Cystites interstitielles: Réévaluation des patients ne répondant pas aux thérapeutiques standards

Translated title of the contribution: Reassesment of patients treated for interstitial cystitis not responding to standard therapies

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

Objective : Insterstitial cystitis (IC) is an uncommon disease without an existing positive diagnostic test. Our experience has been that it tends to be overly considered, with many patients treated for long periods with several different regimens and no improvement. This impression prompted a review of our recent experience in the exclusionary diagnosis of IC. Material and Methods : A retrospective review of patients referred to our specialty clinic between December 1995 and October 1998 revealed 23 patients (21 women, 2 men) who had been diagnosed with IC, and had received at least one treatment for this disease (intravesical DMSO or Heparin, Elmiron, 1-Arginine, or therapeutic hydrodistension) with little or no benefit. Our own evaluation of these patients included urinalysis, non-invasive uroflow, post void residual determination and office cystoscopy (all patients), filling cystometrogram and pressure-flow-EMG studies (21 patients), voiding cystourethrogram (17 patients), urethral MRI (9 patients), and other studies as indicated. The results of our reevaluation are reported. Results : Of the 23 patients referred with a diagnosis of IC, only 4 were considered to meet the diagnostic criteria as established by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) after a thorough evaluation. One other patient did not meet the criteria but responded to medications for IC. Urethral pathology was a common finding (distal periurethral fibrosis causing obstruction in 5 patients, intraurethral wall diverticulum in 2, and chronic urethritis in 2), particularly among women with abnormal pressure flow studies during urodynainics. Conclusions : In our experience, many patients who carried the diagnosis of interstitial cystitis were found to have other causes contributing to their urinary symptoms after careful reassessment. Urodynamic studies were found to be of paramount importance in excluding the diagnosis in many cases. On the basis of our findings, we recommend that if local urethral tenderness is noted on physical examination or an abnormal pressure-flow relationship is seen during urodynamics, further investigation is warranted.

Translated title of the contributionReassesment of patients treated for interstitial cystitis not responding to standard therapies
Original languageFrench
Pages (from-to)239-244
Number of pages6
JournalProgres en Urologie
Volume11
Issue number2
StatePublished - Apr 1 2001

Keywords

  • Bladder outlet obstruction
  • Female
  • Interstitital cystitis

ASJC Scopus subject areas

  • Urology

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