Measuring the success of combined intravesical dimethyl sulfoxide and triamcinolone for treatment of bladder pain syndrome/interstitial cystitis
International Urogynecology Journal, 06/20/2012
Gafni–Kane A et al. – Percent change in bladder capacity is a useful objective measure of response to intravesical dimethyl sulfoxide (DMSO)/triamcinolone for newly diagnosed bladder pain syndrome/interstitial cystitis (BPS/IC). Clinical outcomes do not differ based upon presence of DO.Methods
- 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).