title: Bladder pain syndrome: do the different morphological and cystoscopic features correlate?
abstract: OBJECTIVE
  For the diagnosis of bladder pain syndrome (BPS), the International Society for the Study of Bladder Pain Syndrome (ESSIC) recommends a specific diagnostic work-up using cystoscopy with hydrodistension and bladder biopsies. This study evaluates the correlation between the histological findings in bladder biopsies handled following ESSIC recommendations, as well as the importance of the histological features in BPS compared with the cystoscopic findings.
  
  
  METHODS
  The study included 15 men and 93 women. All patients underwent cystoscopy with hydrodistension, and at least three deep biopsies including detrusor muscle were taken. For the cell count the Leder stain was used most frequently. A cut-off point of 28 mast cells/mm(2) was used for detrusor mastocytosis.
  
  
  RESULTS
  Significant correlations were found between urothelial damage and inflammatory infiltrate (p < 0.001). Detrusor mastocytosis was significantly more elevated in biopsies with normal urinary epithelium (Tukey corrected p < 0.0001) than in biopsies where the urothelium was damaged. No other correlations were found between histological findings or between histological and cystoscopic findings.
  
  
  CONCLUSIONS
  Both cystoscopy with hydrodistension and histology can be used to illustrate different pathophysiological mechanisms in patients with BPS. These results favour the use of both in the classification of BPS patients.
authors.affiliation: Department of Urology, Faculty of Medicine, University Antwerp and Antwerp University Hospital, Belgium.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Geurts
authors.forename: Johan
authors.initials: J
authors.lastname: Van Dyck
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Wyndaele
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D018856:Cystitis, Interstitial / Q000175:diagnosis / Q000473:pathology*; D003558:Cystoscopy; D005260:Female; D006801:Humans; D008297:Male; D008407:Mast Cells / Q000473:pathology; D008875:Middle Aged; D001743:Urinary Bladder / Q000473:pathology*; D019459:Urothelium / Q000473:pathology