The value of an initial cystoscopy and bladder hydrodistension in patients with Bladder Pain Syndrome (BPS): Real world data with 5-year follow-up
BAUS ePoster online library. Krishnan J. Jun 24, 2019; 259515; P3-10
Mr. Jamie Krishnan
Mr. Jamie Krishnan
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Abstract
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INTRODUCTION

Controversy exits around optimal management of Bladder Pain Syndrome (BPS) due to a lack of high-level evidence. Thus its management varies greatly. Our clinical routine is to perform cystoscopy and bladder hydrodistension (CBH) under general anaesthesia (GA) on all patients with a clinical diagnosis of BPS. This study aims to determine the therapeutic and prognostic value of initial CBH in BPS patients.

METHODS

A retrospective review of prospectively collected data on patients with newly diagnosed BPS undergoing initial CBH under GA between 2005-2006 was undertaken. Demographics, prior treatments, CBH findings (maximum anaesthetic capacity (MAC), physiological response), treatment response (at 6-week post-operatively) and further treatments were recorded.

RESULTS

62 patients underwent CBH. Median follow-up was 5yrs. Mean MAC was 738ml. 45% had concomitant urethral dilatation. Complete, partial and no symptom response was observed in 18%, 53% & 29% respectively. 27% had no further treatment, 30% had pharmacotherapy, 30% had further CBH.

Those with complete response were significantly more likely to have undergone concomitant urethral dilatation compared to non-responders (72.7% vs 27.3%, p=0.03). Complete & partial responders were significantly more likely to undergo further CBH (76.5% vs 23.5%; p=0.04). 3.6% of non-responders had reconstructive surgery (vs 0% partial/complete response; p=0.04); and had significantly lower MAC (375ml Vs 750ml; p=0.03).

Conclusions

Initial GA CBH is a useful intervention, with therapeutic and prognostic benefit, in patients with BPS. One third of patients required no further intervention. The initial treatment response and MAC provide useful prognostic information as to the need for further intervention.
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