Erol Bulent, Kazan Huseyin Ozgur, Keser Ferhat, Efiloglu Ozgur, Danacıoğlu Yavuz Onur, Onur Rahmi
Department of Urology, İstanbul Medeniyet University School of Medicine, İstanbul, Turkey.
Department of Urology, BakırkÖy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey.
Turk J Urol. 2021 Jul;47(4):325-337. doi: 10.5152/tju.2021.21093.
To define the relationship between cystoscopic findings, including novel findings such as the hypervascularization, of bladder pain syndrome/interstitial cystitis (BPS/IC) and the response to intravesical therapy.
We retrospectively evaluated cystoscopy findings in patients who had a preliminary diagnosis of BPS/IC. All patients received early intravesical combined therapy (ICT), ie, within 2 hours after hydrodistention. Additionally, ICT was continued according to our protocol. Cystoscopic findings were classified as glomerulations, hypervascularization, and Hunner's lesion (HL). The therapy responses were evaluated at 1st, 3rd, 6th, and 12thmonths using the visual analog scale (VAS), O'Leary/Sant interstitial cystitis symptom index (ICSI), and interstitial cystitis problem index (ICPI) scores.
Out of 61 patients, HL was diagnosed during cystoscopy in six (9.8%) patients, glomerulations in 35 (57.4%) patients, and hypervascularization in 15 (24.6%) patients. No pathological findings were defined in five (8.2%) patients. In the glomerulation and hypervascularization group, the median VAS, ICSI, and ICPI scores were lower than those in the preoperative period in the follow-up. In patients with HL, the median VAS scores were lower in the entire follow-up compared to the preoperative period, with an increase at 1st year compared to 6th month, and ICSI scores were lower than preoperative period in the entire follow-up, with an increase at 3rd month and 1st year. ICPI scores were also lower during the follow-up, with an increase observed in the 1st year.
The presence of hypervascularization should be defined since it might show different characteristics that may affect the ICT response. Patients with glomerulations might be good candidates for early combined intravesical therapy.
明确膀胱疼痛综合征/间质性膀胱炎（BPS/IC）的膀胱镜检查结果，包括如血管增生等新发现，与膀胱内治疗反应之间的关系。
我们回顾性评估了初步诊断为BPS/IC的患者的膀胱镜检查结果。所有患者均接受早期膀胱内联合治疗（ICT），即在膀胱扩张术后2小时内进行。此外，ICT按照我们的方案持续进行。膀胱镜检查结果分为点状出血、血管增生和Hunner病变（HL）。使用视觉模拟量表（VAS）、O'Leary/Sant间质性膀胱炎症状指数（ICSI）和间质性膀胱炎问题指数（ICPI）评分在第1、3、6和12个月评估治疗反应。
61例患者中，膀胱镜检查诊断为HL的有6例（9.8%），点状出血的有35例（57.4%），血管增生的有15例（24.6%）。5例（8.2%）患者未发现病理结果。在点状出血和血管增生组中，随访期间VAS、ICSI和ICPI评分的中位数低于术前。HL患者在整个随访期间VAS评分中位数低于术前，与第6个月相比，第1年有所增加；ICSI评分在整个随访期间低于术前，在第3个月和第1年有所增加。随访期间ICPI评分也较低，第1年有所增加。
应明确血管增生的存在，因为它可能表现出不同的特征，可能影响ICT反应。点状出血的患者可能是早期膀胱内联合治疗的良好候选者。
