Department of Nursing, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.
Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, 707, Section 3, Chung-Yang Road, Hualien, Taiwan.
Sci Rep. 2021 Jan 11;11(1):455. doi: 10.1038/s41598-020-80252-x.
To evaluate the correlations of clinical symptoms, urodynamic parameters, and long-term treatment outcomes with different findings of cystoscopic hydrodistention (HD) in patients with interstitial cystitis/bladder pain syndrome (IC/BPS). This retrospective analysis of 486 patients with IC/BPS investigated baseline clinical symptoms, disease duration, medical comorbidities, urodynamic findings, cystoscopic characteristics [including maximal bladder capacity (MBC) and the presence of glomerulations and Hunner's lesions], and outcomes according to the five IC/BPS HD subtypes based on the glomerulation grade, MBC, and the presence of Hunner's lesions. Receiver operation characteristic analysis identified an optimal cutoff value of MBC ≥ 760 ml as a predictor of satisfactory outcomes. Glomerulation grade and MBC were significantly correlated (r = - 0.403, P < 0.001), and both were significantly associated with IC Symptom Index scores. The rate of satisfactory outcomes was better for the patients with low glomerulation grade and MBC ≥ 760 ml (64.2%), and significantly worse for those with Hunner's lesions (36.8%); no significant differences were noted among the other groups. The results suggested that IC/BPS patients can be classified into the following three distinct subgroups: (1) those with low glomerulation grade and MBC ≥ 760 ml; (2) those with low glomerulation grade and MBC < 760 ml, or with high glomerulation grade regardless of MBC; and (3) those with Hunner's lesions. The results showed that three IC/BPS subgroups had distinct bladder characteristics and treatment outcomes. The patients with high MBC and low glomerulation grade after HD had more medical comorbidities but a significantly higher rate of satisfactory treatment outcome.IRB: 105-25-B.
评估临床症状、尿动力学参数与不同膀胱镜下扩张（HD）表现对间质性膀胱炎/膀胱疼痛综合征（IC/BPS）患者的相关性。对 486 例 IC/BPS 患者进行回顾性分析，调查患者的基线临床症状、疾病持续时间、合并症、尿动力学检查结果、膀胱镜下表现[包括最大膀胱容量（MBC）和有无肾小球表现和 Hunner 病变]，并根据肾小球病变程度、MBC 和有无 Hunner 病变将患者分为 5 种 IC/BPS HD 亚型，根据这些亚型评估患者的结局。受试者工作特征（ROC）分析确定 MBC≥760ml 为结局满意的最佳截断值。肾小球病变程度和 MBC 显著相关（r=−0.403，P<0.001），且与 IC 症状指数评分均显著相关。低肾小球病变程度且 MBC≥760ml 患者的结局满意度更好（64.2%），而 Hunner 病变患者的结局满意度更差（36.8%）；其他组间无显著差异。结果提示，IC/BPS 患者可分为以下 3 个亚组：（1）低肾小球病变程度且 MBC≥760ml；（2）低肾小球病变程度且 MBC<760ml，或高肾小球病变程度而不论 MBC 情况；（3）伴有 Hunner 病变。结果表明，3 个 IC/BPS 亚组的膀胱特征和治疗结局不同。HD 后 MBC 高且肾小球病变程度低的患者合并症更多，但治疗结局满意度显著更高。IRB：105-25-B。
