From the Research
Treatment of eosinophilic cystitis should prioritize the use of low-dose cyclosporine therapy, as it has shown excellent response in refractory cases, both symptomatically and anatomically, as demonstrated in a recent case report 1. The management of eosinophilic cystitis involves a range of options, from conservative medical therapy to surgical interventions, depending on the severity and response to treatment.
- First-line treatment may include antihistamines and nonsteroidal anti-inflammatory drugs to reduce inflammation, as well as corticosteroids for their anti-inflammatory effects.
- Identification and elimination of allergic triggers are crucial for patients with suspected allergic causes.
- Antibiotics are only indicated when a bacterial infection is confirmed.
- For cases resistant to medical therapy, immunosuppressive agents like azathioprine or cyclosporine may be considered, with cyclosporine showing promise in recent reports 1.
- Intravesical therapies, including dimethyl sulfoxide (DMSO) instillations, can provide direct anti-inflammatory effects.
- Surgical options, such as transurethral resection of localized lesions or partial cystectomy for extensive disease, are considered for severe cases unresponsive to medical management. Key considerations in the treatment of eosinophilic cystitis include the variability in patient response and the potential for recurrence, highlighting the need for regular cystoscopic follow-up to monitor response and detect recurrence, as noted in various studies 2, 3, 4. Given the rarity of the condition and the lack of standard treatment guidelines, treatment decisions should be individualized, taking into account the patient's specific symptoms, disease severity, and response to initial therapies, with a focus on minimizing morbidity, mortality, and improving quality of life.