La cystite interstitielle en 2008

RésuméLa cystite interstitielle (CI) est une pathologie de la vessie qui reste largement méconnue du monde médical français. Cette pathologie touche plus les femmes que les hommes. L’étiologie de la CI reste indéterminée. Les différentes études suggèrent que sa physiopathologie est multifactorielle. Le diagnostic de la CI doit être suspecté par le clinicien sur les données de l’interrogatoire. La confirmation de ce diagnostic, qui reste un diagnostic d’élimination repose sur une série d’examens dont le but est d’écarter d’autres pathologies. Aucun test pathognomonique de la CI n’est disponible. La méconnaissance de la physiopathologie rend les traitements empiriques. Un algorithme décisionnel est proposé à la fin de cet article.

SummaryInterstitial cystitis (IC) is a chronic, debilitating condition that is often associated with late diagnosis and a delay in initiation of appropriate IC-specific therapy. The typical patient with interstitial cystitis (IC) is symptomatic for many years and consults multiple physicians before IC is diagnosed. These observations suggest that the clinical presentation of IC is not widely recognized. The resultant underdiagnosis may be explained in part by the nonspecific nature of IC symptoms, such as urinary urgency, frequency, nocturia and pain, as well as by the lack of an objective diagnostic test. Pelvic pain of bladder origin may refer to pain in any location in the pelvis, is affected by the menstrual cycle and flares with sexual intercourse. As a result of variations in disease definition and diagnostic criteria for interstitial cystitis (IC), the performance of epidemiologic studies has been challenging. The true prevalence of IC is much greater than the early studies suggested. Over the last decade, the recognized prevalence of IC has increased and it is consistently greater among women as compared to men.