Using the Intersitital Cystitis New Diagnostic Criteria in Daily Practice: About 156 Patients

 

Objectives

To describe the characteristic of patients with interstitial cystitis and to determine what proportion of those patients met the ESSIC 2005 (European Society for the Study of IC/PBS (interstitial cystitis/painful bladder syndrome)) definition and how those who met the definition differed from those who did not.

Material and Method

A total of 156 patients diagnosed as having an interstitial cystitis were followed in our institution between 1997 and 2007. The diagnosis was suggested by the clinical history and confirmed on the basis of clinical symptoms, voiding diary findings, pearson’s test, O’leary-Sant questionnaire, cystoscopy and hydrodistention and by the exclusion of other significant pathologies. The patients were evaluated in a prospective manner. We studied the demographics of our patients, described the common clinical presentation. We applied the ESSIC 2005 definition of CI/PBS on this population and found the proportion that meets this definition.

Results

The sex ration F/M was 8:1. The patients were symptomatic for a median of 7,3 years before IC is diagnosed. The most common symptom was pain which was found in 100% of patients, frequency was found in 82% and nocturia in 62%. The common sites where pain was localized were suprapubic in 80%, perineal in 70% and genital in 40%. Aburning sensation was found in 55% of patients. Hunner’s lesion was found in 3 patients. The cystoscopy and hydrodistension revealed glomérulations in 88,4% of patients. when applying The ESSIC 2005 definition,80% (125) of patients met the defintion of PBS (Painful bladder syndrome is the complaint of suprapubic pain related to bladder filling, accompanied by other symptoms, such as increased daytime and night-time frequency, in the absence of proven urinary infection or other obvious pathology), of whom 92%(115) met the definition of IC (Interstitial cystitis is PBS with typical cystoscopic and/or histological features in the absence of infection or other pathology). The ESSIC 2005 identified only 74% (115) of the 156 patients diagnosed as having IC/PBS.

Conclusions

The symptoms in interstitial cystitis are variable. The ESSIC 2005 definition may not be sufficiently sensitive excluding over 26% of patients diagnosed as having IC. Minor modifications (pain type and location) of the definition appeared to increase its sensitivity.

Keywords

interstitial cystitis, painful bladder syndrome, glomerulations