscle in patients with interstitial cystitis and other types of chronic cystitis. Br J Urol 55:495–500Google Scholar
  16. Kirby RS, Fowler CJ, Gosling JA, Bannister R (1985) Bladder dysfunction in distal autonomic neuropathy of acute onset. J Neurol Neurosurg Psychiatry 48:762–767Google Scholar
  17. Meirowsky AM (1969) The management of chronic interstitial cystitis by differential sacral neurotomy. J Neurosurg 30:604–607Google Scholar
  18. Nyiri S, Gajó M, Kálmán G (1977) The role of mast cells in the development of adrenergic innervation in the rat iris. Z Mikrosk Anat Forsch 91:765–772Google Scholar
  19. Perez-Marrero R, Emerson LE, Feltis JT (1988) A controlled study of dimethyl sulphoxide in interstitial cystitis. J Urol 140:36–39Google Scholar
  20. Rode J, Dhillon AP, Doran JF, Jackson P, Thompson RJ (1985) PGP 9.5, a new marker for human neuroendocrine tumours. Histopathology 9:147–158Google Scholar
  21. Weisner-Menzel L, Schulz B, Vakilzadeh F, Czartnetzki HM (1981) Electron microscopic evidence for a direct contact between nerve fibres and mast cells. Acta Derm Venereol (Stockh) 61:465–469Google Scholar
  22. Wilson POG, Barber PC, Hamid QA, Power BF, Dhillon AP, Rode J, Day INM, Thompson RJ, Polak JM (1988) The immun olocalisation of protein gene product 9.5 using rabbit polyclonal and mouse monoclonal antibodies. Br J Exp Pathol 69:91–104Google Scholar
  23. Worth PHL, Turner-Warwick RT (1973) The treatment of interstitial cystitis by cystolysis with observations on cystoplasty. Br J Urol 45:65–71Google Scholar

Copyright information

© Springer-Verlag 1990

Authors and Affiliations

  • T. J. Christmas
    • 2
  • J. Rode
    • 1
  • C. R. Chapple
    • 2
  • E. J. G. Milroy
    • 2
  • R. T. Turner-Warwick
    • 2
  1. 1.Department of HistopathologyUniversity College and Middlesex School of Medicine, The Middlesex HospitalLondonUK
  2. 2.Department of UrologyUniversity College and Middlesex School of Medicine, The Middlesex HospitalLondonUK

Personalised recommendations