Female Urology, Urodynamics, Incontinence, and Pelvic Floor Reconstructive SurgeryTransurethral Resection Alone Vs Resection Combined With Therapeutic Hydrodistention as Treatment for Ulcerative Interstitial Cystitis: Initial Experience With Propensity Score Matching Studies
Section snippets
Methods
With a power set at 0.95 and type I error rate at 0.05 (2-sided), the required sample size was 19 subjects in each group to detect a difference of 35.25 ± 28.75 cc between TUR and TUR with therapeutic hydrodistention for the maximum tolerable bladder capacity. Considering a dropout rate of 10%, in this study, we planned to collect more than 22 subjects in each group.
This was actually performed using simple randomization with 1:1 fixed randomization. All of the procedures were performed by a
Statistical analysis
The propensity score matching was performed to match patients for whom the likelihood of having TUR was similar. In the first step, the logistic regression was used to generate a propensity score for having TUR for each patient using age, symptom duration, ulcer, VAS score, maximum FBC, and the frequency of urination at baseline. Each case of TUR was then matched with a case having TUR with therapeutic hydrodistention based on the nearest propensity score. Then, the patients having TUR were
Results
Our candidate study subjects were 57 patients who were available for follow-up over 12 months, excluding 4 patients lost to follow-up, for a total of 61 patients who underwent TUR to treat ulcerative IC in our hospital during the 3-year interval from January 2009 to January 2012. Of the 57 patients, 27 underwent TUR alone (47.4%) and 30 underwent TUR with therapeutic hydrodistention (52.6%). Eleven patients who developed recurrences within 12 months of their procedures were excluded from the
Comment
The cause of IC remains unknown; IC is a chronic inflammatory bladder disease that poses a urologic dilemma. There is no standard treatment strategy for IC yet. However, 2 treatment strategies including TUR and hydrodistention have been regarded as reliable options. These 2 treatments could be valuable options, especially considering that ulcerative-typed IC has shown clinical improvement by TUR and also considering the long treatment history of hydrodistention. However, clinical trial for this
Conclusion
The combination of TUR with therapeutic hydrodistention increased bladder capacity and improved voiding symptoms more than did TUR alone in patients with ulcerative IC. Therefore, the combination treatment can be used to relieve pain and voiding symptoms and increase FBC in patients with ulcerative IC. However, further studies should feature longer term follow-up.
Acknowledgment
This study was supported by the Soonchunhyang University Research Fund (Grant No. 20160006).
References (23)
- et al.
Chronic interstitial cystitis: a heterogeneous syndrome
J Urol
(1987) Interstitial cystitis: treatment by transurethral resection
J Urol
(1971)Anatomic effect of distention therapy in unstable bladder: new approach
Urology
(1978)- et al.
Toward a precise definition of interstitial cystitis: further evidence of differences in classic and nonulcer disease
J Urol
(2002) - et al.
Discovery of morphological subgroups that correlate with severity of symptoms in interstitial cystitis: a proposed biopsy classification system
J Urol
(2007) - et al.
Treatment of ulcer and nonulcer interstitial cystitis with sodium pentosanpolysulfate: a multicenter trial
J Urol
(1987) - et al.
Use of the neodymium: YAG laser for interstitial cystitis: a prospective study
J Urol
(2001) - et al.
Electrosurgical management of Hunner ulcers in a referral center's interstitial cystitis population
Urology
(2015) - et al.
A prospective study of interstitial cystitis: results of longitudinal followup of the interstitial cystitis data base cohort. The Interstitial Cystitis Data Base Study Group
J Urol
(2000) - et al.
Standard intravesical therapies for interstitial cystitis
Urol Clin North Am
(1994)
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Financial Disclosure: The authors declare that they have no relevant financial interests.