Chronic cystitis with bladder disorders

Physiopathology & Diagnosis

In recent years there has been an increasing number of studies advocating a significant role of glycosaminoglycans (GAGs) disorders in the pathogenesis of many chronic bladder diseases.6

The loss of the GAGs layer independently of the original cause of the inflammatory process may be the first step in the cascade of events that lead to chronic bladder diseases.7

CHRONIC CYSTITIS IS MAINLY LINKED TO A DAMAGED GAG LAYER

Loss of GAGs in bladder epithelium would allow both normal and abnormal constituents of urine to come into direct contact with the subepithelial layers causing:

  • chronic bladder epithelial damage
  • neurogenic inflammation

Normal bladder epithelium is coated by a thick layer of GAGss that acts as:7

  • a nonspecific antiadherence factor
  • a nonspecific defence mechanism against infection and urine irritants

Recurrent bacterial cystitis (RBC), interstitial cystitis (BPS / IC) and radiation or chemical induced cystitis (RIC & CIC) can be linked in the first step of this pathogenesis.7