The role of glomerulations in Bladder Pain Syndrome - A review

Glomerulations as a diagnostic marker for bladder pain syndrome/interstitial cystitis (BPS/IC) was first popularized by Messing & Stamey in 1978. Later this was included in the NIDDK criteria for research and consequently used by many urologists as a default diagnostic criterion.

Today, the connection between glomerulations and BPS/IC is much debated, as research has found glomerulations in asymptomatic populations. This paper systematically looks at the available research to see if there is valid data to support the use of glomerulations as a marker for BPS/IC.

A systematic literature search of the PubMed database in March 2014 using the search term "Cystitis, Interstitial/diagnosis" [MAJR] OR (glomerulations OR glomerulation OR bladder petechiae) was performed and yielded 463 hits, and an Embase search using the search term "glomerulations" yielded 110 references of which 68 were duplicates. Relevant articles were reviewed and included in the study. Bibliographies of reviews, articles and status reports were examined to find studies not included in the search. In total twenty-nine publications were included in this review.

There is no consistent relationship between glomerulations and the diagnosis of BPS/IC. In the reviewed studies, we found evidence of the grade of glomerulations changing over time. Furthermore, many studies showed no link between the severity of symptoms and the number of glomerulations. There were studies that found glomerulations in healthy asymptomatic populations as well as in symptomatic populations with another primary diagnosis. One study found no glomerulations in an asymptomatic population.

From the reviewed literature, we found no convincing evidence that glomerulations should be included in diagnosis or phenotyping of BPS/IC. It does not correlate with symptoms and is found in patients without BPS/IC.

The Journal of urology. 2015 Aug 26 [Epub ahead of print]

Gjertrud E Wennevik, Jane M Meijlink, Philip Hanno, Jørgen Nordling

University of Copenhagen, Denmark. , International Painful Bladder Foundation, The Netherlands. , Professor of Urology, University of Pennsylvania, Philadelphia, Pennsylvania. , Professor of Urology, University of Copenhagen, Copenhagen, Denmark.


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