Editorial Comment to Angiogenesis in bladder tissues is strongly correlated with urinary frequency and bladder pain in patients with interstitial cystitis/bladder pain syndrome

The authors collected bladder biopsies from 12 Hunner lesion patients, 12 non-Hunner interstitial cystitis/bladder pain syndrome (IC/BPS) patients, and 12 controls. A variety of immunohistochemical testing was performed on the specimens to correlate among bladder inflammation, angiogenesis, fibrosis, and urothelial denudation in bladder tissues among immunohistochemistry, and symptom scores. Results suggest that bladder angiogenesis evident as the increased expression of CD31 is strongly correlated with urinary frequency and bladder pain in patients with non Hunner and Hunner positive IC. The study is quite interesting and suggests that angiogenesis might be a therapeutic target. There are a couple of questions that came to my mind reading the research. Could the bladder distention performed on all patients but not on controls prior to biopsy have affected the results? Why was there not a group of hypersensitive bladder patients (those with no mucosal bleeding or glomerulations under distention) included? These missing group would comprise patients considered to have IC/BPS in Europe and North America but not in East Asia where they would be classified as having hypersensitive bladder syndrome. Certainly, there is more work to be done, but the authors have provided much to think about as we try to unravel this disorder. None declared.