Olson Louise E, Dyer James E, Haq Ahsanul, Ockrim Jeremy, Greenwell Tamsin J
Health Education North West, Manchester, UK.
Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK.
Int Urogynecol J. 2018 Feb;29(2):251-257. doi: 10.1007/s00192-017-3355-y. Epub 2017 May 26.
There is significant variability in technique for cystodistension and an international discrepancy in the role in its treatment of bladder pain syndrome (BPS). The authors evaluate the evidence base for the use of cystodistension for BPS with particular reference to patient-related outcomes.
In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis statement, a prospective search and evaluation protocol was prepared and registered with the PROSPERO database (ID CRD42017053710). A review of the literature was performed using the search terms cystodistension and hydrodistension of the bladder using the PubMed database on 6 October 2016.
A total of 59 papers were reviewed, but only 17 studies contained original data available for analysis from 1975 to 2016. Ten studies evaluated the outcome of cystodistension in a single arm design or used cystodistension as the control for evaluating adjunctive treatments. Seven studies evaluated cystodistension in combination with other agents or therapies. The best symptomatic responses reported a subjective improvement in 56% of men with moderate to severe prostatitis and 57% in patients with "inflammatory cystitis" respectively. There were no studies that employed a validated outcome measure, neither a questionnaire nor an analogue scale, to assess the effect of cystodistension alone.
Cystodistension is increasingly popular, despite a weak evidence base by current standards. The quality of available evidence falls below the level that would be expected of a new intervention. This review highlights the need for cystodistension to be further investigated with randomised control trials.
膀胱扩张术的技术存在显著差异，且在膀胱疼痛综合征（BPS）治疗中的作用存在国际差异。作者评估了膀胱扩张术用于BPS的证据基础，特别关注与患者相关的结局。
根据系统评价和Meta分析的首选报告项目声明，制定了前瞻性检索和评估方案，并在PROSPERO数据库（ID CRD42017053710）中进行了注册。2016年10月6日，使用PubMed数据库，以膀胱扩张术和膀胱水扩张术为检索词进行了文献综述。
共检索到59篇论文，但只有17项研究包含1975年至2016年可用于分析的原始数据。10项研究采用单臂设计评估膀胱扩张术的结局，或使用膀胱扩张术作为评估辅助治疗的对照。7项研究评估了膀胱扩张术与其他药物或疗法联合使用的情况。报告的最佳症状缓解情况分别为，中度至重度前列腺炎男性患者主观改善率为56%，“炎症性膀胱炎”患者为57%。没有研究采用经过验证的结局指标（既没有问卷也没有视觉模拟量表）来单独评估膀胱扩张术的效果。
尽管按照当前标准证据基础薄弱，但膀胱扩张术越来越受欢迎。现有证据的质量低于对一种新干预措施预期的水平。本综述强调需要通过随机对照试验对膀胱扩张术进行进一步研究。
