Department Of Urology, SMS Medical College, Jaipur, Rajasthan, India.
Urologia. 2024 Feb;91(1):189-193. doi: 10.1177/03915603231203431. Epub 2023 Sep 29.
Interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic painful bladder condition characterized by pelvic pain and urinary symptoms without another identifiable cause. Cystoscopy as primary initial investigation for IC/BPS has not been accepted yet and needs more studies to definitely conclude.
We aimed to assess cystoscopy findings in patients of interstitial cystitis/bladder pain syndrome and to prove role of cystoscopy as primary initial investigation for interstitial cystitis/bladder pain syndrome.
Our prospective observational study included 35 female patients aged 18-69 years presenting to the Urology OPD at SMS Hospital with suprapubic or pelvic pain for 6 months, bladder pain that worsens with bladder filling and reduced with voiding, dysuria, urinary frequency and urgency, nocturia, dyspareunia. Those with history of bladder capacity more than 350 ml, duration of symptoms less than 6 months, day time frequency less than eight times per day, diagnosis of bacterial cystitis or prostatitis, bladder or ureteral calculi, active genital herpes, any existing urological malignancy, radiation cystitis were excluded from the study. They were then subject to cystoscopy and the findings of the cystoscopy were analyzed.
Out of the 35 patients, 11 (31.43%) had a normal cystoscopy. Of the 24 patients (68.57%) who had a positive cystoscopy, cystoscopy in seven patients (20.0%) revealed an ulcer. All these seven patients underwent fulguration. In the remaining 17 patients the abnormal findings were petechiae, large submucosal bleed. The sensitivity of cystoscopy in detecting the ulcerative type of Interstitial cystitis was found to be 20.0%.
Our study found that Cystoscopy, if employed in initial investigation can help early detection of ulcerative variety of IC/BPS and can act as therapeutic modality by using fulguration plus hydrodistension. Larger comparative studies are needed for diagnostic/Therapeutic value of cystoscopy.
间质性膀胱炎/膀胱疼痛综合征（IC/BPS）是一种以盆腔疼痛和尿路症状为特征的慢性疼痛性膀胱疾病，无其他可识别的病因。膀胱镜检查作为 IC/BPS 的主要初始检查尚未被接受，需要更多的研究来明确结论。
我们旨在评估间质性膀胱炎/膀胱疼痛综合征患者的膀胱镜检查结果，并证明膀胱镜检查作为间质性膀胱炎/膀胱疼痛综合征的主要初始检查的作用。
我们的前瞻性观察性研究包括 35 名年龄在 18-69 岁之间的女性患者，她们因耻骨上或骨盆疼痛到 SMS 医院泌尿科就诊，症状持续 6 个月，膀胱疼痛随膀胱充盈而加重，随排尿而减轻，伴有尿痛、尿频、尿急、夜尿、性交困难。那些膀胱容量大于 350ml、症状持续时间小于 6 个月、白天频率小于 8 次/天、诊断为细菌性膀胱炎或前列腺炎、膀胱或输尿管结石、活动性生殖器疱疹、任何现有的泌尿系统恶性肿瘤、放射性膀胱炎的患者均被排除在研究之外。然后对这些患者进行膀胱镜检查，并对膀胱镜检查结果进行分析。
在 35 名患者中，11 名（31.43%）的膀胱镜检查正常。在 24 名（68.57%）有阳性膀胱镜检查结果的患者中，7 名（20.0%）患者的膀胱镜检查发现溃疡。所有这 7 名患者都接受了电灼治疗。在其余 17 名患者中，异常发现为瘀斑、大的黏膜下出血。膀胱镜检查对溃疡性间质性膀胱炎的检出率为 20.0%。
我们的研究发现，膀胱镜检查如果用于初始检查，可以帮助早期发现溃疡性 IC/BPS，并通过电灼联合水扩张作为治疗方式。需要更大的比较研究来确定膀胱镜检查的诊断/治疗价值。
