Effectiveness of hydrodistention procedure under local anesthesia in the treatment of bladder pain syndrome/interstitial cystitis

Yıl 2022, , 357 - 362, 15.03.2022

Kubilay Sarıkaya , Çağri Şenocak , Muhammed Arif İbiş , Fahri Erkan Sadioğlu , Mehmet Çiftçi , Ömer Faruk Bozkurt

https://doi.org/10.32322/jhsm.1032338

Öz

Objective: We aimed to indicate the effectiveness of local anesthesia in the treatment of hydrodistention in women with Bladder Pain Syndrome/interstitial Cystitis (BPS/IC) in our study.
Material and Method: The data of a total of 77 female patients who underwent hydrodistention treatment for BPS/IC in our clinic between January 2015 and July 2021 were analyzed retrospectively. The patients were divided into two groups as local anesthesia (LA, n=41) and spinal anesthesia (SA, n=36) groups according to the type of anesthesia applied. The groups were compared by determining the preoperative and postoperative O'Leary symptom index (SI) and problem index (PI), minimum voiding volume (MinVV), maximum voiding volume (MaxVV), average voiding volume (AvgVV) and daily frequency.
Results: The mean age of the patients was 48.97±11.09 years in the LA group and 45.19±14.35 years in the SA group (p=0.197). There was no significant difference between the groups in terms of the preoperative European Society for the Study of Interstitial Cystitis (ESSIC) group (p=0.999). During the postoperative period, a median (IQR) improvement of 11.0 (2.0) points was observed in the SI of the LA group, while a median improvement of 11.0 (2.0) points were observed in the SA group (p=0.437). The median improvement in PI score was 8.4 (4.0) points in the SA group, while it was 7.0 (3.0) points in the LA group (p=0.415). There was no significant difference between the groups in terms of improvements in minVV, maxVV, avgVV and daily frequency (p=0.480, p=0.460, p=0.614 and p=0.910, respectively).
Conclusion: Hydrodistention treatment in women with BPS/IC can be performed safely and with high success rate under local anesthesia and it is well tolerated by the patients. Local anesthesia offers a minimally invasive treatment option as well as the advantage of avoiding possible complications of spinal, epidural or general anesthesia.

Anahtar Kelimeler

Bladder pain, hydrodistention treatment, local anesthesia

Kaynakça

• Hanno P, Dmochowski R. Status of international consensus on interstitial cystitis/bladder pain syndrome/painful bladder syndrome: 2008 snapshot. Neurourol Urodyn 2009; 28: 274-86.
• Parsons CL. The therapeutic role of sulfated polysaccharides in the urinary bladder. Urol Clin North Am 1994; 21: 93-100.
• Bogart LM, Suttorp MJ, Elliott MN, Clemens JQ, Berry SH. Validation of a quality-of-life scale for women with bladder pain syndrome/interstitial cystitis. Qual Life Res 2012; 21: 1665-70.
• van de Merwe JP, Nordling J, Bouchelouche P, et al. Diagnostic criteria, classification, and nomenclature for painful bladder syndrome/interstitial cystitis: an ESSIC proposal. Eur Urol 2008; 53: 60-7.
• Engeler D, Baranowski AP, Borovicka J, et al. Guidelines on Chronic Pelvic Pain. The Annual EAU Congress. Spanish, 2015. Available online: http: /uroweb.org/guideline/ chronic-pelvic-pain.
• Thrasher JB, Kreder KJ, Peterson NE, Donatucci CF. Lidocaine as topical anesthesia for bladder mappings and cold-cup biopsies. J Urol 1993; 150: 335-6.
• Teichman JM, Nielsen-Omeis BJ, McIver BD. Modified urodynamics for interstitial cystitis. Tech Urol 1997; 3: 65-8.
• O'Leary MP, Sant GR, Fowler FJ Jr, Whitmore KE, Spolarich-Kroll J. The interstitial cystitis symptom index and problem index. Urology 1997; 49: 58-63.
• Nigro DA, Wein AJ, Foy M, et al. Associations among cystoscopic and urodynamic findings for women enrolled in the Interstitial Cystitis Data Base (ICDB) Study. Urology 1997; 49: 86-92.
• El Khoudary SR, Talbott EO, Bromberger JT, Chang CC, Songer TJ, Davis EL. Severity of interstitial cystitis symptoms and quality of life in female patients. J Womens Health (Larchmt) 2009; 18: 1361-8.
• Nickel JC, Kaufman DM, Zhang HF, Wan GJ, Sand PK. Time to initiation of pentosan polysulfate sodium treatment after interstitial cystitis diagnosis: effect on symptom improvement. Urology 2008; 71: 57-61.
• Dunn M, Smith JC, Ardran GM, Ramsden P. Urgency and urge incontinence of urine treated by prolonged bladder dystension: interim results. Urol Int 1977; 32: 107-13.
• Hanno PM, Burks DA, Clemens JQ, et al. AUA guideline for the diagnosis and treatment of interstitial cystitis/bladder pain syndrome. J Urol. 2011; 185: 2162-70.
• Yamada T, Murayama T, Andoh M. Adjuvant hydrodistension under epidural anesthesia for interstitial cystitis. Int J Urol 2003; 10: 463-8.
• Ens G, Garrido GL. Role of cystoscopy and hydrodistention in the diagnosis of interstitial cystitis/bladder pain syndrome. Transl Androl Urol 2015 ; 4: 624-8.
• Ahmad I, Sarath Krishna N, Meddings RN. Sequential hydrodistension and intravesical instillation of hyaluronic acid under general anaesthesia for treatment of refractory interstitial cystitis: a pilot study. Int Urogynecol J Pelvic Floor Dysfunct 2008; 19: 543-6.
• Ströck V, Holmäng S. Is bladder tumour fulguration under local anaesthesia more painful than cystoscopy only? Scand J Urol 2020; 54: 277-80.
• Fabuel Alcañiz JJ, Martínez Arcos L, Jimenez Cidre M, Burgos Revilla FJ. Toxina botulínica intravescal con anestesia local como procedimiento ambulante (Intravesical botulinum toxin under local anestesia as ambulatory procedure). Arch Esp Urol 2017; 70: 635-44.
• Syed HA, Talbot N, Abbas A, et al. Flexible cystoscopy and Holmium: Yttrium aluminum garnet laser ablation for recurrent nonmuscle invasive bladder carcinoma under local anesthesia. J Endourol 2013; 27: 886-91.
• Offiah I, Dilloughery E, McMahon SB, O'Reilly BA. Prospective comparative study of the effects of lidocaine on urodynamic and sensory parameters in bladder pain syndrome. Int Urogynecol J 2019 ; 30: 1293-301.
• Aihara K, Hirayama A, Tanaka N, Fujimoto K, Yoshida K, Hirao Y. Hydrodistension under local anesthesia for patients with suspected painful bladder syndrome/interstitial cystitis: safety, diagnostic potential and therapeutic efficacy. Int J Urol 2009; 16: 947-52.