Infection

Infection
    

• R. Thilagarajah, R.O’N. Witherow and M.M. Walker [Urology Unit, St. Mary’s Hospital, London, UK]
  Oral Cimetidine gives Effective Symptom Relief in Painful Bladder Disease : A Prospective, Randomized, Double-blind Placebo-controlled Trial
  BJU International, volume 87, Number 1, January 2001, Pg.Nos. 207-212
  
  Introduction – Painful bladder disease [PBD] encompasses a spectrum of conditions that include a symptom complex of suprapubic pain, frequency, dysuria, and nocturia in the absence of detectable urine infection. Ulcerative and nonulcerative interstitial cystitis (IC), painful bladder syndrome [PBS], a bacterial cystitis and the urethral syndrome are all contained within this wide ranging term as defined by international guidelines.
  
  Patients and Methods – The study comprised 36 patients with PBD enrolled in a double blind clinical study with two treatment arms i.e. oral cimetidine or placebo for 3 months trial. 
  
  Results – Of the 36 patients recruited, 34 completed the study. Those receiving cimetidine had a significant improvement in symptoms; with mean symptom scores decreasing from 19 to 11.
  
  Suprapubic pain and nocturia decreased markedly. However, histologically the bladder mucosa showed no qualitative change in the glycosaminoglycan layer or basement membrane or in muscle collagen deposition, in either group. The T. cell infiltrate was marginally reduced in the cimetidine group and increased in the placebo group. Angiogenesis remained relatively unchanged. The incidence of mast cells and B cells was sporadic in both groups.
  
  Conclusion – Oral cimetidine is very effective in relieving symptoms in patients with PBD but there is no apparent histological change in the bladder mucosa after treatment.