To investigate real-world practices in transurethral surgeries for bladder pain syndrome (BPS) and interstitial cystitis (IC) in Japan, with a focus on procedural characteristics of hydrodistension (HD) and transurethral elimination of Hunner lesions (TUEH).
An internet-based questionnaire was sent to all members of the Society of Interstitial Cystitis of Japan in November 2024. The survey inquired about institutional characteristics, the number of procedures performed in the previous 12 months, and detailed surgical techniques. BPS was defined by the absence of Hunner lesions, and IC by their presence. Responses were analyzed to describe procedural patterns and compare practices between HD and TUEH.
Of 205 eligible members, 86 responded (response rate: 42%). Among them, 52 had performed HD for BPS and 67 had performed TUEH for IC within the study period. Most surgeons distended the bladder to a preset pressure of ≤ 80 cm H2O for 3-10 min and repeated the procedure at least twice during HD. At TUEH, coagulation was preferred over resection to eliminate Hunner lesions. HD was frequently co-performed, though the sequence of elimination and HD varied. Compared to HD, TUEH more often relied on abdominal palpation rather than fixed pressure, used shorter distension time, and involved longer catheter placement.
This nationwide survey highlights contemporary surgical practices for BPS and IC in Japan. These findings may help clinicians evaluate and refine their own approaches to transurethral interventions for these complex conditions.
Lower urinary tract symptoms. 2026 Mar [Epub]
Niimi Aya, Akiyama Yoshiyuki, Furuta Akira, Matsuo Tomohiro, Kitta Takeya, Otsuka Atsushi, Mitsui Takahiko, Masumori Naoya, Matsukawa Yoshihisa, Torimoto Kazumasa, Kinjo Manami, Chiba Hiroki, Nomiya Akira, Maeda Daichi, Homma Yukio
Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan., Department of Urology, Shinshu University School of Medicine, Matsumoto, Japan., Department of Urology, Jikei University School of Medicine, Tokyo, Japan., Department of Urology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan., Department of Renal and Urologic Surgery, Asahikawa Medical University, Asahikawa, Japan., Department of Urology, Iwata City Hospital, Shizuoka, Japan., Department of Urology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Yamanashi, Japan., Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan., Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan., Department of Urology, Nara Prefecture General Medical Center, Nara, Japan., Department of Urology, Faculty of Medicine, Kyorin University, Mitaka, Japan., Department of Urology, Graduate School of Medicine, Hokkaido University, Sapporo, Japan., Department of Urology, Kanto Rosai Hospital, Kawasaki, Japan., Department of Pathology, Division of Molecular and Genomic Pathology, Graduate School of Medicine, Kobe University, Kobe, Japan.