To assess the impact of multiple (two or more) bladder hydrodistentions (HODs) on anesthetic BC in a large cohort of IC/BPS patients. Urinary bladder hydrodistention (HOD) under anesthesia is a third line therapeutic approach used to treat patients with interstitial cystitis/bladder pain syndrome (IC/BPS). There is some concern that performing multiple therapeutic HODs may be contraindicated due to the potential for contributing to a diminished bladder capacity (BC) over time.
This is a retrospective chart review of IC/BPS patients from a single institution who had undergone two or more bladder HOD procedures. Patient demographic and clinical data, including BC under anesthesia, was retrieved from patient charts for analysis. Least squares regression slopes of BC under anesthesia were calculated and used to estimate within-patient BC changes over time.
Data from 168 patients (637 HOD procedures) were included for analysis. The average change in BC, 0.52 ± 8.33 mL/month, was not significantly different from zero (p = 0.42). Linear regression analyses did not identify any significant correlation between BC over time with: (1) age, (2) number of HODs, (3) frequency of HODs, (4) average BC, (5) length of time with an IC/BPS diagnosis, or (6) length of time during which the patient's BC was evaluated. Moreover, there was no difference in BC change over time in patients with and without Hunner's lesion (p = 0.86).
Multiple therapeutic HODs, over several years, do not result in a significant change in BC in IC/BPS patients.
Urology. 2019 Jul 09 [Epub ahead of print]
Stephen J Walker, Andre Plair, Kshipra Hemal, Carl D Langefeld, Catherine Matthews, Gopal Badlani, Joao Zambon, Heather Heath, Robert J Evans
Department of Urology/Female Pelvic Health, Wake Forest Baptist Medical Center, Winston-Salem, NC; Wake Forest Institute for Regenerative Medicine, Wake Forest Baptist Medical Center, Winston-Salem, NC. Electronic address: ., Department of Urology/Female Pelvic Health, Wake Forest Baptist Medical Center, Winston-Salem, NC., Wake Forest University School of Medicine, Winston-Salem, NC., Department of Biostatistics and Data Science, Wake Forest Baptist Medical Center, Winston-Salem, NC., Wake Forest Institute for Regenerative Medicine, Wake Forest Baptist Medical Center, Winston-Salem, NC.