Beneficial effect of Bletilla striata extract solution on zymosan-induced interstitial cystitis in rat.

AIMS: Interstitial cystitis (IC) is a chronic pain syndrome that is characterized by suprapubic pain upon bladder filling. Bletilla striata, a well-known traditional Chinese herb with established efficacy in wound healing and anti-inflammation, was hypothesized to improve the symptoms of IC possibly though forming a physical barrier that could isolate the bladder tissue from irritants. This study was conducted to evaluate the beneficial effects of intravesical treatment with B. striata extract solution (BSES) on visceral pain and bladder function of rats with zymosan-induced IC. METHODS: Thirty female rats were randomly divided into control group, zymosan-induced cystitis rats treated with normal saline (Z + NS), and zymosan-induced cystitis rats treated with BSES (Z + BSES). All rats underwent evaluation for abdominal withdrawal reflex (AWR) scores to assess visceral hypersensitivity, cystometrography, and electromyogram (EMG) of both external urethral sphincter and bladder detrusor. Data were analyzed by one way analysis of variance. RESULTS: The Z + NS group had an increased visceral hypersensitivity as compared to control group. Rats treated with BSES (Z + BSES group) had decreased AWR scores and amplitude of bladder detrusor-EMG. Besides, BSES treatment improved overactive bladder with significant effects on the extend of micturition interval and increase of storage of urine. CONCLUSIONS: Intravesical instillation of BSES can significantly alleviate zymosan-induced visceral hypersensitivity and bladder overactivity associated with IC. This study suggested that intravesical instillation with BSES might be a promising treatment for IC.

Effects of sacral nerve stimulation on postpartum urinary retention-related changes in rat bladder.

OBJECTIVE: To examine the effect of sacral nerve stimulation (SNS) on the urodynamic function and molecular structure of bladders in rats following acute urinary retention (AUR) after parturition. MATERIAL AND METHODS: Thirty primiparous rats were divided into three groups: postpartum, postpartum+AUR, and postpartum+AUR+SNS. AUR was achieved by clamping the distal urethra of a rat for 60 minutes. The postpartum+AUR+SNS group received electrical stimulation 60 minutes daily for 3 days after AUR. In addition to cystometric studies and external urethral sphincter electromyography, the expression of caveolins and nerve growth factor (NGF) and caveolae number in bladder muscle were analyzed. RESULTS: The postpartum+AUR group has significantly greater residual volume than the postpartum group, but the residual volume decreased significantly after SNS treatment. The postpartum+AUR group had significantly lower peak voiding pressure, a longer bursting period and lower amplitude of electromyograms of external urethral sphincter activity than the postpartum and postpartum+AUR+SNS groups. The postpartum+AUR rats had higher NGF expression, lower caveolin-1 expression, and fewer caveolae in bladder muscle compared with the postpartum rats. Conversely, the caveolin-1 expression and caveolae number increased, and the NGF expression decreased after SNS treatment. CONCLUSION: Bladder dysfunction after parturition in a rat model caused by AUR may be restored to the non-AUR structural and functional level after SNS treatment.

Effect of extracorporeal magnetic energy stimulation on bothersome lower urinary tract symptoms and quality of life in female patients with stress urinary incontinence and overactive bladder.

AIMS: The aim of this study was to investigate the efficacy of extracorporeal magnetic stimulation (EMS) for the treatment of bothersome and severe symptoms of stress urinary incontinence (SUI) and overactive bladder syndrome (OAB) in female patients. MATERIAL AND METHODS: A retrospective review was conducted on patients with SUI and OAB who were referred to EMS therapy. Successful treatment for the bothersome symptoms of OAB and SUI was defined as score ≤1 for questions 2 and 3 on the Urodynamic Distress Inventory-6. The objective cure of SUI and OAB was defined as no urinary leakage during the cough stress test and any urgency, urge incontinence and voiding frequency of less than eight times per 24 h based on the 3-day bladder diary, after the 9 weeks of treatment, respectively. RESULTS: Ninety-three patients with SUI or OAB underwent a 9-week course of EMS at 20 min twice weekly. Seventy-two (77%) patients completed EMS treatment. Geographical factor and poor economic status were two main factors for dropout. A total of 94.1% (32 of 34) and 86.8% (33 of 38) of subjects had successful treatment for the bothersome symptoms of OAB and SUI, respectively. In contrast, the cure rate for OAB and SUI was only 61.7% and 42.1%, respectively. There was also a significant improvement in both Urogenital Distress Inventory Short Form (bothersome on lower urinary tract symptoms) and the Incontinence Impact Questionnaire Short Form (quality of life) total score in both groups after EMS. CONCLUSIONS: EMS is a safe and effective alternative method for treating SUI and OAB. Further studies are needed to evaluate the long-term efficacy.

Urgency-free time interval as primary endpoint for evaluating the outcome of a randomized OAB treatment.

INTRODUCTION AND HYPOTHESIS: This study was conducted to determine whether urgency-free interval (UFI) was effective to evaluate the outcome of overactive bladder (OAB) and the correlation of changes between this parameter and urgency episodes. METHODS: A randomized placebo-controlled trial was conducted involving 73 women with OAB. The interventions for a 12-week period included a vaginal electric stimulation and oxybutynin (2.5 mg) or placebo three times per day. Identical preintervention and postintervention assessments included the measurement of UFI and warning time (WT). The King's Health Questionnaire, Spearman's correlation coefficient (SCC), Kruskal-Wallis, Mann-Whitney U, and Wilcoxon-signed rank tests were used for analysis. RESULTS: A positive and significant correlation between the improvements of WT and UFI was noted in the oxybutynin group (p = 0.009). In all groups, none of the SCC revealed significant correlation between the improvement of UFI and urgency episodes (all p >or= 0.145). CONCLUSIONS: The efficacy of UFI in evaluating treatment outcome of OAB was comparable with that of WT in selected modality.

Genome-based expression profiles as a single standardized microarray platform for the diagnosis of bladder pain syndrome/interstitial cystitis: an array of 139 genes model.

INTRODUCTION AND HYPOTHESIS: The aim of the study was to investigate the molecular signatures underlying bladder pain syndrome/interstitial cystitis (BPS/IC) using cDNA microarray. METHODS: Microarray gene expression profiles were [corrected] studied in a matched case-control study [corrected] by using a system of conditional regression modeling. RESULTS: The main [corrected] findings are summarized as follows: Firstly, a "139-gene" model was discovered to contain high expressions of bladder epithelium, which feature in BPS/IC. Secondly, complex metabolic reactions, including carbohydrate, lipid, cofactors, vitamins, xenobiotics, nucleotide, and amino acid metabolisms, were [corrected] found to have a strong relationship with bladder smooth muscle contraction through IC status. Thirdly, we [corrected] found the transcriptional regulations of IC-induced bladder smooth muscle contraction status, including the level of contractile force, tissue homeostasis, energy homeostasis, and the development of the [corrected] nervous system. In addition, our study suggested the mast-cell activation mediated by the high-affinity receptor of Fc epsilon [corrected] RI triggering allergic inflammation through IC status. Such genetic changes, jointly termed "bladder remodeling," [corrected] can constitute an important long-term consequence of BPS/IC. [corrected]. CONCLUSIONS: The success of this innovation has supported the use of microarray-based expression profiling as a single standardized platform for diagnosis of PBS/IC and offers [corrected] drug discovery.