Lupus cystitis in Korean patients with systemic lupus erythematosus: risk factors and clinical outcomes

Koh, J H,Lee, J,Jung, S M,Ju, J H,Park, S-H,Kim, H-Y,Kwok, S-K SAGE Publications 2015 Lupus Vol.24 No.12

<P>This study was performed to investigate the clinical characteristics of lupus cystitis and determine the risk factors and clinical outcomes of lupus cystitis in patients with systemic lupus erythematosus (SLE). We retrospectively reviewed 1064 patients at Seoul St. Mary’s Hospital in Seoul, Korea, from 1998 to 2013. Twenty-four patients had lupus cystitis. Lupus cystitis was defined as unexplained ureteritis and/or cystitis as detected by imaging studies, cystoscopy, or bladder histopathology without urinary microorganisms or stones. Three-fourths of patients with lupus cystitis had concurrent lupus mesenteric vasculitis (LMV). The initial symptoms were gastrointestinal in nature for most patients (79.2%). High-dose methylprednisolone was initially administered to most patients (91.7%) with lupus cystitis. Two patients (8.3%) died of urinary tract infections. Sixty-five age- and sex-matched patients with SLE who were admitted with other manifestations were included as the control group. Patients with lupus cystitis showed a lower C3 level (<I>p</I> = 0.031), higher SLE Disease Activity Index score (<I>p</I> = 0.006), and higher ESR (<I>p</I> = 0.05) upon admission; more frequently had a history of LMV prior to admission (<I>p</I> < 0.001); and less frequently had a history of neuropsychiatric lupus (<I>p</I> = 0.031) than did patients with SLE but without lupus cystitis. The occurrence of lupus cystitis was associated with a history of LMV (OR, 21.794; 95% CI, 4.061–116.963). The median follow-up period was 3.4 years, and the cumulative one-year mortality rate was 20%. Complications developed in 33.3% of patients with lupus cystitis and were related to survival (log-rank <I>p</I> = 0.021). Our results suggest that the possibility of lupus cystitis should be considered when a patient with SLE and history of LMV presents with gastrointestinal symptoms or lower urinary tract symptoms. Development of complications in patients with lupus cystitis can be fatal. Thus, intensive treatment and follow-up are needed, especially in the presence of complications.</P>

Cyclophosphamide로 유발된 백서 방광염에서 Hyaluronic Acid의 방광보호 효과

이정원,허정식,이선주,김윤화 대한비뇨의학회 2009 Investigative and Clinical Urology Vol.50 No.8

Purpose: We investigated the effect and duration of hyaluronic acid (HA) on the bladder of rats with cyclophosphamide (CYP)-induced cystitis. Materials and Methods: CYP (250 mg/kg) was injected intraperitoneally in female Sprague-Dawley rats to induce cystitis. HA (0.5%) was instilled intravesically. First, the rats were separated into 2 groups for urodynamic study (CYP group, CYP+HA group), and we assessed the inter-contraction interval, maximal voiding pressure (MVP), and pressure threshold of the 2 groups. Second, the rats were separated into 3 groups to assess the duration of effect of HA (CYP group; HA-1 group: HA was instilled 1 day before injection of CYP; HA-3 group: HA was instilled 3 days before injection of CYP), and we assessed the voiding interval for 7 days after confining the rats in metabolic cages. Results: The inter-contraction interval of the CYP+HA group (236.0±18.3 min) was significantly longer than that of the CYP group (178.0±13.4 min; p<0.03), but the MVPs of both groups did not differ significantly (32.3± 1.2 vs. 34.0±2.4 cmH2O, respectively; p=0.56). The pressure threshold of the CYP+HA group (9.9±0.5 cmH2O) was significantly longer than that of the CYP group (13.2±0.7 cmH2O; p=0.002). The voiding interval decreased in each of the 3 groups according to the time after cystitis had been induced. The voiding interval was maximally decreased on the second day and returned to the pre-CYP injection level on the fifth day in each group. There was a significant difference in voiding interval among the 3 groups on the second day (p<0.05). There was no significant difference between the CYP+HA-1 and CYP+HA-3 groups on the second day (p>0.05). Conclusions: HA has an effect of increasing the voiding interval in rats with CYP-induced cystitis, and the duration of effect is concluded to be 5 days. Purpose: We investigated the effect and duration of hyaluronic acid (HA) on the bladder of rats with cyclophosphamide (CYP)-induced cystitis. Materials and Methods: CYP (250 mg/kg) was injected intraperitoneally in female Sprague-Dawley rats to induce cystitis. HA (0.5%) was instilled intravesically. First, the rats were separated into 2 groups for urodynamic study (CYP group, CYP+HA group), and we assessed the inter-contraction interval, maximal voiding pressure (MVP), and pressure threshold of the 2 groups. Second, the rats were separated into 3 groups to assess the duration of effect of HA (CYP group; HA-1 group: HA was instilled 1 day before injection of CYP; HA-3 group: HA was instilled 3 days before injection of CYP), and we assessed the voiding interval for 7 days after confining the rats in metabolic cages. Results: The inter-contraction interval of the CYP+HA group (236.0±18.3 min) was significantly longer than that of the CYP group (178.0±13.4 min; p<0.03), but the MVPs of both groups did not differ significantly (32.3± 1.2 vs. 34.0±2.4 cmH2O, respectively; p=0.56). The pressure threshold of the CYP+HA group (9.9±0.5 cmH2O) was significantly longer than that of the CYP group (13.2±0.7 cmH2O; p=0.002). The voiding interval decreased in each of the 3 groups according to the time after cystitis had been induced. The voiding interval was maximally decreased on the second day and returned to the pre-CYP injection level on the fifth day in each group. There was a significant difference in voiding interval among the 3 groups on the second day (p<0.05). There was no significant difference between the CYP+HA-1 and CYP+HA-3 groups on the second day (p>0.05). Conclusions: HA has an effect of increasing the voiding interval in rats with CYP-induced cystitis, and the duration of effect is concluded to be 5 days.

Possible Risk Factors Associated with Radiation Proctitis or Radiation Cystitis in Patients with Cervical Carcinoma after Radiotherapy

Yang, Lin,Lv, Yin Asian Pacific Journal of Cancer Prevention 2012 Asian Pacific journal of cancer prevention Vol.13 No.12

Radiation proctitis and radiation cystitis are major complications for patients with cervical carcinoma following radiotherapy. In the present study, we aimed to determine the potential risk factors for the development of radiation proctitis and radiation cystitis after irradiation. A total of 1,518 patients with cervical carcinoma received external beam radiotherapy (EBRT) followed by high-dose-rate intracavitary brachytherapy (HDRICB) in our hospital. The incidences of radiation proctitis and radiation cystitis were recorded and associations with different factors (age, time period, tumor stage) were analyzed with ${\chi}^2$ (chi-squared) and Fisher exact tests. We found that 161 and 94 patients with cervical carcinoma were diagnosed with radiation proctitis and radiation cystitis, respectively, following radiotherapy. The prevalence of Grade I-II radiation proctitis or radiation cystitis was significantly lower than that of Grade III (radiation proctitis: 3.82% vs. 6.76%, P < 0.05; radiation cystitis: 2.31% vs. 3.87%, P < 0.05) and was significantly enhanced in patients with late stage (IIIb) tumor progression compared to those in early stage (Ib, IIa) (P < 0.05). Moreover, the incidence of radiation proctitis and cystitis was not correlated with age or, time period following radiation, for each patient (P > 0.05). These observations indicate that a late stage of tumor progression is a potential risk factor for the incidence of radiation proctitis and cystitis in cervical carcinoma patients receiving radiotherapy.

간질성 방광염 환자 25예에 대한 임상적 고찰

손기정,오현조,이중곤,남승규,김철중,조충식,Son, Gi-Jeong,Oh, Hyeon-Jo,Lee, Jung-Gon,Nam, Seung-Kyu,Kim, Chul-Jung,Cho, Chung-Sik 대한한방내과학회 2012 大韓韓方內科學會誌 Vol.33 No.2

Background : Interstitial cystitis is a disorder of the bladder characterized by urgency and frequency of urination, and pelvic pain. The cause of interstitial cystitis is not clear. Modern medical treatments include behavioral therapy, medication, intravesical infusion therapy, and surgical treatment, but the goal of treatment is based on symptom relief rather than a cure. According to a recent report, in an animal model, oriental medicine treatment, Yukmijihwang-tang improved the symptoms of interstitial cystitis. However, clinical studies and experimental research are lacking. Objectives : In this study, We investigated Chuknyojetong-tang, acupuncture, moxibustion and bee venom effect on interstitial cystitis. Methods : We targeted 25 patients diagnosed with interstitial cystitis at the university hospital and treated them for more than one month. We used acupuncture, Chuknyojetong-tang, and bee venom. The effects were evaluated using ICSI and ICPI at the begin of treatment and at the end of treatment. Results : All of the 25 patients were female, average age was $53.3{\pm}13.5$ years, and the average month of disease-duration was $69.0{\pm}59.8$. The duration of treatment was $8.0{\pm}5.4$ months, and 60% of patients were improved. After treatment, we used correlation coefficient method, multiple regression analysis. ICSI difference increased as treatment period increased. ICPI difference increased as age decreased. Total difference also increased as treatment period increased. These results imply that treatment effect was improved. Conclusions : These findings suggest that oriental medicine therapy using Chuknyojetong-tang, acupuncture, moxibustion, and bee venom would be very effective on interstitial cystitis.

여성 방광염에 초점을 맞춘 재발성 요로감염에 대한 인식 제고의 필요성

안순태,이승주,오미미 대한의사협회 2023 대한의사협회지 Vol.66 No.6

Background: Recurrent cystitis is a common condition affecting women, often causing discomfort and negatively impacting their quality of life. Despite the high level of morbidity, this condition is frequently overlooked due to relatively low fatality rate. This lack of adequate awareness about recurrent cystitis has led to increased healthcare costs, inappropriate utilization of medical resources, and growing antibiotic resistance. Therefore, there is an urgent need to raise awareness and improve the strategies employed for managing recurrent cystitis. Current Concepts: The socioeconomic burden imposed by recurrent cystitis is substantial, with billions of dollars spent worldwide every year on its diagnosis and treatment. Unnecessary emergency room visits and loss of labor due to illness further exacerbate the costs. Additionally, recurrent cystitis significantly diminishes patients’ quality of life, leading to psychological challenges such as anxiety and depression. Recent research has highlighted the importance of identifying underlying conditions and modifying lifestyle behaviors, in addition to actual treatment, to improve patients’ quality of life. Discussion and Conclusion: It is important to implement various strategies to raise awareness and foster interest in recurrent cystitis. These include patient education, public awareness campaigns, healthcare professional training, online resources, and research collaboration. By increasing awareness and adopting a proactive approach to managing recurrent cystitis, we can improve patient outcomes and enhance the overall efficiency of the healthcare system, ultimately benefiting patients, medical staff, and society as a whole.

급성 출혈성 방광염 치험 1례

김수민 ( Su Min Kim ),정태영 ( Tae Young Jung ),신현철 ( Hyeon Cheol Shin ) 대구한의대학교 제한동의학술원 2016 東西醫學 Vol.41 No.2

Cystitis is an inflammation of the bladder lining. The most common mechanism of cystitis is bacterial infection through the urethra. The symptoms are urodynia, dysuria, pyuria and hematuria. In Korean Medical theory, acute hemorrhagic cystitis results from Heat-poison(熱毒) in urinary bladder. That is, Heat-poison is accumulated in Lower Burner(下焦) and results in cystitis. So, we treated for cystitis with Heat-cooling and Dampness-irrigating(淸熱利濕) formula, for example, Yongdamsagan-tang. In this study, we had a case of a cystitis patient who had severe hematuria. The patient was treated with Yongdamsagan-tang without any antibiotics. The case showed favorable results in symptom, urinalysis and blood test. All the symptoms, urinalysis and blood test results were recovered after 5 days medication. It is suggested that acute hemorrhagic cystitis can be treated with Heat-cooling and Dampness-irrigating formula like Yongdamsagan-tang.

Case Report : Hemorrhagic cystitis with massive bleeding from nontyphoidal Salmonella infection: A case report

( Sun Kyung Na ),( Hye Kyung Jung ),( Young Shin Kim ),( Hye Won Yun ),( Jung Wha Chung ),( Ka Young Jung ),( Ki Nam Shim ),( Sung Ae Jung ) 대한신장학회 2013 Kidney Research and Clinical Practice Vol.32 No.2

Hemorrhagic cystitis is de?ned by lower urinary tract symptoms that include dysuria, hematuria, and hemorrhage and is caused by viral or bacterial infection or chemotherapeutic agents. Reports of hemorrhagic cystitis caused by non-typhoidal salmonella (NTS) are extremely rare. We report a case of a 41-year-old man with hemorrhagic cystitis from NTS that caused massive bleeding and shock. The patient was hospitalized for uncontrolled diabetes and obstructive uropathy related to severe cystitis. A urine culture was positive for group D NTS. This case demonstrated that hemorrhagic cystitis in a patient with a risk factor such as diabetes can be a manifestation of local extraintestinal NTS infection.

BK virus-associated hemorrhagic cystitis after pediatric stem cell transplantation

Han, Seung Beom,Cho, Bin,Kang, Jin Han The Korean Pediatric Society 2014 Clinical and Experimental Pediatrics (CEP) Vol.57 No.12

Hemorrhagic cystitis is a common stem cell transplantation-related complication. The incidence of early-onset hemorrhagic cystitis, which is related to the pretransplant conditioning regimen, has decreased with the concomitant use of mesna and hyperhydration. However, late-onset hemorrhagic cystitis, which is usually caused by the BK virus, continues to develop. Although the BK virus is the most common pathogenic microorganism of poststem cell transplantation late-onset hemorrhagic cystitis, pediatricians outside the hemato-oncology and nephrology specialties tend to be unfamiliar with hemorrhagic cystitis and the BK virus. Moreover, no standard guidelines for the early diagnosis and treatment of BK virus-associated hemorrhagic cystitis after stem cell transplantation have been established. Here, we briefly introduce poststem cell transplantation BK virus-associated hemorrhagic cystitis.

간질성 방광염의 개괄과 한의학적 연구의 필요성

박상우(Sang-woo Park),김철중(Chul-jung Kim),조충식(Chung-sik Cho) 대한한의학회 2012 대한한의학회지 Vol.33 No.3

Radiation Induced Cystitis and Proctitis - Prediction, Assessment and Management

Mallick, Supriya,Madan, Renu,Julka, Pramod K,Rath, Goura K Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.14

Cystitis and proctitis are defined as inflammation of bladder and rectum respectively. Haemorrhagic cystitis is the most severe clinical manifestation of radiation and chemical cystitis. Radiation proctitis and cystitis are major complications following radiotherapy. Prevention of radiation-induced haemorrhagic cystitis has been investigated using various oral agents with minimal benefit. Bladder irrigation remains the most frequently adopted modality followed by intra-vesical instillation of alum or formalin. In intractable cases, surgical intervention is required in the form of diversion ureterostomy or cystectomy. Proctitis is more common in even low dose ranges but is self-limiting and improves on treatment interruption. However, treatment of radiation proctitis is broadly non-invasive or invasive. Non-invasive treatment consists of non-steroid anti-inflammatory drugs (NSAIDs), anti-oxidants, sucralfate, short chain fatty acids and hyperbaric oxygen. Invasive treatment consists of ablative procedures like formalin application, endoscopic YAG laser coagulation or argon plasma coagulation and surgery as a last resort.