Cystoscopic Hydrodistension Under Local Anesthesia: Therapeutic Implications in Non-Hunner IC Subtypes

Area of Science:

• Urology
• Gastroenterology

Background:

• Interstitial cystitis (IC) is a chronic bladder condition affecting quality of life.
• Non-Hunner lesion IC (NHIC) subtypes require distinct management approaches.
• Bladder mucosal hemorrhage severity is a potential factor influencing treatment outcomes in NHIC.

Purpose of the Study:

• To evaluate the clinical outcomes of cystoscopy with hydrodistension (CWH) under local anesthesia in NHIC patients.
• To compare outcomes between NHIC subtypes based on bladder hemorrhage severity.
• To identify predictors of treatment response and recurrence.

Main Methods:

• A cohort of 24 female NHIC patients was divided into two groups based on hemorrhage severity: Group IC1 (diffuse/multiple punctate hemorrhage) and Group IC2 (focal punctate hemorrhage).
• All patients underwent CWH under local anesthesia.
• Clinical outcomes including maximum bladder capacity (MBC), Interstitial Cystitis Symptom Index (ICSI), Interstitial Cystitis Problem Index (ICPI), and visual analogue scale (VAS) were assessed at baseline and followed up for 6 months.

Main Results:

• Group IC1 had significantly lower baseline MBC compared to Group IC2.
• Both groups showed significant improvement in all outcome measures at one week post-CWH.
• NHIC patients with more severe hemorrhage (Group IC1) experienced earlier elevation in ICSI scores at 3 months and ICPI scores at 6 months post-procedure.

Conclusions:

• CWH under local anesthesia offers short-term symptom relief for NHIC patients across hemorrhage severities.
• More severe bladder mucosal hemorrhage in NHIC is associated with reduced baseline bladder capacity and earlier symptom recurrence after CWH.
• These findings support the development of individualized treatment and follow-up strategies for NHIC based on hemorrhage severity to optimize patient care and quality of life.