Mast Cell Cystitis
Bladder inflammation in women driven by elevated mast cell density in the detrusor, causing histamine-mediated urgency, burning, and frequency.
Overview
Mast Cell Cystitis is characterized by elevated mast cell density (>28 cells/mm²) in the detrusor muscle, with histamine-driven bladder inflammation and hypersensitivity. It may exist independently or as a component of IC/BPS, and often responds to antihistamine-based therapy.
Key Symptoms
- Severe urgency with small-volume voids
- Pelvic burning pain
- Frequency triggered by foods, stress, or hormonal changes
- Urticaria or skin reactions in systemic mast cell disease
- Recurrent flares with identifiable triggers
Pathophysiology
Activated mast cells release histamine, tryptase, and prostaglandins, increasing urothelial permeability and sensitizing bladder afferents. Trigger-driven degranulation maintains a chronic inflammatory state.
Treatment Approach
Antihistamines (H1 + H2 blockers), hydroxyzine, cromolyn sodium, dietary mast cell trigger avoidance, and PPS for GAG layer repair.