De Cian M, Tricard T, Saussine C. [Bladder pain syndrome: Long-term results (15 years) of a single-center experience].
Prog Urol 2022;
32:681-690. [PMID:
35697555 DOI:
10.1016/j.purol.2022.03.003]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 02/18/2022] [Accepted: 03/11/2022] [Indexed: 11/28/2022]
Abstract
INTRODUCTION
The management of bladder pain syndrome (BPS) in our center is standardized although there is no real consensus and recommendations. The objectives of our study were to assess the effectiveness of the treatment offered and to identify predictive factors of response to treatment.
PATIENTS AND METHODS
Single-center retrospective study including all patients with BPS. Patient and outcome measures included ICSI and ICPI scores, daytime voiding interval (DVI), nocturnal pollakiuria (NPK), and subjective satisfaction (SS). The complete care protocol (CCP) was based on a hydrodistension test followed by a cimetidine treatment then by 6 instillations of dimethyl sulfoxide followed by a maintenance treatment with pentosan polysulfate. The main objective of our study was the patient's SS at 3months and at medium term. One of the secondary objectives was to study the predictive factors of response to treatment.
OUTCOMES
From 2002 to 2019, 211 patients (90.5% women) were treated for BPS. Sixty-nine patients (35%) underwent the CCP that provided significant improvement in ICSI, ICPI, DVI and NPK and SS of 52.2%.). In the medium term, 149 patients were reassessed with a median follow-up of 99.6months (±3.6): 71.8% were satisfied and 54.2% were no longer receiving treatment. Among the 49 patients who initially received PSC, 74% were satisfied at 89.8 months of median follow-up (±2.9). In multivariate analysis, patients with a pain perception disorder (HR=0.17 IC95=0.05-0.52; P=0.002) or consuming anxiolytics (HR=0.3; IC95=0.13-0.69; P=0.004) had a statistically greater risk of not being satisfied.
CONCLUSION
In our study, the CCP achieves subjective medium-term satisfaction in nearly 75% of patients with BPS. These data deserve to be confirmed on a larger scale in a prospective protocol.
LEVEL OF EVIDENCE: 4
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