Podium Session

Poster, Podium & Video Sessions

PD01-10: Effects of Repeat Hydrodistention for Interstitial Cystitis

Friday, May 12
8:30 AM - 8:40 AM
Location: BCEC: Room 159

Presentation Authors: Peter Kirk*, Ann Arbor, MI, Yahir Santiago-Lastra, San Diego, CA, John Stoffel, J Quentin Clemens, Anne Pelletier Cameron, Ann Arbor, MI

Introduction: Cystoscopy and hydrodistention is a therapeutic procedure for interstitial cystitis (IC) which achieves symptomatic relief in many patients, though its use varies widely between providers. The long term effects of repeated hydrodistention are not well understood and it is not known if patients suffer a reduction in bladder capacity due to these multiple procedures or develop ulcerating disease over time. We sought to investigate the effects of multiple hydrodistentions in patients with IC.

Methods: We retrospectively queried our institutional records for patients without ulcerative disease who underwent 2 or more hydrodistentions for IC over a ten year period. Patient charts were reviewed for demographic and clinical factors at the time of diagnosis and treatment.

Results: There were 97 patients who underwent multiple cystoscopy and hydrodistention procedures for non ulcerative IC during the ten year study period. The cohort was 98% female and 92% Caucasian. Mean age at diagnosis was 35.7 years, and mean BMI was 27.1. Average number of procedures performed was 3.7 (range 2 to 18), and mean time between procedures was 430.6 days. Within this cohort 63.3% of patients had at least 1 comorbid pain disorder. Mean initial and final anesthetic bladder capacity were 723.9cc and 753.1cc, respectively, which were not significantly different (p=0.15). One patient in this cohort later developed ulcerative disease which was not present at initial cystoscopy. Among patients who completed AUA symptom questionnaires before and after hydrodistention, both symptom and quality of life scores were significantly improved following treatment (17.1 vs 14.3, 4.3 vs 3.6, p <0.001 for both). The complication rate during the study period was 0.83% and comprised an extraperitoneal bladder perforation managed conservatively, anaphylaxis to DMSO instillation, and transient tachycardia with hypotension.

Conclusions: Repeated hydrodistention did not decrease bladder capacity over time and development of ulceration was rare. In this cohort of patients it had significant positive effects on symptom control and quality of life. Hydrodistention is a safe procedure with low complication rates.

Source Of Funding: Ruth L. Kirschstein National Research Service Award 4TL1TR000435 10 (PK)

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