The Significance of Glomerulation in the Diagnosis of Interstitial Cystitis

Kim, Jang Hwan; Mah, Sang Yol

Abstract

An objective finding for the diagnosis of interstitial cystitis (IC) is the so called `glomerulation`, petechial hemorrhages that occur after distention of the bladder. Glomerulation occurs in most IC patients and although there are some reports that it occurs in the normal bladder as well, there has been no actual study carried out to confirm this and further study into this matter is needed. Therefore, we induced glomerulations in non-IC patients and compared its frequency and severity with IC patients in order to elucidate the importance of glomerulation in IC. 25 (10 males, 15 females; mean age 44.3 years) IC patients received hydrodistention between Jan 1992 to Sep 1996 at the Department of Urology at Yongdong Severance Hospital. 12 (8 males, 4 females; mean age 47.5 years) non-IC patients who were to receive urological surgery under spinal or general anesthesia were selected for hydrodistention; there were 6 ureter stone, 4 BPH, and 2 stress urinary incontinence patients. 92.0% (23/25) of IC patients and 83.3% (10/12) of non-IC patients showed glomerulation and there was no statistical significance between the two groups. 76.0% (6 grade 2, 13 grade 3 glomerulation) of IC patients and 50.0% (3 grade 2, 3 grade 3) of non-IC patients showed glomerulation of grade 2 or higher. The frequency and severity of glomerulation was in an inverse relationship with trabeculation of the bladder. The sensitivity of glomerulation in the diagnosis of IC was 92.0% whereas the specificity was low with 16.7%. These findings suggest that glomerulation is nonspecific in IC and warrants further investigation.