MP72-10 CHARACTERIZATION OF NON-HUNNER TYPE INTERSTITIAL CYSTITIS USING NARROW BAND IMAGING (NBI)-ASSISTED CYSTOSCOPY IN 1298 CASES

Abstract

You have accessJournal of UrologyInfections/Inflammation/Cystic Disease of the Genitourinary Tract: Interstitial Cystitis1 Apr 2016MP72-10 CHARACTERIZATION OF NON-HUNNER TYPE INTERSTITIAL CYSTITIS USING NARROW BAND IMAGING (NBI)-ASSISTED CYSTOSCOPY IN 1298 CASES Tomohiro Ueda, Noriyuki Kanemitsu, Osamu Ukimura, and Naoki Yoshimura Tomohiro UedaTomohiro Ueda More articles by this author , Noriyuki KanemitsuNoriyuki Kanemitsu More articles by this author , Osamu UkimuraOsamu Ukimura More articles by this author , and Naoki YoshimuraNaoki Yoshimura More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1623AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES According to the AUA guideline, interstitial cystitis/bladder pain syndrome (IC/BPS) is diagnosed based on the patients' symptoms. However, phenotyping of the disease to identify the bladder specific pathology such as Hunner lesion is important for tailored treatments of IC/BPS. However, glomerulations, which are the diagnostic criteria of non-Hunner type IC and defined as multiple petechia-like hemorrhages shown after bladder hydrodistension, are reportedly not the specific observation of IC/BPS. We therefore investigated whether the narrow-band imaging (NBI) system, which can evaluate superficial vascular structures, is useful to identify mucosal lesions without bladder distension, for the diagnosis of non-Hunner IC/BPS. METHODS Under local anesthesia, cystoscopic examination with NBI was performed in 1,298 IC/BPS cases. After baseline evaluation of the entire bladder mucosa, patients were divided to those with Hunner or non Hunner IC. RESULTS Among 1,298 cases, 1,279 patients (98.7%) showed the hypervascular, overstretched bladder mucosa before bladder distension by NBI, in contrast to the folded whitish mucosa with few vessels of the normal bladder (Fig. 1). In those 1279 cases, Hunner lesions were found in 727 cases (57%), atypical Hunner lesions showing hypervascular, edematous mucosal changes in 51 cases (3%) and non-Hunner lesions characterized by spotty superficial neovascular lesions identified without bladder distension (Fig. 2) in 480 cases (33%). CONCLUSIONS NBI is useful for detecting Hunner and non-Hunner lesions in 93% of patients. The hypervascular, overstretched condition of the bladder mucosa found in the majority of patients and non-Hunner lesions in one third of patients may indicate a hypersensitive bladder condition underlying IC/BPS symptoms. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e955-e956 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Tomohiro Ueda More articles by this author Noriyuki Kanemitsu More articles by this author Osamu Ukimura More articles by this author Naoki Yoshimura More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...