Abstract
Electrocautery is a promising treatment option for patients with Hunner type interstitial cystitis (HIC), but frequently requires multiple sessions due to recurrence of the lesions. In the present study, we assessed the relationship between the frequency of electrocautery of Hunner lesions and changes in maximum bladder capacity (MBC) at hydrodistension in a large cohort of 118 HIC patients. Three mixed-effect linear regression analyses were conducted for MBC against (1) the number of sessions; (2) the number of sessions and the time between each session and the first session; and (3) other relevant clinical parameters in addition to the Model (2). The mean number of sessions was 2.8 times. MBC decreased approximately 50 mL for each additional electrocautery session, but this loss was offset by 10 mL for each year the subsequent session was postponed. MBC of < 400 mL at the first session was a significant risk factor for MBC loss with further sessions. No other clinical parameters were associated with MBC over time. This study demonstrates a significant relationship between the frequency of electrocautery of Hunner lesions and MBC changes in HIC patients. Low MBC at the first session is a poor prognostic marker for MBC loss over multiple sessions.
Highlights
Electrocautery is a promising treatment option for patients with Hunner type interstitial cystitis (HIC), but frequently requires multiple sessions due to recurrence of the lesions
maximum bladder capacity (MBC) decreased by 55.5 Maximum voided volume (mL) with each additional session, but this MBC loss was reversed by 10.9 mL for each year that elapsed until the following session
Model 3, which was adjusted for clinical parameters, still showed a significant association between MBC changes and both the number of sessions (β: − 52.6 mL, 95% confidence interval (CI) − 88.9, − 16.3) and the period between each session and the first session (β: 9.55 mL, 95% CI 3.60, 21.5)
Summary
Electrocautery is a promising treatment option for patients with Hunner type interstitial cystitis (HIC), but frequently requires multiple sessions due to recurrence of the lesions. No of patients (male/female) Mean age at symptom onset (years) Duration of illness (years from symptom onset to the first visit to our institution) Follow-up period (months from the first session to the last session) Number of surgeries OSSI OSPI Pain score‡ Daytime urination frequency Nocturia frequency Average voided volume (mL) Maximum voided volume (mL) MBC at the first hydrodistension (mL) Extent of Hunner lesions (%)¶ Previous studies reported that multiple sessions of electrocautery of Hunner lesions, with or without hydrodistension, did not negatively affect bladder capacity over time[16,17,18].
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