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The significance of potassium chloride sensitivity test and urinary uronic acid level in the diagnosis of chronic pelvic pain syndrome

  • Urology - Original Paper
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Abstract

Objectives

Noninvasive tests are needed for the diagnosis of chronic pelvic pain syndrome. We evaluated the significance of potassium chloride sensitivity test and urinary CTAB-precipitable uronate level in patients with chronic pelvic pain syndrome (CPPS).

Methods

We included 25 patients with interstitial cystitis (IC), and 30 patients with chronic prostatitis (CP) who applied to our outpatient clinic with the complaints of frequency, dysuria and pain on urination between the years 2003 and 2005. Thirty-five subjects were studied as healthy controls. All patients underwent cystoscopy, cystometry, voiding diary, sodium chloride, and potassium chloride filling tests. Visual analog scale (VAS) was used to determine pain scores. Patients with CP also underwent NaCl and KCl voiding tests. Urinary CTAB-precipitable uronate levels were obtained in all subjects.

Results

KCl test had a good sensitivity for IC. As for the patients with CP, KCl voiding test was useful, but KCl filling test was not. Urinary CTAB-precipitable uronate level was found to be significantly higher in patients with IC and CP than controls, and in patients with IC than in patients with CP.

Conclusions

The results of our study suggest that KCl voiding test is a good candidate to be used in the diagnostic workup of patients with category III CP, and urinary CTAB-precipitable uronate level measurement may be a noninvasive diagnostic aid for IC and CP.

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References

  1. Fall M, Baranowski AP, Fowler CJ, Lpinard V (2004) EAU guidelines on chronic pelvic pain. Eur Urol 46:681–689. doi:10.1016/j.eururo.2004.07.030

    Article  PubMed  CAS  Google Scholar 

  2. Hanno PM (2002) Interstitial cystitis and related disorders. In: Walsh PC, Retik AB, Vaughan ED Jr, Wein AJ (eds) Campbell’s urology, vol 1, 8th edn. Saunders, Philadelphia, pp 631–670

    Google Scholar 

  3. Nickel JC, Nyberg LM, Hennenfelt M (1999) Research guidelines for chronic prostatitis consensus report from the First National Institute of Health International Prostatitis Collaborative Network. Urology 54:229–233. doi:10.1016/S0090-4295(99)00205-8

    Article  PubMed  CAS  Google Scholar 

  4. Nickel JC et al (2002) Prostatitis and related conditions. In: Walsh PC, Retik AB, Vaughan ED Jr, Wein AJ (eds) Campbell’s Urology, vol 1, 8th edn. Saunders, Philadelphia, pp 603–630

    Google Scholar 

  5. Held PJ, Hanno PM, Wein AJ et al (1990) Epidemiology of interstitial cystitis. In: Hanno PM, Staskin DR, Krane RJ, Wein AJ (eds) Interstitial cystitis. Springer, London, pp 29–48

    Google Scholar 

  6. Ho N, Koziol JA, Parsons CL (1997) Epidemiology of interstitial cystitis. In: Sant GR (ed) Interstitial cystitis. Lippincott-Raven, Philadelphia, pp 9–16

    Google Scholar 

  7. Nickel JC, Downey J, Hunter D, Clark J (2001) Prevalence of prostatitis-like symptoms in a population based study using the National Institute of Health Chronic Prostatitis Symptom Index. J Urol 165:842–845. doi:10.1016/S0022-5347(05)66541-X

    Article  PubMed  CAS  Google Scholar 

  8. Calhoun EA, McNaughton-Collins M, Oleary MP (2001) What is the economic impact of chronic prostatitis? J Urol 165(suppl):25. Abstract 106

    Google Scholar 

  9. Akcay T, Konukoglu D (1999) Glycosaminoglycan excretion in interstitial cystitis. Int Urol Nephrol 31:431–435. doi:10.1023/A:1007198708404

    Article  PubMed  CAS  Google Scholar 

  10. Wei DC, Politano VA, Selzer MG, Lokeshwar VB (2000) The association of elevated urinary total to sulfated glycosaminoglycan ratio and high molecular mass hyaluronic acid with interstitial cystitis. J Urol 163(5):1577–1583. doi:10.1016/S0022-5347(05)67682-3

    Article  PubMed  CAS  Google Scholar 

  11. Nickel JC, Emerson L, Cornish J (1993) The bladder mucus (glycosaminoglycan) layer in interstitial cystitis. J Urol 149(4):716–718

    PubMed  CAS  Google Scholar 

  12. Vinata B, Marie G, Wolfgang H (2005) Urinary uronate and sulfated glycosaminoglican levels: markers for IC severity. J Urol 174:344–349. doi:10.1097/01.ju.0000161599.69942.2e

    Article  Google Scholar 

  13. Hurst RE, Parsons CL, Roy JB, Young JL (1993) Urinary glycosaminoglycan excretion as a laboratory marker in the diagnosis of interstitial cystitis. J Urol 149(1):31–35

    PubMed  CAS  Google Scholar 

  14. de Lima CR, Baccarin RY, Michelacci YM (2007) Reliability of 1, 9-dimethylmethylene blue tests in comparison to agarose gel electrophoresis for quantification of urinary glycosaminoglycans. Clin Chim Acta 378(1–2):206–215. doi:10.1016/j.cca.2006.11.025

    PubMed  Google Scholar 

  15. Pennock CA, Charles RG, Stansbie D (1975) Glycosaminoglycan fractions in normal human urine. Ann Clin Biochem 12(5):207–211

    PubMed  CAS  Google Scholar 

  16. Barbalias GA (1990) Prostatodynia or painful male urethral syndrome? Urology 36:146–153. doi:10.1016/0090-4295(90)80214-8

    Article  PubMed  CAS  Google Scholar 

  17. Miller JL, Rothman I, Bavendam TG, Berger RE (1995) Prostatodynia and interstitial cystitis: one and the same? Urology 45(4):587–590. doi:10.1016/S0090-4295(99)80048-X

    Article  PubMed  CAS  Google Scholar 

  18. Weidner W, Fall M, Bjerklund Johansen TE (2002) Interstitial cystitis and prostatitis. Eur Urol 42(6):1–11. doi:10.1016/S0302-2838(02)00363-9

    Article  Google Scholar 

  19. Weidner W, Ebner H (1985) Cytological analysis of urine after prostatic massage (VB3): a new technique for discriminating diagnosis of prostatitis. In: Brunner H, Krause W, Rothaug CF, Weidner E (eds) Chronic prostatitis. Schattauer, Stuttgart, pp 141–151

    Google Scholar 

  20. Blumenkrantz N, Hansen GA (1973) New method for quantitive determination of uronic acids. Anal Biochem 54:484–489. doi:10.1016/0003-2697(73)90377-1

    Article  PubMed  CAS  Google Scholar 

  21. Parsons CL, Bautista SL, Stein PC (2000) Cyto-injury factors in urine: a possible mechanism for the development of interstitial cystitis. J Urol 164:1381–1384. doi:10.1016/S0022-5347(05)67203-5

    Article  PubMed  CAS  Google Scholar 

  22. Parsons CL, Greenberger M, Gabal L et al (1998) The role of urinary potassium in the pathogenesis and diagnosis of interstitial cystitis. J Urol 159:1862–1867. doi:10.1016/S0022-5347(01)63178-1

    Article  PubMed  CAS  Google Scholar 

  23. Parsons CL (1990) Interstitial cystitis: clinical manifestations and diagnostic criteria in over 200 cases. Neurourol Urodyn 9:241–246. doi:10.1002/nau.1930090302

    Article  Google Scholar 

  24. Ratliff TL, Klutke CG, McDougall EM (1994) The etiology of interstitial cystitis. Urol Clin North Am 21(1):21–30

    PubMed  CAS  Google Scholar 

  25. Parsons CL, Albo M (2002) Intravesical potassium sensitivity in patients with prostatitis. J Urol 168(3):1054–1057. doi:10.1016/S0022-5347(05)64573-9

    Article  PubMed  Google Scholar 

  26. Parsons CL, Zupkas P, Parsons JK (2001) Intravesical potassium sensitivity with interstitial cystitis and urethral syndrome. Urology 57(3):428–432. doi:10.1016/S0090-4295(00)01110-9

    Article  PubMed  CAS  Google Scholar 

  27. Parsons CL (1996) Potassium sensitivity test. Tech Urol 2(3):171–173

    PubMed  CAS  Google Scholar 

  28. Chanbers GK, Fenster HN, Crips S, Taylor D (1999) An assessment of the use of intravesical potassium in the diagnosis of interstitial cystitis. J Urol 162:699–701. doi:10.1097/00005392-199909010-00018

    Article  Google Scholar 

  29. Chen TY-H, Begin LR, Corcos J (2001) Assessment of potassium chloride test in comparison with symptomatology, cystoscopic findings and bladder biopsy in the diagnosis of interstitial cystitis. J Urol 165(Suppl):67. Abstract 276. doi:10.1016/S0022-5347(05)66535-4

    Google Scholar 

  30. Gregoire M, Liandier F, Naud A, Lacomb L, Fradet Y (2002) Does the potassium stimulation test predict cystometric, cystoscopic outcome in interstitial cystitis? J Urol 168:556–557. doi:10.1016/S0022-5347(05)64678-2

    Article  PubMed  Google Scholar 

  31. Hassan AA, Elgamal SA, Sabaa MA, Salem K (2007) Evaluation of intravesical potassium sensitivity test and bladder biopsy in patients with chronic prostatitis/chronic pelvic pain syndrome. Int J Urol 14:738–742. doi:10.1111/j.1442-2042.2007.01821.x

    Article  PubMed  Google Scholar 

  32. Sairanen J, Tammela TLJ, Leppilahti M, Onali M, Forsell T, Ruutu M (2007) Potassium sensitivity test (PST) as a measurement of treatment efficacy of painful bladder syndrome/interstitial cystitis: a prospective study with cyclosporine A and pentosan polysulfate sodium. Neurourol Urodyn 26:267–270. doi:10.1002/nau.20350

    Article  PubMed  CAS  Google Scholar 

  33. Berger E, Yilmaz U, Rothman I (2004) Intravesical potassium chloride sensitivity test in men with chronic pelvic pain. J Urol 172:548–550. doi:10.1097/01.ju.0000139725.96817.f3

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Urology, Maresal Cakmak Hospital, Erzurum, Turkey

    Bilal Firat Alp

  2. Department of Urology, GATA Haydarpasa Teaching Hospital, Kadikoy, 34668, Istanbul, Turkey

    Ilker Akyol, Cuneyt Adayener, Temucin Senkul, Kadir Baykal & Cuneyt Iseri

  3. Department of Biochemistry, GATA Haydarpasa Teaching Hospital, Istanbul, Turkey

    Mustafa Gultepe

Authors
  1. Bilal Firat Alp
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  2. Ilker Akyol
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Correspondence to Ilker Akyol.

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Alp, B.F., Akyol, I., Adayener, C. et al. The significance of potassium chloride sensitivity test and urinary uronic acid level in the diagnosis of chronic pelvic pain syndrome. Int Urol Nephrol 41, 483–489 (2009). https://doi.org/10.1007/s11255-008-9463-3

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  • DOI: https://doi.org/10.1007/s11255-008-9463-3

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