Poster, Podium & Video Sessions
Presentation Authors: Joao Zambon*, Steve J Walker, Gopal Badlani, Catherine Matthews, Heather Bowman, Robert Evans, Winston-Salem, NC
Introduction: IC/BPS is a diagnosis of exclusion for which there is no specific cystoscopic or pathological marker. The symptom heterogeneity and the myriad comorbid medical conditions in this population add confusion to the clinical picture. We recently reported that a subset of IC/BPS patients with BC < 400 ml display a molecular profile that is consistent with an inflammatory disease phenotype. This study aims to correlate the bladder capacity (BC) measured by hydrodistension with urinary and gynecological symptoms, non-urological chronic diseases, cystoscopy & histopathology.
Methods: This is a retrospective chart review of women diagnosed with IC/BPS between 2011 and 2015 at one tertiary referral institution (IRB#00018552) who underwent bladder hydrodistention per the AUA guideline algorithm. Assessments for each patient included history, physical examination, OLeary/Sant Voiding & Pain Indices (ICPI & ICSI), and the Pelvic Pain Urgency and Frequency Questionnaire (PUF). After hydrodistension, bladder biopsies were collected and analyzed for pathology. Inflammation severity was characterized according to the degree of submucosal lymphocyte and monocyte infiltration, basement membrane thickness, submucosal edema, vascular ectasia, and fibrosis.
Results: This study, which included data from 145 consecutively consented IC/BPS patients found a significant inverse correlation between BC and scores on three gold standard IC/BPS metrics: ICPI (p=0.0014), ICSI (p=0.0022) and PUF (p=0.0009), as well as with urinary frequency (p=0.0025) and age (p=0.014). A significant positive correlation was seen between BC and depression (p=0.0059), and BC and IBS (p=0.022). These data are demonstrated in Table 1. Cystoscopy and hystopathology data are demonstrated in Graph 1.
Conclusions: Patients with lower BC had more severe disease characterized either by clinical symptoms, cystoscopy and pathology. Our data suggest that low BC is a biomarker for a bladder-centric manifestation of IC/BPS.
Source Of Funding: R21DK106554
Saturday, May 13
7:00 AM – 9:00 AM