Real World Long-Term Outcome in IC/BPS Patients with Multiple Treatments Modalities

Jhang J1, Lori B2, Jiang Y1, Hsu Y3, Ho H4, Kuo H1

Research Type

Clinical

Abstract Category

Prevention and Public Health

Abstract 705
Non Discussion Abstracts
Scientific Non Discussion Abstract Session 36
Painful Bladder Syndrome/Interstitial Cystitis (IC) Female Quality of Life (QoL)
1. Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan, 2. Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA, 3. Department of Pathology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan, 4. Department of Anatomy, Tzu Chi University, Hualien, Taiwan
Links

Abstract

Hypothesis / aims of study
Interstitial cystitis and bladder pain syndrome (IC/BPS) is considered as a chronic disease. However, the long-term (> 10 years) therapeutic outcome of patients with IC/BPS has been rarely reported. The objective of current study is to investigate the long-term symptoms changes and satisfaction to management in IC/BPS patients with multiple treatments modalities, and the patients who had been lost to follow-up.
Study design, materials and methods
IC/BPS patients with history for more than 5 years were enrolled into this study. A telephone interview was used to assess current IC/BPS symptoms. Questionnaires for IC/BPS, including Interstitial Cystitis Symptoms and Problem Index (ICSI and ICPI), O’Leary-Sant symptom score (OSS), and Visual Analogue Scale for pain (VAS), were completed during the interview. The treatments modalities among these patients, including hydrodistention, intravesical hyaluronic acid installation and botulinum toxin A injection, were also recorded. A 5-point scale (from -1 to 3) was also used to grade current overall treatment outcome (symptoms change from baseline, -1: worse, 0: 0-25% improved, 1: 25-50% improved, 2: 50% improved, 3: symptom free).
Results
A total of 198 IC/BPS patients completed the telephone interview. The mean age of these patients was 57.5±12.5 (ranged 23~94yrs), and the mean IC/BPS follow-up duration is 15.8±9.9 years. At long-term follow-up, the IC/BPS patients experienced significantly improvement of ICPI, ICSI, OSS and VAS than baseline (all p<0.001, Table 1). Almost 50% of patients had symptoms improvement of more than 50%, and even 14% patients were free of IC/BPS symptoms (Fig. 1). About 30% of our patients had been lost to follow-up for more than 5 years. The symptom improvements between the patients who had been lost to follow-up or not were not significantly different. Most patients had received 2 or 3 kinds of treatments of IC/BPS (Fig. 2). The number of treatment modalities did not impact the treatment outcome.
Interpretation of results
Almost 50% of IC/BPS patients experienced symptoms improvement of > 50% in long-term follow-up. However, there were more than 50% patients who did not have great symptoms improvement even after multiple treatments. Current treatment modalities could not significant impact the long-term outcome in IC/BPS.
Concluding message
At long-term follow up, most IC/BPS patients experienced symptoms improvement. However, the symptoms improve may be not enough in most IC/BPS patients with current treatment modalities.
Figure 1
Figure 2
Disclosures
Funding None Clinical Trial No Subjects Human Ethics Committee Research Ethics Committee, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation Helsinki Yes Informed Consent Yes