間質性膀胱炎52症例の臨床的検討

Abstract

To examine clinical features of the patients of interstitial cystitis (IC) undergoing hydrodistension at our institution. We retrospectively evaluated 52 IC patients who underwent hydrodistension between July 2002 and December 2004. Transurethral coagulation (TUC) of Hunner's ulcer (HU) was subsequently performed for patients with HU (ulcer type). Descriptive statistics of the patients' characteristics and outcomes were provided and compared between ulcer type and nonulcer type IC patients. Of the 52 patients, 44 (85%) were female and 8 were male. Mean symptom duration at diagnosis was 59 months (range 2 to 388). Mean patient age was 55 years (range 24 to 78). Of them, 92% reported urinary frequency, 54% bladder or lower abdominal pain and 40% voiding difficulty. The daily voiding frequency was 19 times (range 8 to 52) and mean bladder capacity by voiding log was 100 ml (range 33 to 260). The mean of bladder capacity at hydrodistension was 580 ml (range 220 to 880). All the patients showed glomerulations during hydrodistension and 75% of them experienced amelioration of their symptoms after hydrodistension. Symptom relief lasted for 1 year for two thirds of the patients. Mean observation period was 15 months (range 2 to 30 months). Of 52 patients, 19 (37%) were ulcer type, who were significantly older at diagnosis (60 yrs vs. 52 yrs), had smaller maximum bladder capacity of voiding log (140 ml vs. 230 ml) and bladder capacity at hydrodistension (500 ml vs. 620 ml). However, ulcer type IC patients responded significantly better to hydrodistension (95%vs. 64%). IC patients suffered from severe symptoms for a long time without correct diagnosis or proper treatments. Hydrodistension was effective for IC patients, especially for ulcer type, combined with TUC.