Wan-Ru Yu1, Wei-Chuan Chang2, Hann-Chorng Kuo3. 1. Department of Nursing, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan. 2. Department of Medical Research, Buddhist Tzu Chi General Hospital, Hualien, Taiwan. 3. Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, and Tzu Chi University, Hualien, Taiwan.
Abstract
PURPOSE: The role of urodynamic study in the diagnosis and prognostication of interstitial cystitis/bladder pain syndrome (IC/BPS) is still controversial. This study evaluated the correlation of the baseline voiding dysfunctions and long-term treatment outcome in patients with non-Hunner's ulcer IC (NHIC). MATERIALS AND METHODS: A total of 211 NHIC patients were enrolled. All patients underwent videourodynamic (VUDS) examination at baseline to identify their voiding conditions and received subsequent treatments. The primary endpoint was Global Response Assessment (GRA) at the interview. Secondary endpoints included O'Leary-Sant symptom score (OSS), Visual Analogue Scale (VAS) for pain, and the rate of IC symptom flare-up. RESULTS: The mean age was 56.8±12.8 years, and mean duration of IC was 16.0±9.9 years. At baseline, 83 (39.3%) patients had a voiding dysfunction and 132 (62.7%) had 1 to 3 comorbidities. The duration, comorbidities, treatments, changes in OSS and VAS, maximum bladder capacity (MBC), glomerulations, GRA, and flare-up rate showed no significant difference among different subgroups. When we divided patients by their storage and voiding conditions, patients with non-hypersensitivity bladder (HSB) (n=32) had significantly greater MBC (p=0.002) whereas those with HSB with (n=76) or without (n=103) voiding dysfunction had higher glomerulation (p=0.021). When we analyzed voiding dysfunction subgroups by GRA, patients with a GRA≥2 had a significantly shorter duration of disease (13.9±8.6 years, p=0.021). There were also significant associations between GRA and the changes of OSS (p<0.001) and VAS (p<0.001). CONCLUSIONS: VUDS can disclose voiding dysfunction in 39.3% of NHIC patients. With adequate therapy, the voiding dysfunctions in NHIC patients do not affect long-term treatment outcome. This article is protected by copyright. All rights reserved.
PURPOSE: The role of urodynamic study in the diagnosis and prognostication of interstitial cystitis/bladder pain syndrome (IC/BPS) is still controversial. This study evaluated the correlation of the baseline voiding dysfunctions and long-term treatment outcome in patients with non-Hunner's ulcer IC (NHIC). MATERIALS AND METHODS: A total of 211 NHIC patients were enrolled. All patients underwent videourodynamic (VUDS) examination at baseline to identify their voiding conditions and received subsequent treatments. The primary endpoint was Global Response Assessment (GRA) at the interview. Secondary endpoints included O'Leary-Sant symptom score (OSS), Visual Analogue Scale (VAS) for pain, and the rate of IC symptom flare-up. RESULTS: The mean age was 56.8±12.8 years, and mean duration of IC was 16.0±9.9 years. At baseline, 83 (39.3%) patients had a voiding dysfunction and 132 (62.7%) had 1 to 3 comorbidities. The duration, comorbidities, treatments, changes in OSS and VAS, maximum bladder capacity (MBC), glomerulations, GRA, and flare-up rate showed no significant difference among different subgroups. When we divided patients by their storage and voiding conditions, patients with non-hypersensitivity bladder (HSB) (n=32) had significantly greater MBC (p=0.002) whereas those with HSB with (n=76) or without (n=103) voiding dysfunction had higher glomerulation (p=0.021). When we analyzed voiding dysfunction subgroups by GRA, patients with a GRA≥2 had a significantly shorter duration of disease (13.9±8.6 years, p=0.021). There were also significant associations between GRA and the changes of OSS (p<0.001) and VAS (p<0.001). CONCLUSIONS: VUDS can disclose voiding dysfunction in 39.3% of NHIC patients. With adequate therapy, the voiding dysfunctions in NHIC patients do not affect long-term treatment outcome. This article is protected by copyright. All rights reserved.