BERKELEY, CA (UroToday Inc.) - Urine culture and bladder biopsies of patients with interstitial cystitis or painful bladder syndrome have produced variable results. None of these studies provided convincing evidence that interstitial cystitis is associated with ongoing infection. Al-Hadithi et.al. now report what appears to be a definitive study showing that painful bladder syndrome / interstitial cystitis is not associated with persistence of viral or bacterial DNA in the bladder. The authors examined bladder biopsies of 92 patients with PBS/IC, and compared them to 91 control bladder biopsies. PCR for the 16S ribosomal RNA gene, as well as for adenovirus, cytomegalovirus, herpes simplex virus types 1 and II, human papillomavirus and Chlamydia trachomatis were negative in all samples.

This study, the largest and most comprehensive analysis of screening for microbial DNA by polymerase chain reaction in PBS/IC reported to date, clearly indicates that persistence of microbial species or the DNA from these is not implicated in the ongoing pathogenesis of the disease. It does not rule out the possibility that an initial injury to the urothelium caused by a viral or bacterial infection could initiate the cascade of events that results in the PBS/IC symptom complex. It does strongly suggest that empiric use of antibiotics in these patients is unlikely to have any beneficial effect.

J Urol 2005 Jul; 174(1):151-154