Long-term treatment outcomes in patients with interstitial cystitis/painful bladder syndrome: 10-year experience in NCKUH

Abstract

ObjectiveA retrospective review of long-term treatment outcomes for patients diagnosed with interstitial cystitis/painful bladder syndrome (IC/PBS) over a 10-year period. Materials and MethodsPatients who were diagnosed with IC/PBS based on cystoscopic hydrodistention from 2001 to 2010 and thereafter received regular follow-up treatments were enrolled in this study. Clinical information was collected via a retrospective chart review. The following aspects were evaluated: treatment modalities and outcomes; symptom manifestation before and after treatments; and patients' perception on treatment effectiveness. The O'Leary–Sant Interstitial Cystitis Symptom Index (ICSI) and Interstitial Cystitis Problem Index (ICPI), and the Global Response Assessment Questionnaire were used as evaluation tools. ResultsA total of 54 patients with adequate clinical information were included for analysis in this study. The mean age was 38.11 ± 12.71 years and the female-to-male ratio was 3.15:1. The average follow-up duration was 30.61 ± 25.54 months. All patients had bladder or pelvic pain. Pretreatment urinary frequency and nocturia were 13.43 ± 5.09 times per day and 3.74 ± 2.18 times per night, respectively. Functional bladder capacity recorded from urinary diary was 228.1 ± 116.5 mL. Under anesthesia, bladder capacity at the start of a 10-minute therapeutic hydrodistention was 422.0 ± 197.5 mL, which increased to 542.9 ± 220.1 mL at the end of hydrodistention. No major complications were reported during and after the procedure. Additional treatments including oral medications and bladder instillation therapies were instituted in 98.1% of patients. Compared with pretreatment condition, the O'Leary–Sant ICSI and ICPI were decreased by 24% and 15.5%, respectively, after treatments. The subjective improvement rate, which was evaluated by the Global Response Assessment Questionnaire, was 81.6%. ConclusionLong-term continual treatments for IC/PBS are appreciated by most patients even though combinations of modalities are required and the improvements in symptoms and problems are only moderate.