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Does repeated hydrodistension with transurethral fulguration for interstitial cystitis with Hunner’s lesion cause bladder contraction?
Objective: To evaluate the effect of repeated bladder hydrodistension with transurethral resection or fulguration (TUF) of Hunner’s lesions on bladder capacity and interstitial cystitis (IC) symptoms. TUF for Hunner’s lesion is recommended in several IC/BPS guidelines, although recurrence is highly...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Taylor & Francis
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6583749/ https://www.ncbi.nlm.nih.gov/pubmed/31258947 http://dx.doi.org/10.1080/2090598X.2019.1589753 |
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author | Tomoe, Hikaru Yamashita, Kaori |
author_facet | Tomoe, Hikaru Yamashita, Kaori |
author_sort | Tomoe, Hikaru |
collection | PubMed |
description | Objective: To evaluate the effect of repeated bladder hydrodistension with transurethral resection or fulguration (TUF) of Hunner’s lesions on bladder capacity and interstitial cystitis (IC) symptoms. TUF for Hunner’s lesion is recommended in several IC/BPS guidelines, although recurrence is highly probable. Patients and methods: The study cohort comprised 44 IC patients with Hunner’s lesions who underwent multiple bladder hydrodistensions with TUF and electrocautery (EC) at our institution between July 2005 and June 2018. We analysed their frequency–volume chart, O’Leary Sant Interstitial Cystitis Symptom Index (ICSI), Interstitial Cystitis Problem Index (ICPI), and visual analogue scale (VAS) for pain, before and at 2, 6, and 12 months after surgery. Results: The 44 Hunner-type IC patients underwent a total of 117 surgeries. Patients were divided into three groups based upon the number of hydrodistensions with TUF they underwent. Group 1 (n = 44), Group 2 (n = 44) and Group 3 (n = 21) underwent one, two, and three surgeries, respectively. At 6 months after surgery, the mean average voided volume (AVV) and maximum voided volume (MVV) were 157 mL and 228 mL in Group 1; 203 mL, 283 mL in Group 2; and 193 mL, 264 mL in Group 3. The AVV in Group 2 (P < 0.01) and Group 3 (P < 0.03), and the MVV in Group 2 (P < 0.02) increased significantly compared to Group 1. ICSI, ICPI and VAS pain score in groups 2 (P < 0.003, P < 0.01, P < 0.05) and 3 (P < 0.001, P < 0.001, P < 0.001) decreased significantly compared to Group 1. Conclusion: Repeated hydrodistension and TUF with EC of Hunner’s lesions for recurrent Hunner-type IC patients improved their symptoms. There was a tendency toward an increase in bladder capacity and repeated hydrodistension with TUF did not appear to be a direct cause of bladder contraction. Abbreviations: AVV: average voided volume; BPS: bladder pain syndrome; EC: electrical cautery; IC: interstitial cystitis; ICPI: Interstitial Cystitis Problem Index; ICSI: Interstitial Cystitis Symptom Index; MVV: maximum voided volume; TUF: transurethral fulguration; TUR: transurethral resection; VAS: visual analogue scale |
format | Online Article Text |
id | pubmed-6583749 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Taylor & Francis |
record_format | MEDLINE/PubMed |
spelling | pubmed-65837492019-06-28 Does repeated hydrodistension with transurethral fulguration for interstitial cystitis with Hunner’s lesion cause bladder contraction? Tomoe, Hikaru Yamashita, Kaori Arab J Urol Lower Urinary Tract Dysfunction Objective: To evaluate the effect of repeated bladder hydrodistension with transurethral resection or fulguration (TUF) of Hunner’s lesions on bladder capacity and interstitial cystitis (IC) symptoms. TUF for Hunner’s lesion is recommended in several IC/BPS guidelines, although recurrence is highly probable. Patients and methods: The study cohort comprised 44 IC patients with Hunner’s lesions who underwent multiple bladder hydrodistensions with TUF and electrocautery (EC) at our institution between July 2005 and June 2018. We analysed their frequency–volume chart, O’Leary Sant Interstitial Cystitis Symptom Index (ICSI), Interstitial Cystitis Problem Index (ICPI), and visual analogue scale (VAS) for pain, before and at 2, 6, and 12 months after surgery. Results: The 44 Hunner-type IC patients underwent a total of 117 surgeries. Patients were divided into three groups based upon the number of hydrodistensions with TUF they underwent. Group 1 (n = 44), Group 2 (n = 44) and Group 3 (n = 21) underwent one, two, and three surgeries, respectively. At 6 months after surgery, the mean average voided volume (AVV) and maximum voided volume (MVV) were 157 mL and 228 mL in Group 1; 203 mL, 283 mL in Group 2; and 193 mL, 264 mL in Group 3. The AVV in Group 2 (P < 0.01) and Group 3 (P < 0.03), and the MVV in Group 2 (P < 0.02) increased significantly compared to Group 1. ICSI, ICPI and VAS pain score in groups 2 (P < 0.003, P < 0.01, P < 0.05) and 3 (P < 0.001, P < 0.001, P < 0.001) decreased significantly compared to Group 1. Conclusion: Repeated hydrodistension and TUF with EC of Hunner’s lesions for recurrent Hunner-type IC patients improved their symptoms. There was a tendency toward an increase in bladder capacity and repeated hydrodistension with TUF did not appear to be a direct cause of bladder contraction. Abbreviations: AVV: average voided volume; BPS: bladder pain syndrome; EC: electrical cautery; IC: interstitial cystitis; ICPI: Interstitial Cystitis Problem Index; ICSI: Interstitial Cystitis Symptom Index; MVV: maximum voided volume; TUF: transurethral fulguration; TUR: transurethral resection; VAS: visual analogue scale Taylor & Francis 2019-04-08 /pmc/articles/PMC6583749/ /pubmed/31258947 http://dx.doi.org/10.1080/2090598X.2019.1589753 Text en © 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. 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 work is properly cited. |
spellingShingle | Lower Urinary Tract Dysfunction Tomoe, Hikaru Yamashita, Kaori Does repeated hydrodistension with transurethral fulguration for interstitial cystitis with Hunner’s lesion cause bladder contraction? |
title | Does repeated hydrodistension with transurethral fulguration for interstitial cystitis with Hunner’s lesion cause bladder contraction? |
title_full | Does repeated hydrodistension with transurethral fulguration for interstitial cystitis with Hunner’s lesion cause bladder contraction? |
title_fullStr | Does repeated hydrodistension with transurethral fulguration for interstitial cystitis with Hunner’s lesion cause bladder contraction? |
title_full_unstemmed | Does repeated hydrodistension with transurethral fulguration for interstitial cystitis with Hunner’s lesion cause bladder contraction? |
title_short | Does repeated hydrodistension with transurethral fulguration for interstitial cystitis with Hunner’s lesion cause bladder contraction? |
title_sort | does repeated hydrodistension with transurethral fulguration for interstitial cystitis with hunner’s lesion cause bladder contraction? |
topic | Lower Urinary Tract Dysfunction |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6583749/ https://www.ncbi.nlm.nih.gov/pubmed/31258947 http://dx.doi.org/10.1080/2090598X.2019.1589753 |
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