Advertisement

Cystoscopy and Hydrodistension in the Diagnosis of Bladder Pain Syndrome

Chapter

Abstract

Originally, interstitial cystitis was described as a particular, severe inflammation of the urinary bladder. When cystoscopes became available it was possible to diagnose the disease endoscopically, as described by Guy Hunner in his classic papers. More than a 100 years after the pioneering reports a new paradigm was launched and, while preserving the denomination IC, the concept was widened to include a larger population of subjects with bladder pain. With this approach cystoscopy was regarded as less important in the diagnostic workup. It has become evident, though, that the classic Hunner type of disease, the primary understanding of the diagnosis IC, stands out as a distinct entity. Examples of differences are that the results of various treatments and complication patterns, respectively, differ between phenotypes. The Hunner type of disease is more rewarding to treat, including excellent responses to ablative surgery, in bright contrast to other bladder pain syndrome (BPS) phenotypes. With this knowledge in mind it is not justifiable to do without confirmation or exclusion of this entity when evaluating chronic bladder pain. Cystoscopy and hydrodistension are still the means to make the differentiation. In this chapter, directions for how to carry out cystoscopy and hydrodistension in BPS are presented together with some typical examples of findings.

Keywords

Interstitial Cystitis Bladder Capacity Normal Bladder Bladder Distension Bladder Pain Syndrome 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Skene AJC. Diseases of bladder and urethra in women. New York: Wm Wood; 1887. p. 167.Google Scholar
  2. 2.
    Hunner GL. Elusive ulcer of the bladder: further notes on a rare type of bladder ulcer with report of 25 cases. Am J Obstet. 1918;78:374–95.Google Scholar
  3. 3.
    Messing EM, Stamey TA. Interstitial cystitis: early diagnosis, pathology and treatment. Urology. 1978;12:381–92.PubMedCrossRefGoogle Scholar
  4. 4.
    Fall M, Johansson SL, Aldenborg F. Chronic interstitial cystitis: a heterogeneous syndrome. J Urol. 1987;137:35–8.PubMedGoogle Scholar
  5. 5.
    Gillenwater JY, Wein AJ. Summary of the National Institute of Arthritis, Diabetes, Digestive and Kidney Diseases Workshop on Interstitial Cystitis, National Institutes of Health, Bethesda, Maryland, August 28–29, 1987. J Urol. 1988;140(1):203–6.PubMedGoogle Scholar
  6. 6.
    Hanno P, et al. The diagnosis of interstitial cystitis revisited: lessons learned from the National Institutes of Health Interstitial Cystitis Database study. J Urol. 1999;161:553–7.PubMedCrossRefGoogle Scholar
  7. 7.
    Oravisto KJ. Epidemiology of interstitial cystitis. Ann Chir Gynaecol Finn. 1975;64:75–7.Google Scholar
  8. 8.
    Wyndaele J, Van Dyck J, Toussaint N. Cystoscopy and bladder biopsies in patients with bladder pain syndrome carried out following ESSIC guidelines. Scand J Urol Nephrol. 2009;25:1–5.CrossRefGoogle Scholar
  9. 9.
    van de Merwe J, et al. Diagnostic criteria, classification, and nomenclature for painful bladder syndrome/interstitial cystitis: an ESSIC proposal. Eur Urol. 2008;53:60–7.PubMedCrossRefGoogle Scholar
  10. 10.
    Nordling J, et al. Primary evaluation of patients suspected of having interstitial cystitis (IC). Eur Urol. 2004;45:662–9.PubMedCrossRefGoogle Scholar
  11. 11.
    Sant G, Meares EJ. Interstitial cystitis: pathogenesis, diagnosis, and treatment. Infect Urol. 1990;31:24–30.Google Scholar
  12. 12.
    Peeker R, Fall M. Toward a precise definition of interstitial cystitis: further evidence of differences in classic and nonulcer disease. J Urol. 2002;167:2470–2.PubMedCrossRefGoogle Scholar
  13. 13.
    Messing EM. The diagnosis of interstitial cystitis. Urology. 1987;29(4 Suppl):4–7.PubMedGoogle Scholar
  14. 14.
    Lamale L, et al. Symptoms and cystoscopic findings in patients with untreated interstitial cystitis. Urology. 2006;67:242–5.PubMedCrossRefGoogle Scholar
  15. 15.
    Herbst RH, Baumrucker GO, German KL. Elusive ulcer (Hunner) of the bladder with an experimental study of the etiology. Am J Surg. 1937;38:152–6.CrossRefGoogle Scholar
  16. 16.
    Badenoch AW. Chronic interstitial cystitis. Br J Urol. 1971;43:718–21.PubMedCrossRefGoogle Scholar
  17. 17.
    Braunstein R, et al. The role of cystoscopy in the diagnosis of Hunner’s ulcer disease. J Urol. 2008;180:1383–6.PubMedCrossRefGoogle Scholar
  18. 18.
    Nigro D, Wein A. Interstitial cystitis: clinical and endoscopic features. In: Sant GR, editor. Interstitial cystitis. Philadelphia: Lippincott-Raven; 1997. p. 137–42.Google Scholar
  19. 19.
    Waxman J, Sulak P, Kuehl T. Cystoscopic findings consistent with interstitial cystitis in normal women undergoing tubal ligation. J Urol. 1998;160:1663–7.PubMedCrossRefGoogle Scholar
  20. 20.
    Furuya R, et al. Glomerulation observed during transurethral resection of the prostate for patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia is a common finding but no predictor of clinical outcome. Urology. 2007;70(5):922–6.PubMedCrossRefGoogle Scholar
  21. 21.
    Sant G. Diagnosis of interstitial cystitis: a clinical, endoscopic and pathologic approach. In: Hanno PM, Staskin DR, Krane RJ, Wein AJ, editors. Interstitial cystitis. London: Springer; 1990. p. 107–14.CrossRefGoogle Scholar
  22. 22.
    Messing E, et al. Associations among cystoscopic findings and symptoms and physical examination findings in women enrolled in the Interstitial Cystitis Data Base (ICDB) Study. Urology. 1997;49:81–5.PubMedCrossRefGoogle Scholar
  23. 23.
    Johansson SL, Fall M. Clinical features and spectrum of light microscopic changes in interstitial cystitis. J Urol. 1990;143(6):1118–24.PubMedGoogle Scholar
  24. 24.
    Zabihi N, Allee T, Maher MG, et al. Bladder necrosis following hydrodistention in patients with interstitial cystitis. J Urol. 2007;177:149–52.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Department of UrologyMoscow State Medical Stomatological UniversityMoscowRussian Federation
  2. 2.Department of Urology, Institute of Clinical SciencesSahlgrens Academy at University of GothenburgGöteborgSweden

Personalised recommendations