Relationship Between the Frequency of Electrocautery of Hunner Lesions and Changes in Bladder Capacity in Patients with Hunner Type Interstitial Cystitis - Beyond the Abstract

Electrocautery of Hunner lesions is a promising surgical intervention for Hunner type interstitial cystitis (HIC) patients. However, the effect is not long-lasting, and repeated sessions are frequently required. There is therefore a growing concern that repeated sessions of electrocautery of Hunner lesions may affect bladder capacity, ultimately resulting in bladder contraction. Previous studies reported that multiple sessions of electrocautery of Hunner lesions did NOT negatively affect bladder capacity over time.

In this study, we aimed to assess the association between the frequency of electrocautery and the maximum bladder capacity at hydrodistension using the largest patient cohort (n = 118 HIC patients) ever and mixed-effect statistical models. Ordinary least square models or repeated-measures ANOVA, which are frequently used for the analysis of longitudinal data, do not have the flexibility to determine the effects of multiple factors simultaneously and thus occasionally yield misleading results. Mixed-effect models have this flexibility and can address specific questions of clinical importance.

In this article, we reported that the mixed-effect linear regression analyses performed here identified a statistically significant relationship between the frequency of electrocautery of Hunner lesions and maximum bladder capacity (MBC) changes in HIC patients. In addition, we found that low MBC (≤ 400 mL) at the first session is a poor prognostic marker for MBC loss over further sessions.

Written by: Yoshiyuki Akiyama, MD, PhD, Senior Assistant Professor of Urology, Department of Urology, The University of Tokyo, Tokyo, Japan

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