Comparison of clinical characteristics between interstitial cystitis and hypersensitive bladder

Watanabe D1, Akiyama Y1, Nomiya A1, Niimi A1, Aizawa N2, Kume H1, Igawa Y2, Homma Y3

Research Type

Clinical

Abstract Category

Pelvic Pain Syndromes / Sexual Dysfunction

Abstract 613
Interstitial Cystitis / Bladder Pain Syndrome 2
Scientific Podium Short Oral Session 29
Friday 31st August 2018
14:00 - 14:07
Hall B
Painful Bladder Syndrome/Interstitial Cystitis (IC) Retrospective Study Female
1. Department of Urology, The University of Tokyo, Graduate School of Medicine, 2. Department of Continence Medicine, The University of Tokyo, Graduate School of Medicine, 3. Japanese Red Cross Medical Center
Presenter
D

Daiji Watanabe

Links

Abstract

Hypothesis / aims of study
Interstitial cystitis (IC) and hypersensitive bladder (HSB) have a common lower urinary tract symptom profile called as hypersensitive bladder symptoms, such as bladder pain/discomfort, urinary urgency, or high frequency. IC and HSB are to be classified by the endoscopic presence of the Hunner lesions (Hunner type IC, HIC), presence of mucosal bleeding after distension (MBAD) and absence of the Hunner lesions (non-Hunner type IC, NHIC) or absence of both the Hunner lesions and MBAD (HSB), respectively [1]. However, it has been reported that clinical phenotyping could not segregate HIC, NHIC, and HSB due to the similar symptomatic profiles [2]. The aim of this study was to compare the clinical manifestations of patients with HIC, NHIC and HSB.
Study design, materials and methods
Clinical records of female patients with IC or HSB who underwent the hydrodistension at our institution from December, 2008 to December, 2017 were retrospectively reviewed. Age, comorbidity, bladder capacity at hydrodistension, symptom severity before and after hydrodistension measured by O’Leary–Sant’s symptom and problem indexes (OSSI and OSPI), and the visual analog scale (VAS) for pain were compared among HIC, NHIC, and HSB.
Results
A total of 134 female patients with HIC (N=87), NHIC (N=33) and HSB (N=14) were evaluated. Patients with HIC were oldest and significantly older than those with NHIC. Patients with HIC had significantly higher OSSI than those with HSB, and smaller bladder capacity at hydrodistension than those with NHIC or HSB. The global response rate to hydrodistension (with or without fulguration) was highest in patients with HIC (89%), followed by those with HSB (57%) and NHIC (44%) (Table 1). Regarding comorbidities, diabetes mellitus and psychiatric disorders, respectively, were significantly more frequent in patients with HIC and in those with NHIC than the other two (Table 2).
Interpretation of results
Patients with HIC were more aged and symptomatic, and showed better responses to hydrodistension compared to those with NHIC or HSB. There were almost no clinical parameters different between NHIC and HSB.
Concluding message
Clinical characters were distinct in HIC, while indistinguishable between NHIC and HSB.
Figure 1
Figure 2
References
  1. Homma Y, Ueda T, Tomoe H, et al. Clinical guidelines for interstitial cystitis and hypersensitive bladder updated in 2015. Int J Urol 2016; 23: 542-549
  2. Homma Y. Hypersensitive bladder: A solution to confused terminology and ignorance concerning interstitial cystitis. Int J Urol 2014; 21 (suppl 1): 43-47
Disclosures
Funding We neither get any specify source of funding nor grant. Clinical Trial No Subjects None