PubMed · 8753743
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C L Parsons, C J Walker. 1996. Cystoscopic changes in interstitial cystitis.. https://doi.org/10.1016/s0090-4295(96)00179-3
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AIMS: To assess how and why hydrodistension of the bladder is performed by UK urologists and to compare this practise with the published literature on distension. To suggest a standardised technique for hydrodistension to allow comparison of diagnostic and therapeutic studies. METHODS: A questionnaire was sent to all UK consultant urologists. Questions addressed the indications for short bladder distension (SBD), details of technique, evaluation of outcome, and awareness of evidence base. The literature on bladder distension was reviewed. RESULTS: The majority of respondents perform SBD, principally in the diagnosis and therapy of interstitial cystitis (IC). There was considerable variation in the duration of distension, repetition of distension, the pressure used for distension, and the measurement of bladder capacity. The literature on the technique of hydrodistension is imprecise and no respondent was able to cite literature to support his or her practice. We suggest a simple, more objective technique for performing hydrodistension. CONCLUSIONS: SBD is widely used. There is marked variability in technique and little more than anecdotal evidence to support any particular approach. Research into the evaluation and treatment of painful bladder syndrome in general and IC in particular would be facilitated by the adoption of a standardised technique.
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Although the symptoms of interstitial cystitis (IC)--a debilitating, chronic disease characterized by urinary urgency and frequency, and bladder and pelvic pain on bladder filling--are easily confused with those of urinary tract infections, there is an absence of an underlying infection, and antibiotic therapy is of no therapeutic benefit. Severe cases of this disorder, which affects mainly women, can have a great negative impact on the quality of life of patients because of extreme urinary frequency. The diagnosis of IC is difficult and should be based on patient history, physical examination, and cystoscopy. A large number of pharmacologic treatments have been used to treat this condition with limited success, including pentosan polysulfate, heparin, antihistamines, tricyclic antidepressants, intravesical dimethyl sulfoxide, and bacille Calmette-Guérin. Among the potentially effective new treatment modalities currently under investigation are suplatast tosilate, resiniferatoxin, botulinum toxin, and gene therapy to modulate the pain response. As knowledge of the pathogenesis of IC increases through intensified research, the ability to provide effective treatment to patients with this disease will improve.