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Therapeutic efficacy of narrow band imaging‐assisted transurethral electrocoagulation for ulcer‐type interstitial cystitis/painful bladder syndrome
Author(s) -
Kajiwara Mitsuru,
Inoue Shougo,
Kobayashi Kanao,
Ohara Shinya,
Teishima Jun,
Matsubara Akio
Publication year - 2014
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/iju.12350
Subject(s) - medicine , interstitial cystitis , visual analogue scale , cystoscopy , surgery , electrocoagulation , urology , prospective cohort study , urinary system
Objectives Narrow band imaging cystoscopy can increase the visualization and detection of H unner's lesions. A single‐center, prospective clinical trial was carried out aiming to show the effectiveness of narrow band imaging‐assisted transurethral electrocoagulation for ulcer‐type interstitial cystitis/painful bladder syndrome. Methods A total of 23 patients (19 women and 4 men) diagnosed as having ulcer‐type interstitial cystitis/painful bladder syndrome were included. All typical H unner's lesions and suspected areas identified by narrow band imaging were electrocoagulated endoscopically after the biopsy of those lesions. Therapeutic efficacy was assessed prospectively by using visual analog scale score of pain, O ' L eary– S ant's symptom index, O ' L eary– S ant's problem index and overactive bladder symptom score. Results The mean follow‐up period was 22 months. All patients (100%) experienced a substantial improvement in pain. The average visual analog scale pain scores significantly decreased from 7.3 preoperatively to 1.2 1 month postoperatively. A total of 21 patients (91.3%) who reported improvement had at least a 50% reduction in bladder pain, and five reported complete resolution. Daytime frequency was significantly decreased postoperatively. O ' L eary– S ant's symptom index, O ' L eary– S ant's problem index and overactive bladder symptom score were significantly decreased postoperatively. However, during the follow‐up period, a total of six patients had recurrence, and repeat narrow band imaging‐assisted transurethral electrocoagulation of the recurrent lesions was carried out for five of the six patients, with good response in relieving bladder pain. Conclusions Our results showed that narrow band imaging‐assisted transurethral electrocoagulation could be a valuable therapeutic alternative in patients with ulcer‐type interstitial cystitis/painful bladder syndrome, with good efficacy and reduction of recurrence rate.