Bladder Pain Syndrome in Females

The Value of Cystoscopy in the Assessment of Interstitial Cystitis/Bladder Pain Syndrome

Background. There are significant differences in the diagnosis of interstitial cystitis/painful bladder syndrome (IC/ BPS), in particular, controversy regarding the diagnostic role of cystoscopy or hydrodistension cystoscopy.

The aim of the study was to evaluate the results of cystoscopy with hydrodistension in women with IC/BPS.

Materials and methods. The study involved 126 women with IC/BPS, mean age – 46.7 ± 14.0 years. The duration of the disease was 6.0 ± 2.8 years. Questionnaires PUF, VAS, USS, and potassium test were used. Cystoscopy and urinary bladder hydrodistension were performed.

Results. The sum of points on the PUF scale was 8.14 ± 1.76, on the VAS scale – 5.45 ± 0.93, on the USS scale – 2.63 ± 0.91. A positive potassium test was detected in 91.3 % of cases, the sensitivity of the test was 86.5 %, the specificity – 84.6 %. The anatomical bladder capacity was 308.0 ± 77.5 ml. The average indicator of maximum bladder filling in women with mild pain was higher than in moderate and severe pain by 30.9 % (p < 0.05) and 53.0 % (p < 0.01), respectively. In 11.9 % of cases, polyps were detected at the external opening of the urethra. During cystoscopy, diffuse mucosal bleeding was detected in 39.8 % of cases, diffuse submucosal bleeding – in 21.4 %, rare glomerulations – in 14.3 %, Gunner’s lesions in 12.7 % of cases. After hydrodistension, the changes were more often diffuse (n = 57). There was a significant relationship (r = –0.57, p < 0.01) between the maximum filling of the bladder and the degree of severity of mucosal abnormalities. The severity of changes in the mucous membrane of the bladder positively correlated with the sum of points on the PUF questionnaire (r = +0.61, p = 0.003), on the VAS questionnaire (r = +0.59, p = 0.008) and according to the USS questionnaire (r = +0.66, p = 0.005).

Conclusion. Cystoscopy can be used to examine IC/BPS in accordance with the recommendations of international societies. The obtained data can help to improve the effectiveness of IC/PBS diagnostics.