177: Interstitial Cystitis in the Setting of Chronic Pelvic Pain Syndrome

Abstract

To elucidate the presence of interstitial cystitis in patients with chronic pelvic pain and urinary symptoms. Retrospective chart review. Center for special minimally invasive surgery Stanford university medical center. Ninety-two patients with chronic pelvic pain and urinary symptoms were included in this study. Patients with positive urine analysis or congenital anatomical disorders or medical conditions predisposing to urinary symptoms were excluded from the study. All the patients underwent diagnostic laparoscopy and cystoscopy for the evaluation and workup of their complaints. After the completion of the endoscopic procedure, the bladder was evaluated for evidence of interstitial cystitis by cystoscopy. If interstitial cystitis was diagnosed, treatment included hydrodistention for 10 minutes’ duration. The bladder was evaluated for evidence of interstitial cystitis by cystoscopy. If interstitial cystitis was diagnosed, treatment included hydrodistention for 10 minutes’ duration. The mean age of the patients was 36 years, ranging from 20 to 60 years. In 92 patients, the laparoscopic procedure revealed that 87 (95%) had gynecologic pathology. Among these, endometriosis was found to be the most common with 81 (88%) patients. Laparoscopic evaluation revealed that 34 (38%) of the patients had bladder serosal involvement with endometriosis in addition to endometriosis of the other pelvic organs. In 26 (28%), cystoscopy revealed interstitial cystitis. In further subgroup analysis, 24 of the 26 (92%) patients had endometriosis. Bladder serosal involvement with endometriosis was positive in 7 (27%) of the patients diagnosed with interstitial cystitis. Although endometriosis was the most frequent pathology in our patient population, interstitial cystitis was a significant finding in patients with chronic pelvic pain and urinary symptoms, not simply manifestations of the same disorder. Therefore, if might be helpful to further evaluate the bladder of patients presenting with chronic pelvic pain and urinary symptoms.