Korean J Urol.  2013 Oct;54(10):682-688.

Effect of Transurethral Resection With Hydrodistention for the Treatment of Ulcerative Interstitial Cystitis

• Lee ES
• Lee SW
• Lee KW
• Kim JM
• Kim YH
• Kim ME

Abstract

PURPOSE
Many treatment options to help relieve the symptoms of interstitial cystitis (IC) are available, but none are effective. Because no reports of transurethral ulcer resection with hydrodistention are available, we assessed the effects of such combined surgery for ulcerative IC.
MATERIALS AND METHODS
Between June 2006 and June 2011, 87 female patients with IC who underwent transurethral resection with hydrodistention and were followed up for at least 12 months were included. Improvements in patients' voiding symptoms and pain were analyzed retrospectively by using a 3-day micturition chart and a 10-point visual analogue scale (VAS) before and after the operation. The global response assessment (GRA) was used to assess treatment satisfaction.
RESULTS
The mean age of the 87 female patients was 59.1+/-10.1 years, and the mean follow-up period was 26.7+/-14.4 months. Mean maximum functional bladder capacity increased from 168.4+/-92.4 mL to 276.3+/-105.4 mL (1 month) and to 227.3+/-91.7 mL (12 months). The mean frequency of voiding decreased from 17.2+/-8.5 before to 10.6+/-5.3 after (1 month) surgery; however, it increased again to 13.3+/-4.8 at 12 months. The 10-point VAS score decreased from 9.1+/-0.8 to 1.2+/-0.3 (1 month); however, it increased again to 2.5+/-0.4 (3 months), 3.2+/-0.4 (6 months), and 5.3+/-0.5 (12 months) (p<0.001). Symptom improvement based on the GRA was observed in 83 of the 87 patients (95.4%) at 1 month and in 55 of 87 patients (63.2%) at 12 months.
CONCLUSIONS
Transurethral resection with hydrodistention is an effective treatment option for ulcerative IC because it provides improvements in voiding symptoms and pain.

Keyword

Interstitial cystitis; Treatment outcome

MeSH Terms

Cystitis, Interstitial
Female
Follow-Up Studies
Humans
Retrospective Studies
Treatment Outcome
Ulcer
Urinary Bladder
Urination

Figure

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  FIG. 1 Typical appearance of a bladder ulcer lesion before and after surgery. (A) Cystoscopic appearance of ulcerative interstitial cystitis (arrow: ulcer lesion). (B) Transurethral resection of ulcer lesion. (C) Cystoscopic appearance of ulcer lesion (arrow: scar formation) at 12-month follow-up.

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  FIG. 2 Changes in 10-point visual analogue scale (VAS) scores after transurethral ulcer resection with hydrodistention. Preop, preoperation.

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