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Interstitielle Zystitis

Eine wichtige Differentialdiagnose

Interstitial cystitis

An important differential diagnosis

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Zusammenfassung

Bei der interstitiellen Zystitis (IC) handelt es sich um eine chronische Harnblasenerkrankung, die durch ausgeprägte Schmerzen im Bereich der Harnblase, imperativen Harndrang mit Pollakisurie und Nykturie sowie eine deutlich erniedrigte funktionelle Harnblasenkapazität gekennzeichnet ist. Ätiologie und Pathomechanismus der Erkrankung, von der zu 90% Frauen betroffen sind, bleiben nach wie vor unklar; infolge dessen existieren nach wie vor keine kausalen Therapien.

Da es sich um eine strikte Ausschlussdiagnose handelt, ist der diagnostische Abklärungsprozess oft mühsam und zeitintensiv. Histopathologische Veränderungen, welche regelmäßig in der IC-erkrankten Harnblase vorgefunden werden können, sind allerdings keinesfalls pathognomonisch. Die Kriterienliste des nordamerikanischen Gesundheitsministeriums zur Diagnose der IC hat ihren Wert in der klinischen Forschung und würde bei dogmatischer Anwendung 60% der IC-Patienten die Erkrankung absprechen. Der Einsatz spezieller diagnostischer Fragebögen und validierter Symptomskalen erleichtert die Beurteilung des Therapieansprechens.

Abstract

Interstitial cystitis (IC) is a chronic, debilitating inflammatory disease of the urinary bladder, characterized by chronic pelvic pain, urgency/frequency symptoms, and decrease of the functional bladder capacity. Both the etiology and pathogenesis of the condition that predominantly affects women are still not fully understood.

Thus, a causal therapeutic approach still does not exist. IC remains a strict diagnosis of exclusion; distinct histopathological findings within the bladder wall are frequently found, although they are not pathognomonic. The diagnostic criteria elaborated by the NIH are helpful in clinical research; their dogmatic utilization will however lead to an underdiagnosis of IC in 60% of the patients. IC-specific symptom questionnaires and validated symptom scales help the physician to assess the therapeutic response during the follow-up of the patients.

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Authors and Affiliations

  1. Klinik und Poliklinik für Urologie, Universitätsklinikum Bonn

    F. Oberpenning

  2. Klinik und Poliklinik für Urologie, Universitätsklinikum Münster, Albert-Schweitzer-Straße 33, 48129, Münster

    A. van Ophoven

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  2. F. Oberpenning
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Correspondence to A. van Ophoven.

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van Ophoven, A., Oberpenning, F. Interstitielle Zystitis. Urologe 45, 451–456 (2006). https://doi.org/10.1007/s00120-006-1021-y

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