Platinum open access journal
pISSN 2466-0493 eISSN 2466-054X
Indexed in MEDLINE, SCIE, Scopus, DOAJ and more
    Korean J Urol. 2008 Oct;49(10):931-936. Korean.
    Published online Oct 31, 2008.
    https://doi.org/10.4111/kju.2008.49.10.931
    Copyright © 2008 The Korean Urological Association
    Original Article

    Characteristics of Pain and Change in the Severity of Pain after Hydrodistension in Patients with Interstitial Cystitis

    Sung Han Kim, Soo Woong Kim and Seung-June Oh
      • Department of Urology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
    • Email: sjo@snu.ac.kr
    Received June 27, 2008; Accepted August 04, 2008.

    Abstract

    Purpose

    Interstitial cystitis (IC) is characterized by severe irritating voiding symptoms as well as bladder pain without any specific causes in the bladder identified. Hydrodistension is offered as both a therapeutic and diagnostic tool in these patients. The goal of this study was to evaluate the bladder pain associated with IC as well as the severity of pain after hydrodistension in patients with IC.

    Materials and Methods

    Between October 2005 and October 2007, 34 patients with IC who underwent hydrodistension were included in the study. The baseline characteristics of the pain associated with IC and the severity of the pain after the hydrodistension were retrospectively evaluated using a questionnaire. Assessment was performed by one interviewer in a uniform manner using a pre-designed questionnaire. The severity of pain was graded using a 10-point pain scale (between 0 for none and 10 for the most severe pain that can be imaginable).

    Results

    Thirty four patients (9 men and 25 females) with a mean age of 57.8±12.9 (SD) years answered the questionnaire. The median duration of their follow-up was 12.0 (range; 4-36) months. The duration of pain before hydrodistension was a mean of 3.8 years (45.9±31.5 months). The patients reported a mean 8.0 points for bladder pain before hydrodistension and 1.7 points for one week, 2.0 for one month, 2.9 for three months, 4.3 for six months, 4.4 for nine months, and 5.3 for one year after the hydrodistension. The patients responded that they could tolerate their bladder pain up to a median of 2.0 (range; 0-8) points, and they reported that the relief of pain lasted for a median duration of 3.0 (range; 0-10) months after the hydrodistension.

    Conclusions

    Our results showed that hydrodistension was effective for relieving bladder pain after the procedure. However, its effect on pain decreased gradually over time, suggesting that hydrodistension has a therapeutic effect but these effects are time limited in patients with IC.

    Keywords
    Cystitis, interstitial; Hydrodistension; Pain

    Figures

    Fig. 1
    Change in pain score after hydrodistension in patients with interstitial cystitis.

    Tables

    Table 1
    Cystoscopic findings at baseline and after hydrodistension (total 34 patients)

    Table 2
    Baseline characteristics of pain in 34 patients

    References

      1. Fall M, Johansson SL, Aldenborg F. Chronic interstitial cystitis: a heterogenous syndrome. J Urol 1987;137:35–38.
      1. Holm-Bentzen M, Jacobsen F, Nerstrom B, Lose G, Kristensen JK, Pedersen RH, et al. Painful bladder disease: clinical and pathoanatomical differences in 115 patients. J Urol 1987;138:500–502.
      1. Sehn JR. Anatomic effect of distension therapy in unstable bladder: a new approach. Urology 1978;57:82–88.
      1. Ramsden PD, Smith JC, Dunn M, Ardran GM. Distension therapy for the unstable bladder: later results including an assessment of repeat distensions. Br J Urol 1976;48:623–629.
      1. Pengelly AW, Stephenson TP, Milroy EJ, Whiteside CG, Turner-Warwick R. Results of prolonged bladder distention as treatment for detrusor instability. Br J Urol 1978;50:243–245.
      1. Jorgensen L, Mortensen SO, Colstrup H, Andersen JT. Bladder distension in the management of detrusor instability. Scand J Urol Nephrol 1985;19:101–104.
      1. Ottem DP, Teichman JM. What is the value of cystoscopy with hydrodistension for interstitial cystitis? Urology 2005;66:494–499.
      1. Glemain P, Riviere C, Lenormand L, Karam G, Bouchot O, Buzelin JM. Prolonged hydrodistention of the bladder for symptomatic treatment of interstitial cystitis: efficacy at 6 months and 1 year. Eur Urol 2002;41:79–84.
      1. Propert KJ, Schaeffer AJ, Brensinger CM, Kusek JW, Nyberg LM, Landis JR. A prospective study of interstitial cystitis: results of longitudinal followup of the interstitial cystitis data base cohort. J Urol 2000;163:1434–1439.
      1. Sant GR, LaRock DR. Standard intravesical therapies for interstitial cystitis. Urol Clin North Am 1994;21:73–83.
      1. Choi HK, Kim KC, Park JH. A case report of interstitial cystitis. Korean J Urol 1972;13:227–229.
      1. Kim SI, Kwon HY. Clinical results of overdistention in the treatment of interstitial cystitis. Korean J Urol 1996;37:1278–1282.
      1. Kang HW, Hong JY. The effects of simple hydrodistention of bladder in interstitial cystitis. Korean J Urol 1998;39:382–385.
      1. Gillenwater JY, Wein AJ. Summary of the national institute of arthritis, diabetes, digestive and kidney diseases workshop on interstitial cystitis. National Institutes of Health, Bethesda, Maryland, August 28-29, 1987. J Urol 1988;140:203–206.
      1. Hanno PM. Painful bladder syndrome/Interstitial cystitis and related disorders. In: Wein AJ, Kvoussi LR, Novick AC, Partin AW, Peters CA, editors. Campbell-Walsh urology. 9th ed. Philadelphia: Saunders; 2007. pp. 366-367.
      1. Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, et al. The standardisation of terminology in lower urinary tract function: report from the standardisation sub-committee of the International Continence Society. Urology 2003;61:37–49.
      1. Simon LJ, Landis JR, Tomaszewski JE, Nyberg LM. The Interstitial Cystitis Data Base (ICDB) Study. In: Sant GR, editor. Interstitial cystitis. Philadelphia: Lippincott-Raven; 1997. pp. 17-24.
      1. Hanno P, Levin RM, Monson FC, Teuscher C, Zhou ZZ, Ruggieri M, et al. Diagnosis of interstitial cystitis. J Urol 1990;143:278–281.
      1. Parsons CL. Interstitial cystitis: clinical manifestations and diagnostic criteria in over 200 cases. Neurourol Urodyn 1990;9:241–250.
      1. Held PJ, Hanno PM, Wein AJ. Epidemiology of interstitial cystitis. In: Hanno PM, Staskin DR, Krane RJ, Wein AJ, editors. Interstitial cystitis. London: Springer-Verlag; 1990. pp. 29-48.
      1. Rovner E, Propert KJ, Brensinger C, Wein AJ, Foy M, Kikemo A, et al. Treatments used in women with interstitial cystitis: the interstitial cystitis data base (ICDB) study experience. Urology 2000;56:940–945.
      1. Steers WD, Broder SR, Persson K, Bruns DE, Ferguson JE 2nd, Bruns ME, et al. Mechanical stretch increases secretion of parathyroid hormone-related protein by cultured bladder smooth muscle cells. J Urol 1998;160:908–912.
      1. Keay S, Warren JW, Zhang CO, Tu LM, Gordon DA, Whithmore KE. Antiproliferative activity is present in bladder but not renal pelvic urine from interstitial cystitis patients. J Urol 1999;162:1487–1489.
      1. Keay S, Zhang CO, Kagen DI, Hise MK, Jacobs SC, Hebel JR, et al. Concentrations of specific epithelial growth factors in the urine of interstitial cystitis patients and controls. J Urol 1997;158:1983–1988.
      1. Chai TC, Zhang CO, Shoenfelt JL, Johnson HW Jr, Warren JW, Keay S. Bladder stretch alters urinary heparin-binding epidermal growth factor and antiproliferative factor in patients with interstitial cystitis. J Urol 2000;163:1440–1444.
      1. Rofeim O, Shupp-Byrne D, Mulholland GS, Moldwin RM. The effects of hydrodistention on bladder surface mucin. Urology 2001;57(6 Suppl 1):130.
      1. Rosamilia A, Cann L, Dwyer P, Scurry J, Rogers P. Bladder microvasculature in women with interstitial cystitis. J Urol 1999;161:1865–1870.
      1. Rosamilia A, Cann L, Scurry J, Rogers P, Dwyer P. Bladder microvasculature and the effects of hydrodistention in interstitial cystitis. Urology 2001;57(6 Suppl 1):132.
      1. Mishra N. To study the effect of hydrodistention on bladder mucosa and submucosa. Urology 2001;57(6 Suppl 1):126.
      1. Cole EE, Scarpero HM, Dmochowski RR. Are patient symptoms predictive of the diagnostic and/or therapeutic value of hydrodistention? Neurourol Urodyn 2005;24:638–642.
    Cited by
    Crossref 2
    Google Scholar 
    Scopus 2
    MeSH Terms
    Female
    Humans
    Male
    Metrics
    Share
    Figures
    slide

    1 / 1

    Tables
    slide
    slide

    1 / 2

    PERMALINK