Interstitial cystitis/bladder pain syndrome (IC/BPS) presents a significant clinical challenge due to symptom heterogeneity and the myriad associated comorbid medical conditions. We recently reported that diminished bladder capacity (BC) may represent a specific IC/BPS sub-phenotype. The objective of this study is to investigate the relationship between anesthetic bladder capacity and clinical findings (urologic and non-urologic) in a cohort of IC/BPS patients who had undergone therapeutic urinary bladder hydrodistention.
This is a retrospective chart review of prospectively collected data in women diagnosed with IC/BPS between 2011 and 2015 who underwent bladder hydrodistention. Assessments for each patient included a detailed history and physical examination, O'Leary/Sant Voiding & Pain Indices (ICPI & ICSI), and the Pelvic Pain Urgency and Frequency Questionnaire (PUF). Bladder capacity (BC) was determined during bladder hydrodistention under general anesthesia.
Mean age and bladder capacity were 45.8 years and 857 ml, respectively for 110 enrolled patients. We found a significant inverse correlation between BC and scores on three gold standard IC/BPS metrics: ICPI (p=0.0014), ICSI (p=0.0022) and PUF (p=0.0009), as well as with frequency of urination (p=0.0025). Women with higher BC were significantly more likely to report depression (0.0059), and IBS (p=0.022).
Low bladder capacity under anesthesia was significantly associated with high symptom scores on three validated IC/BPS questionnaires as well as with urinary frequency but was not associated with depression or other common systemic pain problems. These results suggest that low bladder capacity is a marker for a bladder-centric manifestation of IC/BPS.
The Journal of urology. 2017 Feb 12 [Epub ahead of print]
Stephen J Walker, Joao Zambon, Karl-Erik Andersson, Carl Langefeld, Catherine A Matthews, Gopal Badlani, Heather Bowman, Robert J Evans
Wake Forest Institute for Regenerative Medicine, Wake Forest University Health Sciences, Department of Urology, Wake Forest University Health Sciences. Electronic address: ., Department of Urology, Wake Forest University Health Sciences., Wake Forest Institute for Regenerative Medicine, Wake Forest University Health Sciences., Public Health Sciences, Wake Forest University Health Sciences.