The voiding dysfunctions in patients with non-Hunner-type interstitial
cystitis/bladder pain syndrome do not affect long-term treatment outcome
Abstract
Aims: The role of urodynamic studies in the diagnosis and prognosis of
interstitial cystitis/bladder pain syndrome (IC/BPS) remains
controversial. We evaluated the correlation of baseline voiding
dysfunctions with long-term treatment outcome in a large cohort of
patients with IC/BPS. Methods: We studied 211 patients with
nonulcerative IC/BPS. All patients underwent video urodynamic
examination at baseline to identify their voiding conditions and they
received subsequent treatments. The primary endpoint was the global
response assessment (GRA) at the current interview. Secondary endpoints
included O’Leary-Sant score (OSS), Visual Analog Scale (VAS) for pain,
and the rate of IC symptom flare-up. Results: Mean patient age was 56.8
± 12.8 years and mean IC symptom duration was 16.0 ± 9.9 years. At
baseline, 83 (39.3%) patients had a voiding problem and 62.7% had one
to three comorbidities. The duration, comorbidity, treatments, changes
in OSS and VAS, maximum bladder capacity (MBC), glomerulations, GRA, and
flare-up rate were not significantly different among the different
voiding subtypes. When we divided the patients by their voiding
conditions of normal (n = 32) and hypersensitive bladder with (n = 76)
and without (n = 103) voiding dysfunctions, only MBC (P = 0.002) and
glomerulation (P = 0.021) demonstrated a significant difference. When we
analyzed subgroups by GRA, patients with a GRA ≥ 2 had a significantly
shorter disease duration. There also were significant associations
between GRA and the changes in OSS and VAS (P < 0.001).
Conclusions: Voiding dysfunctions in patients with non-Hunner IC/BPS do
not affect long-term treatment outcome.