Tiaprofenic acid as a cause of non-bacterial cystitis.

Objective: To draw attention to a relationship between the taking of tiaprofenic acid (Surgam) and the development of severe non-bacterial cystitis.

Design: Seven case reports.

Patients: Six women and one man aged between 62 and 83 years with severe chronic cystitis who were taking tiaprofenic acid regularly for osteoarthritis. Six of the seven had initially been diagnosed as having interstitial cystitis.

Results: All patients had classic symptoms and minimal signs on physical examination of chronic cystitis but urinalyses showed sterile pyuria, microscopic haematuria and proteinuria. Their upper urinary tracts were normal. All had severe and diffuse mucosal inflammation noted on cystoscopy, which became more marked with distension. Histological examination of bladder biopsies showed severe acute and chronic inflammation. Symptoms were present for an average period of six months, resulting in great morbidity. All patients recovered completely after the withdrawal of tiaprofenic acid within four to eight weeks (average 5.7 weeks).

Conclusion: A strong case for a cause-and-effect relationship between tiaprofenic acid and non-bacterial cystitis has been presented and a clinical pattern of disease established. Awareness of this condition is needed to reduce its morbidity in the community and to remove the need for expensive investigations.