Relevance of the endoscopic evaluation in the diagnosis of Bladder Pain Syndrome/Interstitial Cystitis.

In 2008 the European Society for the Study of Interstitial Cystitis (ESSIC) established the diagnostic criteria and classification of Bladder Pain Syndrome/Interstitial Cystitis (BPS/IC), based on clinical features and cystoscopy results. The present study aims to assess the relevance of the endoscopic evaluation in clinically suspected cases of BPS/IC, using ESSIC criteria.

. We included all patients who underwent endoscopic evaluation between 01/01/2015 and 31/10/2019 for clinical suspicion of BPS/IC. Collected data included demographic and baseline clinical features, endoscopic appearance (prior and after hydrodistension) and bladder wall biopsy results, both defined according to ESSIC criteria. Data were cross tabulated to define ESSIC phenotypes, while subgroups and multivariate analyses were carried out to assess the influence of clinical variables on ESSIC phenotypes.

. Fifty-two subjects were included, mainly women (92%). Median age at evaluation was 45 (32.9-58.2) years. At hydrodistension, 21 patients (42%) had positive and 29 (58%) had negative findings. Grade 2-3 glomerulations were found in 18 patients, while Hunner lesions were reported only in 1 patient. Positive results at biopsy were found in 24 pts (51.1%), while negative in 23 (48.9%). Overall, the positive and negative concordance between hydrodistension and biopsy results was 78%. No significant differences in ESSIC subtypes were found after stratification based on clinical features and at multivariate analysis. Retrospective design is the main limitation.

cystoscopy with hydrodistension and biopsy do have a role in the diagnostic pathway of BPS/IC. However, results should be considered in the clinical context of the individual patient.

Urology. 2020 Jun 30 [Epub ahead of print]

Alessandro Morlacco, Mariangela Mancini, Matteo Soligo, Fabio Zattoni, Arturo Calpista, Giuseppe Vizzielli, Rosario Patti, Francesco Gerardo Mandato, Andrea Celeste Barneschi, Filiberto Zattoni, Massimo Iafrate, Fabrizio Dal Moro, European Reference Network for rare UROGENital disease and complex conditions (ERN eUROGEN)

Urology Clinic, Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy. Electronic address: ., Urology Clinic, Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy., Urology Clinic, University of Udine and University Hospital "Santa Maria della Misericordia" - Udine - Italy., Division of Gynecologic Oncology, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS - Roma.