Tiny submucosal hemorrhages otherwise known as “glomerulations” have long been considered a diagnostic marker for PBS/IC even though it was recognized long ago that glomerulations were not unique to patients with PBS/IC. Nevertheless, this association continued to be perpetuated, and many patients who demonstrated glomerulations on hydrodistention were wrongly labelled with PBS/IC. Further, in past research studies, the use of glomerulations as an inclusion criterion lead to recruitment of large, heterogeneous populations including numerous individuals unlikely to have PBS/IC. This was the motivation for BPS/IC expert Philip Hanno and colleagues to critically examine the literature to determine if there was any justification for the use of glomerulations as a diagnostic marker for PBS/IC.
Only 29 relevant publications were identified in the literature review. These papers were divided into 4 categories according to subject matter: glomerulations in patients with a diagnosis of PBS/IC; prevalence in patients without a diagnosis of PBS/IC; relationship of glomerulations to symptoms, especially bladder capacity; and a single paper addressing consistency of glomerulations in patients over time. Not only were contradictory data found, but glomerulations clearly had poor sensitivity and specificity for establishing the presence or absence of PBS/IC. Further, the authors were unable to identify any correlations between glomerulations and any clinical manifestation of PBS/IC.
Article by the Publications and Communications Committee
Wennevik GE, Meijlink JM, Hanno P, Nordling J. The role of glomerulations in bladder pain syndrome: a review. J Urol 195:19-25, 2016