Introduction and hypothesis
The purpose of this study was to investigate change in bladder capacity as a measure of response to combined intravesical dimethyl sulfoxide (DMSO) and triamcinolone instillations for the treatment of newly diagnosed bladder pain syndrome/interstitial cystitis (BPS/IC).
141 newly diagnosed women were identified retrospectively. 79 were treated with weekly DMSO/triamcinolone instillations. Change in bladder capacity with bladder retrofill, daytime urinary frequency, nocturia episodes per night, and Likert scale symptom scores were reviewed. Wilcoxon signed-rank tests, Wilcoxon rank-sum tests, Spearman’s rank correlations, COX regression analysis, and a Kaplan-Meier survival curve were performed.
Significant changes (median (25th-percentile to 75th-percentile) were noted for bladder capacity (75 mL (25 to 130 mL), p < 0.0001), inter-void interval (0 hrs (0 to 1 hour), p < 0.0001), nocturia episodes per night (−1 (−2 to 0), p < 0.0001), and aggregate Likert symptom scores (−2 points (−5 to 0), p < 0.0001). Percent change in bladder capacity correlated positively with percent change in inter-void interval (p = 0.03) and negatively with percent changes in nocturia (p = 0.17) and symptom scores (p = 0.01). Women without detrusor overactivity (DO) had greater percent changes in capacity than women with DO (62.5 % vs. 16.5 %, p = 0.02). 61.3 % of patients were retreated with a 36 weeks median time to retreatment and no difference in time to retreatment based upon DO. Greater capacity was protective against retreatment (hazard ratio = 0.997 [95 % CI 0.994,0.999], p = 0.02).
Percent change in bladder capacity is a useful objective measure of response to intravesical DMSO/triamcinolone for newly diagnosed BPS/IC. Clinical outcomes do not differ based upon presence of DO.
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bladder pain syndrome/interstitial cystitis
Stewart BH, Persky L, Kiser WS (1967) The use of dimethyl sulfoxide (DMSO) in the treatment of interstitial cystitis. J Urol 98:671–672
Perez-Marrero R, Emerson L, Juma S (1987) Urodynamic studies in interstitical cystitis. Urology 29:27–30
Stewart BH, Branson AC, Hewitt CB, Kiser WS, Straffon RA (1972) The treatment of patients with interstitial cystitis, with special reference to intravesical DMSO. J Urol 107:377–380
Stewart BH, Shirley SW (1976) Further experience with intravesical dimethyl sulfoxide in the treatment of interstitial cystitis. J Urol 116:36–38
Fowler JE (1981) Prospective study of intravesicular dimethyl sulfoxide in treatment of suspected early interstitial cystitis. Urology 18:21–26
Peeker R, Haghsheno M, Holmang S, Fall M (2000) Intravesical bacillus calmette-guerin and dimethyl sulfoxide for treatment of classic and nonulcerative interstitial cystitis: a prospective, randomized double-blid study. J Urol 164:1912–1916
Perez-Marrero R, Emerson LE, Feltis JT (1988) A controlled study of dimethyl sulfoxide in interstitial cystisis. J Urol 140:36–39
Peeker R, Haghsheno M-A, Holmang S, Fall M (2000) Intravesical bacillus Calmette-Geurin and dimethyl sulfoxide for treatment of classic and nonulcer interstitial cystitis: a prospective, randomized double-blind study. J Urol 164:1912–1916
Hanno PM, Burks DA, Clemens JQ et al (2011) AUA guideline for the diagnosis and treatmetn of interstitial cystitis/bladder pain syndrome. J Urol 185:2162–2170
Hanno P, Lin A, Nordling J et al (2010) Bladder pain syndrome International Consultation on Incontinence. Neurourol Urodyn 29:191–198
Haylen BT, de Ridder D, Freeman RM et al (2010) An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J 21:5–26
Nigro DA, Wein AJ, Foy M (1997) Associations among cystoscopic and urodynamic findings for women enrolled in the interstitial cystitis data base (ICDB) study. Urology 49(Supplement 5A):86–92
Hanno P, Lin A, Nordling J, Nyberg L, van Ophoven A, Ueda T (2009) Bladder Pain Syndrome International Consultation on Incontinence. In: Abrams P, Cardozo L, Khoury S, Wein A (eds) Incontinence. 4th International Consultation on Incontinence. Health Publication Ltd. 1459–1518.
Pfisterer MHD, Griffiths DJ, Rosenberg L, Schaefer W, Resnick NM (2006) The impact of detrusor overactivity on bladder function in younger and older women. J Urol 175:1777–1783
Steinkohl WB, Leach GE (1989) Urodynamic findings in interstitial cystitis. Urology 34:399–401
Kirkemo A, Peabody M, Diokno AC (1997) Associations among urodynamic findings and symptoms in women enrolled in the interstitial cystitis data base (ICDB) study. Urology 49(Supplement 5A):76–80
Hald T, Barnard RJ, Holm-Bentzen M (1986) Treatment of interstitial cystitis. In: George NJR, Gosling JA (eds) Sensory disorders of the bladder and urethra. Springer-Verlag, Berlin, pp 73–78
Gafni-Kane A, Du H, Nguyen A, Vu M, Goldberg RP, Sand PK, Botros S (2010) Functional bladder capacity as an objective measure of response to intravesical dimethyl sulfoxide for the treatment of newly diagnosed interstitial cystitis. Neurourol Urodyn 29:302–303
Coolsaet B (1985) Bladder compliance and detrusor activity during the collection phase. Neurourol Urodyn 4:263–273
Gillenwater J, Wein AJ (1988) 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 140:203–206
Hanno PM, Landi JR, Matthews-Cook Y et al (1999) The diagnosis of interstitial cystitis revisited: lessons learned from the National Institutes of Health Interstitial Cystitis Database Study. J Urol 161:553–557
Botros SM, Miller J-JR, Goldberg RP et al (2007) Detrusor overactivity and urge urinary incontinence following trans obturator versus midurethral slings. Neurourol Urodyn 26:42–45
Gamble TL, Botros SM, Beaumont JL (2008) Predictors of persistent detrusor overactivity after transvaginal sling procedures. Am J Obstet Gynecol 199:696.e1–696.e7
Dunn M, Ramsden PD, Roberts JBM, Smith JC, Smith PJB (1977) Interstitial cystitis treated by prolonged bladder distension. Br J Urol 49:641–645
Glemain P, Riviere C, Lenormand L, Karam G, Bouchot JB (2002) Prolonged hydrodistension of the bladder for symptomatic treatment of interstitial cystitis: efficacy at 6 months and 1 year. Eur Urol 41:79–84
Yamada T, Murayama T, Andoh M (2003) Adjuvant hydrodistension under epidural anesthesia for interstitial cystitics. Int J Urol 10:463–468
Ottem DP, Teichman JMH (2005) What is the value of cystoscopy with hydrodistension for interstitial cystitis? Urology 66(3):494–499
Hsieh C-H, Chang S-T, Hsieh C-J et al (2008) Treatment of interstitial cystitis with hydrodistension and bladder training. Int Urogynecol J 19:1379–1384
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Gafni-Kane, A., Botros, S.M., Du, H. et al. Measuring the success of combined intravesical dimethyl sulfoxide and triamcinolone for treatment of bladder pain syndrome/interstitial cystitis. Int Urogynecol J 24, 303–311 (2013). https://doi.org/10.1007/s00192-012-1832-x
- Administration, intravesical
- Cystitis, interstitial
- Dimethyl sulfoxide
- Painful bladder syndrome