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Urology (Expert Forum)
IC and Systemic Mastocytosis
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.
IC and Systemic Mastocytosis
by Sam-Scamardo, Jan 16, 1998 12:00AM
Re: IC and Systemic Mastocytosis
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Posted by HFHS M.D.-MS on January 19, 1998 at 14:10:15:
In Reply to: IC and Systemic Mastocytosis posted by Sam Scamardo on January 16, 1998 at 20:51:13:
Has anyone noted the association of IC with sytemic mastocytosis?
I have experienced tremendous urethral and bladder pain during cystocopies (for badder cancer, CIS) and during catheter insertion for BCG treatments. Even though Xylocaine was being used with each cystocopy, it was still a very painful procedure. After some experimenting, it was discovered that the pain could be minimized noticeably if the Xylocaine was allowed to remain in the urethra for twenty five to thirty minutes, before insertion of the cystocope. Because the urethral pain was so excruciating during cathaeter insertion for BCG treatments, a decision was made to use Xylocaine in the same manner now used for my cystocopies.
During each cystocopy, my urologists have noticed a high degree of bladder inflamation (inflammation), but have not been able to pinpoint the cause. One doctor now suspects some form of IC because of the consistent pain, and my bladder being one of the body organs involved with Systemic Mastocytosis. Any applicable information would be very much appreciated. Sam
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Dear Sam:
Thank you for your question.
As you know, everyone has different pain thresholds. BCG causes an intense bladder irritation which can be painful especially with the first few installations. Anesticon package insert( company biased) found in the Physician Desk Reference states 15 ml of 2% jelly should be instilled into the male urethra then left in place for “several minutes” , a second 15 ml should be instilled and then another 5-10 minutes should be allowed before instrumentation.
On Medline, there are 34 articles since 1993 that recognize an association between mast cells and IC. Here is a typical review.
Interstitial cystitis: a critique of current concepts with a new
proposal for pathologic diagnosis and pathogenesis. [Review] [257 refs]
Urology. 49(5A Suppl):14-40, 1997 May.
Medline does not recognize “Mastocystosis” as a Keyword. Your history of Bladder cancer and BCG may not complicate the diagnosis of IC. There has been reports of dramatic improvement of IC with the use of BCG. So if your symptoms don’t get better with BCG this suggest you may have something else causing the irritation.
This information is provided for general medical education purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition.
Sincerely
HFHS M.D.- MS
*Keyword: Interstitial Cystitis
