Treatment of interstitial cystitis with hydrodistention and bladder training

Abstract

This study aimed to evaluate the efficacy of hydrodistention (HD) and bladder training for interstitial cystitis (IC). From 1997 to 2006, 361 consecutive IC patients were treated by HD, followed by bladder training. Each patient was followed up using a diary for 8 weeks after HD weekly and monthly thereafter. The efficacy of the treatment was evaluated using the average of the voided volumes and the voiding frequency. The mean +/- standard deviation of the pre-HD daytime voided volumes and voiding frequency were 110.0 +/- 47.0 ml and 14.7 +/- 11.0, respectively. Furthermore, the nocturnal values were 173.1 +/- 91.8 ml and 2.8 +/- 1.7, respectively. After 72 weeks post-HD, the 185 patients who completed the follow-up had volumes/frequency of daytime, 306.5 +/- 80 ml and 6.9 +/- 2.1, respectively, and nocturnal, 325.8 +/- 122.4 ml and 1.3 +/- 0.6, respectively. The implementation of HD and bladder training is crucially important for long-term remission among IC patients.

Interventional Therapies for Controlling Pelvic Pain: What is the Evidence?

“…Improvement in patient symptoms following HD has been documented for many years, but the duration of treatment effect appears to be limited [70]. In a recent study combining HD with bladder training, 51.2% of patients experienced remission of symptoms, suggesting that bladder training may significantly improve bladder capacity and subsequently, bladder functioning [71].…”

Measuring the success of combined intravesical dimethyl sulfoxide and triamcinolone for treatment of bladder pain syndrome/interstitial cystitis

“…The therapeutic efficacy of hydrodistension has been investigated with varying rates and durations of effect observed [24][25][26][27][28]. The results of those studies, however, were drawn from patients undergoing cystoscopic hydrodistention to maximum anesthetic capacity under general or epidural anesthesia.…”

Diagnosis and Treatment of Interstitial Cystitis in Adolescents

“…Overall, 40.2% and 36.3% of the patients indicated that their IC symptoms deteriorated right before and after menstruation, respectively. 34 Report of pain persisting after intercourse occurs in 46%-53% of patients. 8 As mentioned previously, symptom flares are often associated with sexual relations, menstrual cycle, certain types of foods, and stress.…”

“…Moreover, at 2 months after HD, more than 80% of the IC patients who had suffered flares during menses and coitus reported a significant reduction in these symptoms. 34 In younger women, a retrospective review of 18 patients aged 15-25 showed 11 patients had HD alone, of whom 6 improved, 2 reported no change, 1 reported exacerbation, and 2 had insufficient data charted. In 10 women who had repeat HD, the mean time to repeat cystoscopy was 17 months.…”

“…Use of a questionnaire can help screen for the disease and monitor disease progress, but it should not be relied on solely for diagnosis, as no questionnaire has been validated as a diagnostic tool. 34 Future investigations toward reliable diagnostic tools are needed. Based upon the literature currently available, we feel that IC is a clinical diagnosis in the adolescent patient (see Table).…”