Szemlletvltozs a hlyagfjdalom szindrma diagnosztikjban s terpijbanLovsz Sndor2012

Washington, DC Consensus Meeting on IC/PBS, February 10, 2007; ICA Web site.Interstitial Cystitis Interstitial Cystitis /Painful Bladder Syndrome Bladder Pain Syndrome /Interstitial Cystitis A nomenklatura krdsei

A BPS/IC incidencija

197/100 000

5 : 1

60/100 000 Nk : frfiak = 9 : 1

Az USA-banEuropban: 8 464/100 000Magyarorszgon?Amerikai adatok alapjn Magyarorszgon a BPS/IC betegek becslt szma: ~ 20.000

A PBS/IC diagnosztikjnak nehzsgeiNincsenek biolgiai markerekFjdalmas, invazvtechnikkRestrictv kritriumok kutatsiclokraClemens JQ. In: Urologic Diseases in America. 2007; Hanno PM. In: Penn Clinical Manual of Urology. 2007. Antiproliferatv faktor (APF)Nerve growth factor (NGF)Interleukin-6 (IL-6)Hisztamin, metilhisztaminPlasma norepinephrinRSU-1, SM-22, GAPDH K-terhelses teszt (Parsons)helyettLidocain vagyLidocain + Hyaluronat teszt

A BPS/IC diagnosztikjaHidrodilatci ltalnos anaesthesibanTlts kzben fokozdnylkahrtya glomerulcikA diagnosztika legfontosabb eszkzeAz elvltozsok nyoms- s idfggek !

Ballonos hlyagdilatciA BPS/IC diagnosztikja Magas intravesicalis nyoms (70vzcm) lland szinten 5 percigStandardizlt rtkek!A ballon hirtelen leengedse utn kialakul nylkahrtya vrzsek valamennyi hibs nyh. terletet lthatv tesznek.

HlyagbiopsziaA BPS/IC diagnosztikjaKorbban javasolt beavatkozs nincs diagnosztikus rtke perforci veszlye vrzs veszlyeMalignits (CIS) kizrsra alkalmasabb a vizelet cytolgia ez minden esetben ktelez!

A cystometris lelet nem specifikus IC-reSzenzoros urge alacsony tltsnl jelentkez els ingerrel kis kapacitssalA hlyag kapacitsnak meghatrozsa pontatlan s bizonytalanA compliance meghatrozs nem ad elg informcit a hlyagfal fizikai tulajdonsgairlUrodinmis vizsglat BPS/IC-benA BPS/IC diagnosztikja

Cysto-elastometriacystometria szles nyomstartomnyban Diagnosztikus s prognosztikai rtk paramterek

A BPS/IC terpija Primaer orlis gygyszerels - Analgetikumok (non-steroid - opitok)- Corticosteroidok- Antiallergikumok (H1 s H2 antihisztaminok)- Triciklikus antidepressans - Pentosanpolysulphat (PPS)- Immunosuppressorok Kiegszt intravesicalis loklis kezelsek Primaeren loklis hlyagkezels- hibs nyh. terletek azonostsa s eltvoltsa- intravesicalis gygyszeres kezelssel folytatva Kiegszt orlis gygyszeres kezelsek (szksg esetn) Kiegszt dita Hlyagtorna

A BPS/IC betegek utkvetseObjektv paramterek a kvantitatv kvetshezVizelsi naplNemzetkzileg validlt krdvekTarts email-kapcsolat

A lehetsges jv: utkvets a honlapon keresztl !

Egysgben az erSporadikus, egymstl elszigetelt kutatkzpontok helyett:

ESSIC European Society of Scientific Investigation of ICICICJ - International Consultation on Interstitial Cystitis JapanAsian Association of IC ICS International Continence Society

A BPS/IC elltsnak specilis ignyeiIdigny az els vizsglat minimum 30 perc!Trelem, emptia sok beteg vek ta szenved, szmtalan sikertelen kezelsi ksrlet, gyakori verbalis iatrogniaGondozs, tarts utkvets akr letfogytig

A BPS/IC MagyarorszgonMagyarorszgon 20.000-re becslhet a BPS/IC-ben szenved betegek szma.

Hny urolgusra lenne szksg ennyi beteg korszer elltsra?

Hny urolgus ll kszen erre?

SzemlletvltsLakossg egszsgtudatossgnak fejlesztseUrolgusok folyamatos tovbbkpzseNgygyszok, hziorvosok, pszichiterek felksztseSzakterletek kzti egyttmkds javtsaTerleti BPS/IC kzpontok kialaktsaMagnrendelk, magnklinikk bevonsaSajt magyar Internet honlap ksztsenseglyez betegcsoportok kialaktsaRendszeres mdia-jelenlt (rdi-TV-jsgok)

Ez a mi munknk,s nem is kevs

SZEMLLETVLTS !

[Insert Lecture Name Here]Slide *Talking points:Even the name of the condition is under debate.Names used: interstitial cystitis, interstitial cystitis/painful bladder syndrome, urethral syndrome, trigonitis, or other combinations of these terms.Concerns have been raised about the validity and potential implications of a name change in the United States. These concerns include: [ICA Web site]loss of name recognition by patients if the term interstitial cystitis is removedproblems with coding and reimbursement for medical insurance, disability coverage, and prescription medications, which may adversely affect patientsIn February 2007, a multidisciplinary consensus meeting convened by the ICA and ARHP developed this Majority Statement regarding the nomenclature of IC/PBS:The nomenclature of IC/PBS may need to change, but change should not be undertaken now because there is insufficient evidence to support a change. Any change in nomenclature should be evidence-based. This group favors retaining IC in whatever name is considered in the future and positioning it first, as in IC/PBS.

Reference:Interstitial Cystitis Association. European medical professionals intend to change the name of IC. CAF ICA. 2007;7(1). Available at: http://www.ichelp.org/cafeica/Vol07No01.html#1.1. Accessed: March 1, 2007.

---Original content for this slide submitted by ARHPs Clinical Advisory Committee for Screening, Treatment, Management of Interstitial Cystitis/Painful Bladder Syndrome in October 2007. Original funding received from Ortho Womens Health and Urology through an independent educational grant. This slide is available at www.arhp.org/core.

[Insert Lecture Name Here]Slide *Talking points:The diagnostic criteria for IC/PBS remain unclear and controversial.To date, there are no biological markers for use in diagnosis. However, antiproliferative factor (APF) is under investigation as a potential diagnostic marker (more on this later). Restrictive research-based criteria have been used for diagnosis, missing many patients with the condition.Painful, invasive diagnostic techniques have been used, which may be unnecessary for diagnosis.

References:Clemens JQ, Joyce GF, Wise M, Payne CK. Interstitial cystitis and painful bladder syndrome. In: Litwin MS, Saigal CS, eds. Urologic Diseases in America. US Department of Health and Human Services, Public Health Service, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases. Washington, DC: US Government Printing Office, 2007; NIH Publication No. 07-5512.Hanno PM. Painful bladder syndrome (interstitial cystitis). In: Hanno PM, Wein AJ, Malkowicz SB, eds. Penn Clinical Manual of Urology. Philadelphia: Saunders; 2007.

---Original content for this slide submitted by ARHPs Clinical Advisory Committee for Screening, Treatment, Management of Interstitial Cystitis/Painful Bladder Syndrome in October 2007. Original funding received from Ortho Womens Health and Urology through an independent educational grant. This slide is available at www.arhp.org/core.