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Long-Term Outcomes Favorable for IC Patients Receiving Hydrodistention +/- Fulguration

Niimi A, Nomiya A, Yamada Y, Suzuki M, Fujimura T, Fukuhara H, Kume H, Igawa Y, Homma Y. Hydrodistension with or without fulguration of hunner lesions for interstitial cystitis: Long-term outcomes and prognostic predictors. Neurourol Urodyn. 2015 Jul 24. doi: 10.1002/nau.22837. [Epub ahead of print]

This study details long-term outcomes for a group of interstitial cystitis (IC) patients who were treated with hydrodistension of the bladder, plus fulguration of Hunner lesions, if such lesions were detected. Moreover, the investigators tried to identify what factors might predict that a patient will do well on this recommended treatment strategy, and which patients might be more likely to have a treatment failure (such as the need for a second hydrodistension, an alternate treatment, or a narcotic to control pain). The group of 191 patients included 155 women and 36 men, the majority of whom had Hunner type IC. At first, it seemed like those patients with non-Hunner type IC did worse, since they were more likely to have undesirable outcomes approximately 1.5 years after the procedure, as compared with the patients with Hunner type IC. However, in the longer term, the rates of procedural failure were similar between the two groups. There were actually two factors that seemed to predict a worse outcome: lumbar spinal stenosis (LSS) or irritable bowel syndrome (IBS). Patients with non-Hunner type IC who also had IBS were more likely to fail treatment; whereas LSS increased likelihood of failure for both the Hunner and non-Hunner groups.