Department of Nursing, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.
Department of Medical Research, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.
Int J Clin Pract. 2021 Sep;75(9):e14372. doi: 10.1111/ijcp.14372. Epub 2021 May 29.
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).
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.
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 co-morbidities. The duration, co-morbidities, 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 = .002) whereas those with HSB with (n = 76) or without (n = 103) voiding dysfunction had higher glomerulation (P = .021). When we analysed voiding dysfunction subgroups by GRA, patients with a GRA of ≥2 had a significantly shorter duration of disease (13.9 ± 8.6 years, P = .021). There were also significant associations between GRA and the changes of OSS (P < .001) and VAS (P < .001).
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.
尿动力学检查在间质性膀胱炎/膀胱疼痛综合征（IC/BPS）的诊断和预后中的作用仍存在争议。本研究评估了非 Hunner 溃疡型 IC（NHIC）患者基线排尿功能障碍与长期治疗结果的相关性。
共纳入 211 例 NHIC 患者。所有患者在基线时均行视频尿动力学（VUDS）检查以确定其排尿情况，并接受后续治疗。主要终点是访谈时的总体反应评估（GRA）。次要终点包括 O'Leary-Sant 症状评分（OSS）、疼痛视觉模拟评分（VAS）和 IC 症状发作率。
患者平均年龄为 56.8±12.8 岁，IC 平均病程为 16.0±9.9 年。基线时，83 例（39.3%）患者存在排尿功能障碍，132 例（62.7%）存在 1 至 3 种合并症。不同亚组之间的病程、合并症、治疗方法、OSS 和 VAS 变化、最大膀胱容量（MBC）、肾小球、GRA 和发作率无显著差异。当我们根据患者的储存和排尿情况进行分组时，非高敏感膀胱（HSB）患者（n=32）的 MBC 显著更大（P=0.002），而 HSB 伴有（n=76）或不伴有（n=103）排尿功能障碍的患者肾小球发生率更高（P=0.021）。当我们根据 GRA 分析排尿功能障碍亚组时，GRA≥2 的患者疾病持续时间明显较短（13.9±8.6 年，P=0.021）。GRA 与 OSS（P<0.001）和 VAS（P<0.001）变化之间也存在显著相关性。
VUDS 可发现 39.3%的 NHIC 患者存在排尿功能障碍。经过充分治疗，NHIC 患者的排尿功能障碍不会影响长期治疗效果。
