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Measuring the success of combined intravesical dimethyl sulfoxide and triamcinolone for treatment of bladder pain syndrome/interstitial cystitis

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Abstract

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).

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.

Results

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).

Conclusions

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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Abbreviations

BPS/IC:

bladder pain syndrome/interstitial cystitis

DMSO:

dimethyl sulfoxide

DO:

detrusor overactivity

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Authors and Affiliations

  1. Evanston Continence Center, Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, NorthShore University HealthSystem, University of Chicago, Pritzker School of Medicine, 1000 Central Street #730, Evanston, IL, 60201, USA

    Adam Gafni-Kane, Sylvia M. Botros, Robert I. Sand & Peter K. Sand

  2. Center for Clinical Research and Informatics, NorthShore University HealthSystem, Evanston, IL, USA

    Hongyan Du

Authors
  1. Adam Gafni-Kane
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  2. Sylvia M. Botros
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  3. Hongyan Du
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  4. Robert I. Sand
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  5. Peter K. Sand
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Correspondence to Adam Gafni-Kane.

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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

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  • DOI: https://doi.org/10.1007/s00192-012-1832-x

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