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Features of Various Bladder Lesions and Their Impact on Clinical Symptoms and Recurrence in Interstitial Cystitis

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Abstract
Purpose: We aimed to investigate the impact of various bladder lesions on the clinical symptoms and recurrence of interstitial cystitis (IC).

Materials and Methods: Patients with IC who underwent transurethral resection and cauterization for Hunner lesions (HLs) were enrolled. Features of HLs-noninflamed, inflamed, and gradually inflamed-and associated cystoscopic findings, including waterfall bleeding (none, focal or extensive), submucosal hemorrhage, and mucosal streak, were analyzed to investigate their association with preoperative symptoms and recurrence.

Results: We included 272 procedures from 141 patients (male:female ratio 37:104) with a mean +/- SD age of 61.4 +/- 10.5 years. Recurrence was observed in 160 procedures after a mean of 15.6 months (range 0.7-91.7); repeat transurethral resection and cauterization was performed in 131 cases. The number of HLs observed at each procedure was variable, and sufficient bladder filling revealed hidden lesions in 10.7% of cases. Waterfall bleeding was frequently accompanied with inflamed/gradually inflamed HLs. Inflammatory HLs were associated with smaller functional bladder capacity and preoperative urgency (p=0.007). Extensive waterfall bleeding was associated with smaller functional bladder capacity (p=0.006). On multivariate analysis, initially inflamed HLs (HR: 1.675, 95% CI: 1.022-2.746, p=0.041) and gradual inflammatory changes in HLs (HR: 1.893, 95% CI: 1.050-3.410, p=0.034) were found to be risk factors for recurrence.

Conclusions: Sufficient bladder filling revealed hidden HLs. The features of HLs were not associated with subjective symptoms; inflamed changes were a predictive factor for IC recurrence, and associated with frequent urgency episodes and smaller bladder capacity.
Author(s)
신정현강보식주명수
Issued Date
2021
Type
Article
Keyword
recurrencecystitisintnerstitial cystitis
DOI
10.1097/JU.0000000000001811
URI
https://oak.ulsan.ac.kr/handle/2021.oak/7481
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_proquest_miscellaneous_2518224958&context=PC&vid=ULSAN&lang=ko_KR&search_scope=default_scope&adaptor=primo_central_multiple_fe&tab=default_tab&query=any,contains,Features%20of%20Various%20Bladder%20Lesions%20and%20Their%20Impact%20on%20Clinical%20Symptoms%20and%20Recurrence%20in%20Interstitial%20Cystitis&offset=0&pcAvailability=true
Publisher
JOURNAL OF UROLOGY
Location
미국
Language
영어
ISSN
0022-5347
Citation Volume
206
Citation Number
3
Citation Start Page
670
Citation End Page
670
Appears in Collections:
Medicine > Medicine
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