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Revisiting the Role of Potassium Sensitivity Testing and Cystoscopic Hydrodistention for the Diagnosis of Interstitial Cystitis
OBJECTIVES: To revisit the diagnostic roles of cystoscopic hydrodistention and the potassium sensitivity test (PST) for the diagnosis of interstitial cystitis (IC). METHODS: We prospectively enrolled 214 patients clinically diagnosed with IC, 125 non-IC patients who underwent video urodynamic studie...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Public Library of Science
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4801189/ https://www.ncbi.nlm.nih.gov/pubmed/26999787 http://dx.doi.org/10.1371/journal.pone.0151692 |
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author | Jiang, Yuan-Hong Jhang, Jia-Fong Kuo, Hann-Chorng |
author_facet | Jiang, Yuan-Hong Jhang, Jia-Fong Kuo, Hann-Chorng |
author_sort | Jiang, Yuan-Hong |
collection | PubMed |
description | OBJECTIVES: To revisit the diagnostic roles of cystoscopic hydrodistention and the potassium sensitivity test (PST) for the diagnosis of interstitial cystitis (IC). METHODS: We prospectively enrolled 214 patients clinically diagnosed with IC, 125 non-IC patients who underwent video urodynamic studies and PST, and another 144 non-IC patients who underwent cystoscopic hydrodistention before transurethral surgery. The sensitivity, specificity, and positive and negative predictive values were calculated for the PST and glomerulations after cystoscopic hydrodistention. RESULTS: After cystoscopic hydrodistention, glomerulations developed in 211/214 (98.6%) IC patients and 61/144 (42.4%) of the non-IC patients including patients with stones (45/67, 67%), hematuria (2/5, 40%), and stress urinary incontinence (SUI) (6/17, 35%). When positive glomerulation was defined as grade 2 or more, the sensitivity was 61.7%. The PST was positive in 183/214 (85.5%) IC patients and 7/17 (41%) with hypersensitive bladder, 7/32 (22%) with detrusor overactivity, 5/27 (18%) with SUI, 2/21 (10%) with lower urinary tract symptoms, and 2/25 (8%) with bladder outlet obstruction. The PST had a sensitivity of 85.5% and a specificity of 81.6% for diagnosis of IC. IC patients with a positive PST had a significantly smaller urgency sensation capacity, smaller voided volume, and greater bladder pain score. CONCLUSIONS: Both the PST and glomerulations after hydrodistention are sensitive indicators of IC, but the specificity of glomerulations in the diagnosis of IC is lower than that of the PST. A positive PST is associated with a more hypersensitive bladder and bladder pain, but not the grade of glomerulations in IC patients. Neither test provided 100% diagnostic accuracy for IC, we might select patients into different subgroups based on different PST and hydrodistention results, not for making a diagnosis of IC but for guidance of different treatments. |
format | Online Article Text |
id | pubmed-4801189 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-48011892016-03-23 Revisiting the Role of Potassium Sensitivity Testing and Cystoscopic Hydrodistention for the Diagnosis of Interstitial Cystitis Jiang, Yuan-Hong Jhang, Jia-Fong Kuo, Hann-Chorng PLoS One Research Article OBJECTIVES: To revisit the diagnostic roles of cystoscopic hydrodistention and the potassium sensitivity test (PST) for the diagnosis of interstitial cystitis (IC). METHODS: We prospectively enrolled 214 patients clinically diagnosed with IC, 125 non-IC patients who underwent video urodynamic studies and PST, and another 144 non-IC patients who underwent cystoscopic hydrodistention before transurethral surgery. The sensitivity, specificity, and positive and negative predictive values were calculated for the PST and glomerulations after cystoscopic hydrodistention. RESULTS: After cystoscopic hydrodistention, glomerulations developed in 211/214 (98.6%) IC patients and 61/144 (42.4%) of the non-IC patients including patients with stones (45/67, 67%), hematuria (2/5, 40%), and stress urinary incontinence (SUI) (6/17, 35%). When positive glomerulation was defined as grade 2 or more, the sensitivity was 61.7%. The PST was positive in 183/214 (85.5%) IC patients and 7/17 (41%) with hypersensitive bladder, 7/32 (22%) with detrusor overactivity, 5/27 (18%) with SUI, 2/21 (10%) with lower urinary tract symptoms, and 2/25 (8%) with bladder outlet obstruction. The PST had a sensitivity of 85.5% and a specificity of 81.6% for diagnosis of IC. IC patients with a positive PST had a significantly smaller urgency sensation capacity, smaller voided volume, and greater bladder pain score. CONCLUSIONS: Both the PST and glomerulations after hydrodistention are sensitive indicators of IC, but the specificity of glomerulations in the diagnosis of IC is lower than that of the PST. A positive PST is associated with a more hypersensitive bladder and bladder pain, but not the grade of glomerulations in IC patients. Neither test provided 100% diagnostic accuracy for IC, we might select patients into different subgroups based on different PST and hydrodistention results, not for making a diagnosis of IC but for guidance of different treatments. Public Library of Science 2016-03-21 /pmc/articles/PMC4801189/ /pubmed/26999787 http://dx.doi.org/10.1371/journal.pone.0151692 Text en © 2016 Jiang et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Jiang, Yuan-Hong Jhang, Jia-Fong Kuo, Hann-Chorng Revisiting the Role of Potassium Sensitivity Testing and Cystoscopic Hydrodistention for the Diagnosis of Interstitial Cystitis |
title | Revisiting the Role of Potassium Sensitivity Testing and Cystoscopic Hydrodistention for the Diagnosis of Interstitial Cystitis |
title_full | Revisiting the Role of Potassium Sensitivity Testing and Cystoscopic Hydrodistention for the Diagnosis of Interstitial Cystitis |
title_fullStr | Revisiting the Role of Potassium Sensitivity Testing and Cystoscopic Hydrodistention for the Diagnosis of Interstitial Cystitis |
title_full_unstemmed | Revisiting the Role of Potassium Sensitivity Testing and Cystoscopic Hydrodistention for the Diagnosis of Interstitial Cystitis |
title_short | Revisiting the Role of Potassium Sensitivity Testing and Cystoscopic Hydrodistention for the Diagnosis of Interstitial Cystitis |
title_sort | revisiting the role of potassium sensitivity testing and cystoscopic hydrodistention for the diagnosis of interstitial cystitis |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4801189/ https://www.ncbi.nlm.nih.gov/pubmed/26999787 http://dx.doi.org/10.1371/journal.pone.0151692 |
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