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Adjuvant hydrodistension under epidural anesthesia for interstitial cystitis
Tetsuo Yamada1, Tetsuo Murayama, Masahiko Andoh
1Department of Urology, National Sagamihara Hospital, Kanagawa, Japan. t-yamada@sagamihara-hosp.gr.jp
Summary
Adjuvant hydrodistension is an effective treatment for interstitial cystitis, offering relief for approximately 70% of patients for over three months. Prognostic factors, such as bladder capacity and diagnostic criteria fulfillment, influence treatment outcomes.
Area of Science:
- Urology
- Gastroenterology
Background:
- Hydrodistension is a primary treatment for interstitial cystitis, aiding diagnosis and therapy.
- Variability in hydrodistension methods and efficacy necessitates further investigation.
- Adjuvant hydrodistension was explored to assess its efficacy and prognostic factors.
Purpose of the Study:
- To evaluate the efficacy of adjuvant hydrodistension for interstitial cystitis.
- To identify factors influencing the prognosis of patients undergoing hydrodistension.
Main Methods:
- Fifty-two patients meeting NIDDK criteria for interstitial cystitis were included.
- Hydrodistension was performed under epidural anesthesia, involving bladder distension and biopsy.
- A second hydrodistension session was conducted the following day until hematuria resolved.
Main Results:
- Overall, 70% of patients showed a positive response to adjuvant hydrodistension.
- Good response was observed in 5 patients, moderate in 30, and poor in 17.
- Factors like type I allergy, collagen disease, bladder capacity (<100 mL with VUR), and incomplete NIDDK criteria were associated with response.
Conclusions:
- Adjuvant hydrodistension under epidural anesthesia is effective for approximately 70% of interstitial cystitis patients for over 3 months.
- The procedure can be safely performed in a ward setting with minimal complications.
- Patient characteristics, including fulfillment of diagnostic criteria and bladder capacity, impact treatment outcomes.