目次
はじめに ................................................................................................................ ii
図譜 ........................................................................................................................ v
1 間質性膀胱炎とは .......................................................................................... 1（本ガイドラインの対象とする「間質性膀胱炎」）

2 病因と病態 ..................................................................................................... 7
1. 間質性膀胱炎の病因 .......................................................................................... 7
2. 間質性膀胱炎の病態 .......................................................................................... 83 疫

学 ........................................................................................................... 16

4 QOL .............................................................................................................. 185 診

断 ........................................................................................................... 20

1. 臨床症状 ........................................................................................................ 20
2. 病

歴 ............................................................................................................ 21

3. 検

査 ............................................................................................................ 24

4. 除外診断 ........................................................................................................ 27
5. 臨床的な診断基準 ........................................................................................... 27

6 治療 - 1 保存的治療 .................................................................................. 33
1. 行動療法（Behavioral modification） .................................................................. 33
2. 理学療法（Physical therapy） ............................................................................ 33
3. 緊張の緩和（Stress reduction） ......................................................................... 34
4. 食事療法（Dietary manipulation）....................................................................... 35

7 治療 - 2 膀胱水圧拡張術（Hydrodistension） ........................................ 38
8 治療 - 3 内服薬治療 .................................................................................. 43
1. 抗ヒスタミン薬（Hydroxyzine） ........................................................................ 43
2. 三環系抗うつ薬（Amitriptyline） ........................................................................ 43
3. トシル酸スプラタスト（Suplatast tosilate） ....................................................... 44
4. シメチジン（Cimetidine） ................................................................................. 44
5. 抗生物質・抗菌薬 ........................................................................................... 45
6. ステロイド（Steroid） ...................................................................................... 45
7. アルギニン（L-arginine）................................................................................... 46
8. Pentosan polysulfate ........................................................................................ 46x

目 次9 治療 - 4

膀胱内注入療法 ........................................................................... 50

1. DMSO（Dimethyl sulfoxide）.............................................................................. 50
2. ヘパリン（Heparin）......................................................................................... 51
3. ヒアルロン酸（Hyaluronic acid）........................................................................ 51
4. 硫酸コンドロイチン（Chondroitin sulfate）......................................................... 52
5. Pentosan polysulfate ........................................................................................ 52
6. カプサイシン／レジニフェラトキシン（Capsaicin, Resiniferatoxin）.................... 52
7. Bacillus Calmette-Guérin（BCG）....................................................................... 53
8. オキシブチニン（Oxybutynin）.......................................................................... 53
9. リドカイン（Lidocaine）................................................................................... 53

１０ 治療 - 5

その他の治療 .............................................................................. 56

1. 経皮的電気刺激（Transcutaneous electrical nerve stimulation; TENS）.................. 56
2. 仙骨神経刺激（Sacral nerve neuromodulation）................................................... 56
3. 鍼（Acupuncture）............................................................................................ 57
4. 経尿道的切除術（Transurethral resection; TUR）
・経尿道的レーザー治療 ............ 58
5. 膀胱拡大術（Augmentation）
・膀胱摘出術 ......................................................... 59

治療法の一覧 ................................................................................................ 64

１１ 治療効果の評価 ........................................................................................... 66
1. 対象患者の採用基準 ........................................................................................ 66
2. 有効性の判定基準 ........................................................................................... 67

１２ 特殊な病態 - 1 男性 ................................................................................. 70
1. 男性症例の特徴 .............................................................................................. 70
2. 診

断 ............................................................................................................ 70

3. 治療 ............................................................................................................ 71

１３ 特殊な病態 - 2 小児 ................................................................................. 72
１４ 診療のアルゴリズム ................................................................................... 74
索引 ...................................................................................................................... 76

間質性膀胱炎診療ガイドラインxi