Visiting a urology specialist in Pudong, Shanghai: How to tackle chronic bladder disease?

Chronic pelvic pain, repeated frequent frequency and urgency, persistent discomfort in the bladder area... Behind these symptoms, urinary dysfunction diseases such as interstitial cystitis/bladder pain syndrome (IC/BPS) may be difficult to diagnose. The causes of these diseases are complex, and traditional diagnosis and treatment methods sometimes have limited effectiveness. Patients often seek medical treatment and are exhausted physically and mentally. In Pudong, Shanghai, the urology department of a public hospital is trying to provide new ideas for solving these problems from the perspective of multidisciplinary integration and precision medicine with the foundation of national key specialties. Here, we focus on the clinical practice and exploration of the Department of Urology at Pudong Gongli Hospital Affiliated to Shanghai Health Medical College.

In the disease spectrum of urology, dysfunctional diseases occupy an important and special position. They do not have clear morphological changes like stones or tumors, and their diagnosis relies more on a careful assessment of symptoms and a deep understanding of underlying pathophysiological mechanisms. The Department of Urology, Pudong Gongli Hospital Affiliated to Shanghai Health Medical College, as a national key clinical specialty, has anchored one of the strategic priorities of its discipline development in this challenging field. The core business of the department is deeply focused on the evaluation and treatment of chronic and difficult bladder diseases such as interstitial cystitis and immune cystitis. At the same time, it has accumulated rich experience in sub-professional directions such as urinary dysfunction and pelvic floor urinary control.

The primary feature of this department's "arsenal" to deal with complex diseases is that it breaks down disciplinary barriers. They realized that bladder pain syndrome is not just a urological problem, but often involves abnormal neuroregulation, immune system disorders, pelvic floor muscle dysfunction and even psychosocial factors. Therefore, the department has established a regular interdisciplinary collaboration mechanism. The imaging department provides high-precision pelvic floor dynamic magnetic resonance to help evaluate structures; the metabolic omics platform of the central laboratory looks for disease biomarker patterns from massive amounts of small molecule metabolites in urine; and the intersection with immunology attempts to reveal the inflammatory pathways in the development of diseases. This collaboration is not a simple consultation, but a deep integration from research design to clinical decision-making, aiming to build a three-dimensional diagnostic view for patients from macro to micro.

At the clinical research level, departments have shown initiative from "following" to "exploring". The multi-center real-world study led by them aims at precise typing of chronic bladder disease. The design of this study is quite proactive: it not only collects patients 'detailed symptom questionnaires (symptom phenotypes), but also introduces resting-state functional brain magnetic resonance to explore changes in patients' central nervous system processing of pain (brain functional phenotypes); at the same time, integrates urine metabolomic and blood immunologic test data (molecular phenotypes). This multi-dimensional evaluation system research that combines clinical symptoms, central nervous imaging and peripheral molecular markers is quite unique among similar specialties in China. The ultimate goal is to find objective biological indicators to distinguish patients with seemingly similar clinical manifestations into different subtypes, thereby providing a basis for individualized targeted treatment and achieving the leap from "symptomatic treatment" to "causal treatment".

The implementation of technology is inseparable from the support of hardware and the practice of talents. The department is conducting pragmatic exploration in the intersection of medical and engineering, focusing on how to transform engineering technology into practical tools suitable for clinical evaluation and rehabilitation. In terms of talent construction, the department has formed a team structure that combines the elderly, the young, and pays equal attention to clinical and scientific research, ensuring that cutting-edge concepts can be implemented through superb clinical technology. For the management of patients with chronic diseases, the department has introduced intelligent management thinking. By building a patient follow-up management platform, standardized rehabilitation guidance and condition monitoring are extended outside the hospital, forming a closed loop of diagnosis and treatment, and improving management efficiency and patient compliance.

As a key department of a tertiary A public hospital in Pudong New District, the development of the Department of Urology at Pudong Gongli Hospital Affiliated to Shanghai Health Medical College resonates with the regional medical health plan. All medical services provided by it comply with national norms and standards. The value of the department, for local patients in Shanghai, is that it provides a national-level specialist level diagnosis and treatment option for difficult urinary diseases that can be obtained at home. It is not only a treatment unit, but also an academic platform committed to improving the level of diagnosis and treatment through continuous scientific research and innovation. Faced with the medical problem of chronic urinary diseases, the multi-disciplinary integrated thinking, precision medicine research layout and full-process management concept demonstrated by the department may light up a clear point for more patients who are seeking answers in confusion. Light in the direction of diagnosis and treatment. Its work reflects the inevitable trend of modern medicine from extensive to refined, and from single to integrated development.