Glomerulation

Glomerulation refers to bladder hemorrhages which are thought to be associated with some types of interstitial cystitis (IC). The presence of glomerulations, also known as petechial hemorrhages, in the bladder suggests that the bladder wall has been damaged, irritated, and/or inflamed. Petechial hemorrhages originate from punctuate hemorrhages. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Diagnostic Criteria for IC, developed in 1987, required the presence of glomerulations or Hunner's Ulcers for diagnosis of IC and is still used today, to determine eligibility for some clinical trials. However other research has theorized that the hydrodistention procedure used for the diagnosis of IC itself may have created these tiny broken blood vessels. Studies have found glomerulations in asymptomatic populations, suggesting that they are not applicable as a marker for IC. Thus, a diagnosis of IC is now based upon other, less invasive methods, such as the PUF Scale (Pelvic Pain and Urgency/Frequency Patient Symptom Scale). Glomerulation has been observed to be one of the feature for prostate cancer. However, efforts to determine whether this is association or causation have concluded that while glomerulations may be a common finding in individuals with prostate cancer, they are not a significant predictor.

Glomerulation refers to bladder hemorrhages which are thought to be associated with some types of interstitial cystitis (IC). The presence of glomerulations, also known as petechial hemorrhages, in the bladder suggests that the bladder wall has been damaged, irritated, and/or inflamed. Petechial hemorrhages originate from punctuate hemorrhages. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Diagnostic Criteria for IC, developed in 1987, required the presence of glomerulations or Hunner's Ulcers for diagnosis of IC and is still used today, to determine eligibility for some clinical trials. However other research has theorized that the hydrodistention procedure used for the diagnosis of IC itself may have created these tiny broken blood vessels. Studies have found glomerulations in asymptomatic populations, suggesting that they are not applicable as a marker for IC. Thus, a diagnosis of IC is now based upon other, less invasive methods, such as the PUF Scale (Pelvic Pain and Urgency/Frequency Patient Symptom Scale). Glomerulation has been observed to be one of the feature for prostate cancer. However, efforts to determine whether this is association or causation have concluded that while glomerulations may be a common finding in individuals with prostate cancer, they are not a significant predictor. ==Treatment== Though there is limited research on the treatment of glomerulation, some researchers found that it is safe to implement transcatheter arterial embolization of the prostatic or vesical arteries to sustainably control bladder hemorrhage. It is a minimally invasive procedure with a 90% success rate and is well-tolerated in most cases. It is proven to improve quality of life. Since there are not many established treatment available, the best treatment for glomerulation is prevention, ex. ensure adequate hydration to flush out infection, beware of drug-induced bleeding and continuous bladder irrigation. In people with interstitial cystitis, guidelines such as the American Urological Association (AUC) and Canada Urological Association (CUA) do not differentiate treatment strategies between those with and without glomerulations. While fulguration is listed as a third-line treatment option for interstitial cystitis with Hunner's Lesions, guidelines do not recommend it to treat glomerulations. Instead, guidelines have set symptom control and quality of life as some of the main goals of treatment for IC. However, there is a lack of consistent evidence that the presence of glomerulations affects treatment outcomes. In addition to traditional IC therapies, diet modification remains a core self care strategy as foods that are irritating to the bladder dramatically worsen the symptoms that people may experience. Foods high in acid and/or caffeine (such as all coffees, regular teas, green teas, sodas, diet sodas, artificial sweeteners and most fruit juices) should be avoided. The daily goal should be to soothe rather than irritate the bladder wall. ==References==

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