Diagnostic and therapeutic efficacy of urinary bladder hydrodistension in patients with bladder pain syndrome
Abstract
Background/Aim. Interstitial cystitis (IC)/bladder pain syndrome (BPS) is a condition with recurring discomfort or pain in the urinary bladder and the surrounding pelvic region without an identifiable disease. The aim of this study was to assess hydrodistension as a diagnostic and treatment procedure in patients with BPS. Methods. This prospective study included 45 patients who underwent cystoscopy with hydrodistension. The mean values for 24-hr voiding frequency, maximal voided urine volume, average voided urine volume, and minimal voided urine volume originated from the frequency volume chart. The values were compared between the time before hydrodistension and one, three, and six months after that. Results. By comparing the initial data and data in all three follow-up periods (after 1, 3, and 6 months), the statistical significance (p < 0.046) was found, and that: for 24-hr voiding frequency, it was 19.64 ± 3.56, 9.42 ± 1.71, 9.58 ± 1.45, and 12.2 ± 2.79, respectively; then, for the minimal voided urine volume (p < 0.03), it was 59.11 ± 23.72 mL, 114.89 ± 4.09 mL, 112.44 ± 100.86 mL, and 89.00 ± 29.45 mL, respectively; for an average voided volume (p < 0.04), it was 105.33 ± 18.29 mL, 186.89 ± 23.14 mL, 186.44 ± 21.44 mL, and 155.78 ± 30.78 mL, respectively. There was no significant statistical difference (p < 0.1) regarding the maximal voided urine volume between initial and follow-up interval data: 196.89 ± 43.68 mL, 312.89 ± 54.59 mL, 316.00 ± 49.47 mL, 266.67 ± 53.17 mL, respectively. Conclusion. Our results demonstrate that hydrodistension is a reliable diagnostic and therapeutic procedure.
References
Parsons JK, Parsons CL. The historical origins of interstitial cys-titis. J Urol 2004; 171(1): 20–2.
Gillenwater JY, Wein AJ. Summary of the national institute of arthritis, diabetes, digestive and kidney diseases workshop on interstitial cystitis, national institutes of health, Bethesda, Maryland, August 28−29, 1987. J Urol 1988; 140(1): 203–6.
Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, et al. The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn 2002; 21(2): 167–78.
Van de Merwe JP, Nordling J, Bouchelouche P, Bouchelouche K, Cer-vigni M, Daha LK, et al. Diagnostic criteria, classification, and nomenclature for painful bladder syndrome/interstitial cysti-tis: an ESSIC proposal. Eur Urol 2008; 53(1): 60–7.
Abrams P, Andersson KE, Apostolidis A, Birder L, Bliss D, Bru-baker L, et al. Sixth International Consultation on Inconti-nence Recommendations of the International Scientific Committee: Evaluation and treatment of uri-nary incontinence, pelvic organ prolapse, and faecal inconti-nence. Neurourol Urodyn 2018; 37(7): 2271−2.
European Association of Urology. Chronic pelvic pain [Internet]. The Netherlands: EAU. 2016 [cited 2024 July 2]. Available from: https://uroweb. org/guideline/chronic-pelvic-pain/#1
Bumpus HJ. Interstitial cystitis: its treatment by over-distention of the bladder. Med Clin North Am 1930; 13: 1495–8.
Hand JR. Interstitial cystitis; report of 223 cases (204 women and 19 men). J Urol 1949; 61(2): 291–310.
American Urology Association. Diagnosis and treatment of inter-stitial cystitis/bladder pain syndrome [Internet]. Linthcum: AUA; 2016 [cited 2024 July 2]. Available from: https://www.auanet.org/common/pdf/education/clinical-guidance/IC-Bladder-Pain-Syndrome-Revised.pdf
Homma Y, Akiyama Y, Tomoe H, Furuta A, Ueda T, Maeda D, et al. Clinical guidelines for interstitial cystitis/bladder pain syndrome. Int J Urol 2020; 27(7): 578–89.
Tirlapur SA, Birch JV, Carberry CL, Khan KS, Latthe PM, Jha S, et al. Management of bladder pain syndrome. BJOG 2016; 124(2): e46–72.
D’Ancona C, Haylen B, Oelke M, Abranches-Monteiro L, Arnold E, Goldman H, et al. The International Continence Society (ICS) report on the terminology for adult male lower urinary tract and pelvic floor symptoms and dysfunction. Neurourol Urodyn 2019; 38(2): 433−77.
Homma Y, Ueda T, Tomoe H, Lin AT, Kuo HC, Lee MH, et al. Clinical guidelines for interstitial cystitis and hypersensitive bladder updated in 2015. Int J Urol 2016; 23(7): 542−9.
Hunner GL. A rare type of bladder ulcer in women; report of cases. Boston Med Surg J 1915; 172: 660–4.
Clemens JQ, Erickson DR, Varela NP, Lai HH. Diagnosis and treatment of interstitial cystitis/bladder pain syndrome. J Urol 2022; 208(1): 34−42.
Hanno P, Cervigni M, Choo MS, Clemens JQ, Lee MH, Malde S, et al. Summary of the 2023 report of the international consul-tation on incontinence interstitial cystitis/bladder pain syn-drome (IC/BPS) committee. Continence 2023; 101056.
Yoshimura N, Uno T, Sasaki M, Ohinata A, Nawata S, Ueda T. The O'Leary-Sant Interstitial Cystitis Symptom Index is a clin-ically useful indicator of treatment outcome in patients with interstitial cystitis/bladder pain syndrome with Hunner le-sions: A post hoc analysis of the Japanese phase III trial of KRP-116D, 50% dimethyl sulfoxide solution. Int J Urol 2022; 29(4): 289−96.
Malde S, Palmisani S, Al-Kaisy A, Sahai A. Guideline of guide-lines: bladder pain syndrome BJU Int 2018; 122(5): 729−43.
Kirk PS, Santiago-Lastra Y, Qin Y, Stoffel JT, Clemens JQ, Cam-eron AP. The effects of cystoscopy and hydrodistention on symptoms and bladder capacity in interstitial cystitis/bladder pain syndrome. Neurourol Urodyn 2018; 37(6): 2002–7.