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Cystoscopy, an indispensable tool for the diagnosis and prognosis of bladder pain syndrome, takes nomograms for predicting recurrence

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Abstract

Purpose

We aimed to illustrate the importance of cystoscopy for the diagnosis and prognosis of bladder pain syndrome (BPS) or interstitial cystitis (IC).

Methods and materials

We designed a 4-year prospective follow-up study. Patients who underwent cystoscopy between May 2011 and July 2021 with a diagnosis of BPS/IC before surgery or positive cystoscopic findings during initial surgery at Peking University People's Hospital were enrolled. Data related to symptom recurrence were obtained through clinic visits and telephone follow-up. We compared the differences in clinical features of BPS/IC subtypes differentiated by cystoscopy and first created clinical predictive nomograms for BPS/IC.

Results

A total of 141 patients were included. There was an 8.51% chance of BPS/IC being misdiagnosed as other diseases or other diseases being misdiagnosed as BPS/IC without cystoscopy. Patients with HIC had higher pain scores and ICPI, higher residual urine volume, lower first-sense-to-void, and maximum cystometric bladder capacities than NHIC. Nomogram Models showed that patients who with higher ICPI, ICSI and lower AMBC have a greater recurrence probability, and lesions in the trigone may indicate a greater likelihood of recurrence than lesions in other bladder walls.

Conclusions

Timely detection of bladder cancer and other diseases using cystoscopy can avoid poor treatment effects. BPS/IC subtypes can be classified according to mucosal changes under cystoscopy. Lesions in the bladder triangle can indicate a higher recurrence risk, which is important in follow-up treatment. We strongly recommend that cystoscopy should be included in the international BPS/IC diagnostic criteria.

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Data availability

The authors confirm that the data supporting the findings of this study are available within the article or its supplementary materials.

Abbreviations

AMBC:

Maximum bladder capacity under anesthesia

BPS:

Bladder pain syndrome

CWH:

Cystoscopy with hydrodistension

HIC:

Interstitial cystitis with Hunner lesions

IC:

Interstitial cystitis

ICPI:

Interstitial cystitis problem index

ICSI:

Interstitial cystitis symptom index

NHIC:

Interstitial cystitis without Hunner lesions

OABSS:

Overactive bladder symptom score

PUF:

Patient urgency and frequency scale

SUI:

Stress urinary incontinence

VAS:

Visual analog scale

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Funding

This study was supported by the National Natural Science Foundation of China (Grant No.81970660).

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Authors and Affiliations

  1. Department of Urology, Peking University People’s Hospital, Beijing, 100044, China

    Lin Zhu, Hanwei Ke, Qi Wang & Kexin Xu

  2. Peking University Applied Lithotripsy Institute, Peking University People’s Hospital, Beijing, 10034, China

    Lin Zhu, Hanwei Ke, Qi Wang & Kexin Xu

Authors
  1. Lin Zhu
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  2. Hanwei Ke
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  3. Qi Wang
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  4. Kexin Xu
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Contributions

Zhu: Data collection, data analysis, manuscript writing. Ke: Manuscript writing. Wang: Data collection. Xu: Project development.

Corresponding author

Correspondence to Kexin Xu.

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The authors declare that they have no conflicts of interests.

Research involving human participants and/or animals

Anonymous data of human participants were involved in this study. Animals were not included in this study.

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Informed consent was obtained from all individual participants included in the study.

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Zhu, L., Ke, H., Wang, Q. et al. Cystoscopy, an indispensable tool for the diagnosis and prognosis of bladder pain syndrome, takes nomograms for predicting recurrence. World J Urol 41, 2451–2458 (2023). https://doi.org/10.1007/s00345-023-04517-6

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  • DOI: https://doi.org/10.1007/s00345-023-04517-6

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