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Sex Differences in Cystoscopic Findings Among Veterans With Interstitial Cystitis.

Isabella Dolendo1, Andrew Chen2, Catherine Bresee2

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|September 28, 2025
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Summary

This study found no significant sex differences in Hunner's lesions or glomerulation in veterans with interstitial cystitis/bladder pain syndrome (IC/BPS). However, men showed higher rates of trabeculation on cystoscopy.

Keywords:
Hunner's lesionsbladder paincystitiscystoscopyinterstitial cystitis

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Area of Science:

  • Urology
  • Gastroenterology
  • Pathology

Background:

  • Interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic condition characterized by pelvic pain and urinary symptoms.
  • Previous research indicates sex-based differences in IC/BPS symptom presentation.
  • The translation of these symptomatic differences into observable pathological differences on cystoscopy remains unclear.

Purpose of the Study:

  • To evaluate cystoscopic findings in a cohort of male and female veterans diagnosed with IC/BPS.
  • To determine if significant sex-based differences exist in the pathological manifestations of IC/BPS observed during cystoscopy.
  • To identify specific cystoscopic markers that may differ between sexes in IC/BPS patients.

Main Methods:

  • Retrospective analysis of hospital visits within the Veteran Health Affairs Hospital System (October 2004 - July 2016).
  • Identification of IC/BPS patients using ICD codes and the VINCI system.
  • Inclusion of patients over 18 with confirmed IC/BPS diagnosis who underwent cystoscopy; analysis of ulceration, glomerulation, inflammation, trabeculation, and tumors, adjusted for demographics.

Main Results:

  • A total of 570 patients (57.9% female) were analyzed; the female cohort was younger.
  • No significant sex differences were observed in the prevalence of Hunner's lesions (8.2% men vs. 3.7% women), glomerulation (11.4% vs. 15.2%), or inflammation (19.6% vs. 15.8%).
  • Men exhibited a significantly higher likelihood of trabeculation (15.4% vs. 8.1%), while urothelial tumors were rare in both sexes.

Conclusions:

  • The prevalence of ulceration and Hunner's lesions on cystoscopy was similar between men and women with IC/BPS.
  • Cystoscopic identification of Hunner's lesions is crucial for IC/BPS management due to the relative success of targeted treatments.
  • While some cystoscopic findings like trabeculation may show sex differences, key markers like Hunner's lesions do not appear to differ significantly between sexes in this veteran population.