臨床泌尿器科77巻6号

2023年05月発行

特集 ここだけは押さえておきたい　間質性膀胱炎・膀胱痛症候群診療のポイント

〈診断〉

間質性膀胱炎の症状と検査所見

著者： 吉崎宇蘭¹ 新美文彩¹

所属機関： ¹新東京病院泌尿器科

ページ範囲：P.422 - P.428

文献概要

▶ポイント

・間質性膀胱炎（IC）の代表的な症状は，蓄尿により増悪する下腹部・膀胱・陰部の疼痛と頻尿である．

・下部尿路症状や骨盤痛を来す，すべての疾患が鑑別の対象となる．

・特異的な所見は膀胱鏡によるハンナ病変の存在であり，これがある場合は「間質性膀胱炎（ハンナ型）」，ない場合は膀胱痛症候群（BPS）と診断される．

参考文献

1） Homma Y, et al : Clinical Guidelines for Interstitial Cystitis and Hypersensitive Bladder Syndrome. Int J Urol 16 : 597-615, 2009

2） Hanno PM, et al : Diagnosis and Treatment of Interstitial Cystitis/Bladder Pain Syndrome : AUA Guideline Amendment. J Urol 193 : 1545-1553, 2015

3） 日本間質性膀胱炎研究会, 他 （編） : 間質性膀胱炎・膀胱痛症候群診療ガイドライン. リッチヒルメディカル, 東京, 2019

4） Elliott CS, et al : Interstitial Cystitis and the Overlap with Overactive Bladder. Curr Urol Rep 13 : 319-326, 2012

5） Homma Y : Hypersensitive Bladder : A Solution to Confused Terminology and Ignorance Concerning Interstitial Cystitis. Int J Urol 21 : 43-47, 2014

6） Doiron RC, et al : Clinical Phenotyping Does Not Differentiate Hunner Lesion Subtype of Interstitial Cystitis/Bladder Pain Syndrome : A Relook at the Role of Cystoscopy. J Urol 196 : 1136-1140, 2016

7） Berry SH, et al : Prevalence of Symptoms of Bladder Pain Syndrome/Interstitial Cystitis Among Adult Females in the United States. J Urol 186 : 540-544, 2011

8） Simon LJ, et al : The Interstitial Cystitis Data Base Study : Concepts and Preliminary Baseline Descriptive Statistics. Urology 49 : 64-75, 1997

9） Bogart LM, et al : Prevalence and Correlates of Sexual Dysfunction Among Women with Bladder Pain Syndrome/Interstitial Cystitis. Urology 77 : 576-580, 2011

10） Akiyama Y, et al : Interstitial Cystitis/Bladder Pain Syndrome : The Evolving Landscape, Animal Models and Future Perspectives. Int J Urol 27 : 491-503, 2020

11） Niimi A, et al : Hydrodistension with or without Fulguration of Hunner Lesions for Interstitial Cystitis : Long-Term Outcomes and Prognostic Predictors. Neurourol Urodyn 35 : 965-969, 2016

12） Friedlander JI, et al : Diet and Its Role in Interstitial Cystitis/Bladder Pain Syndrome （IC/BPS） and Comorbid Conditions. BJU Int 109 : 1584-1591, 2012

13） Oh-oka H : Clinical Efficacy of 1-Year Intensive Systematic Dietary Manipulation as Complementary and Alternative Medicine Therapies on Female Patients with Interstitial Cystitis/Bladder Pain Syndrome. Urology 106 : 50-54, 2017

14） Bosch PC, et al : Treating Interstitial Cystitis/Bladder Pain Syndrome as a Chronic Disease. Rev Urol 16 : 83-87, 2014

15） Swamy S, et al : Cross-Over Data Supporting Long-Term Antibiotic Treatment in Patients with Painful Lower Urinary Tract Symptoms, Pyuria and Negative Urinalysis. Int Urogynecol J 30 : 409-414, 2019

16） Kim SH, et al : Voiding Diary Might Serve as a Useful Tool to Understand Differences Between Bladder Pain Syndrome/Interstitial Cystitis and Overactive Bladder. Int J Urol 21 : 179-183, 2014

17） Kuo Y-C, et al : Videourodynamic Characteristics of Interstitial Cystitis/Bladder Pain Syndrome ― The Role of Bladder Outlet Dysfunction in the Pathophysiology. Neurourol Urodyn 37 : 1971-1977, 2018

18） Kim SH, et al : Urodynamic Findings of the Painful Bladder Syndrome/Interstitial Cystitis : A Comparison with Idiopathic Overactive Bladder. J Urol 181 : 2550-2554, 2009

19） Watanabe D, et al : Clinical Characterization of Interstitial Cystitis/Bladder Pain Syndrome in Women Based on the Presence or Absence of Hunner Lesions and Glomerulations. Low Urin Tract Symptoms 13 : 139-143, 2021