Abstract
Originally, interstitial cystitis was described as a particular, severe inflammation of the urinary bladder. When cystoscopes became available it was possible to diagnose the disease endoscopically, as described by Guy Hunner in his classic papers. More than a 100 years after the pioneering reports a new paradigm was launched and, while preserving the denomination IC, the concept was widened to include a larger population of subjects with bladder pain. With this approach cystoscopy was regarded as less important in the diagnostic workup. It has become evident, though, that the classic Hunner type of disease, the primary understanding of the diagnosis IC, stands out as a distinct entity. Examples of differences are that the results of various treatments and complication patterns, respectively, differ between phenotypes. The Hunner type of disease is more rewarding to treat, including excellent responses to ablative surgery, in bright contrast to other bladder pain syndrome (BPS) phenotypes. With this knowledge in mind it is not justifiable to do without confirmation or exclusion of this entity when evaluating chronic bladder pain. Cystoscopy and hydrodistension are still the means to make the differentiation. In this chapter, directions for how to carry out cystoscopy and hydrodistension in BPS are presented together with some typical examples of findings.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Skene AJC. Diseases of bladder and urethra in women. New York: Wm Wood; 1887. p. 167.
Hunner GL. Elusive ulcer of the bladder: further notes on a rare type of bladder ulcer with report of 25 cases. Am J Obstet. 1918;78:374–95.
Messing EM, Stamey TA. Interstitial cystitis: early diagnosis, pathology and treatment. Urology. 1978;12:381–92.
Fall M, Johansson SL, Aldenborg F. Chronic interstitial cystitis: a heterogeneous syndrome. J Urol. 1987;137:35–8.
Gillenwater JY, Wein AJ. 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. 1988;140(1):203–6.
Hanno P, et al. The diagnosis of interstitial cystitis revisited: lessons learned from the National Institutes of Health Interstitial Cystitis Database study. J Urol. 1999;161:553–7.
Oravisto KJ. Epidemiology of interstitial cystitis. Ann Chir Gynaecol Finn. 1975;64:75–7.
Wyndaele J, Van Dyck J, Toussaint N. Cystoscopy and bladder biopsies in patients with bladder pain syndrome carried out following ESSIC guidelines. Scand J Urol Nephrol. 2009;25:1–5.
van de Merwe J, et al. Diagnostic criteria, classification, and nomenclature for painful bladder syndrome/interstitial cystitis: an ESSIC proposal. Eur Urol. 2008;53:60–7.
Nordling J, et al. Primary evaluation of patients suspected of having interstitial cystitis (IC). Eur Urol. 2004;45:662–9.
Sant G, Meares EJ. Interstitial cystitis: pathogenesis, diagnosis, and treatment. Infect Urol. 1990;31:24–30.
Peeker R, Fall M. Toward a precise definition of interstitial cystitis: further evidence of differences in classic and nonulcer disease. J Urol. 2002;167:2470–2.
Messing EM. The diagnosis of interstitial cystitis. Urology. 1987;29(4 Suppl):4–7.
Lamale L, et al. Symptoms and cystoscopic findings in patients with untreated interstitial cystitis. Urology. 2006;67:242–5.
Herbst RH, Baumrucker GO, German KL. Elusive ulcer (Hunner) of the bladder with an experimental study of the etiology. Am J Surg. 1937;38:152–6.
Badenoch AW. Chronic interstitial cystitis. Br J Urol. 1971;43:718–21.
Braunstein R, et al. The role of cystoscopy in the diagnosis of Hunner’s ulcer disease. J Urol. 2008;180:1383–6.
Nigro D, Wein A. Interstitial cystitis: clinical and endoscopic features. In: Sant GR, editor. Interstitial cystitis. Philadelphia: Lippincott-Raven; 1997. p. 137–42.
Waxman J, Sulak P, Kuehl T. Cystoscopic findings consistent with interstitial cystitis in normal women undergoing tubal ligation. J Urol. 1998;160:1663–7.
Furuya R, et al. Glomerulation observed during transurethral resection of the prostate for patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia is a common finding but no predictor of clinical outcome. Urology. 2007;70(5):922–6.
Sant G. Diagnosis of interstitial cystitis: a clinical, endoscopic and pathologic approach. In: Hanno PM, Staskin DR, Krane RJ, Wein AJ, editors. Interstitial cystitis. London: Springer; 1990. p. 107–14.
Messing E, et al. Associations among cystoscopic findings and symptoms and physical examination findings in women enrolled in the Interstitial Cystitis Data Base (ICDB) Study. Urology. 1997;49:81–5.
Johansson SL, Fall M. Clinical features and spectrum of light microscopic changes in interstitial cystitis. J Urol. 1990;143(6):1118–24.
Zabihi N, Allee T, Maher MG, et al. Bladder necrosis following hydrodistention in patients with interstitial cystitis. J Urol. 2007;177:149–52.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2013 Springer Science+Business Media New York
About this chapter
Cite this chapter
Zaytsev, A., Fall, M. (2013). Cystoscopy and Hydrodistension in the Diagnosis of Bladder Pain Syndrome. In: Nordling, J., Wyndaele, J., van de Merwe, J., Bouchelouche, P., Cervigni, M., Fall, M. (eds) Bladder Pain Syndrome. Springer, Boston, MA. https://doi.org/10.1007/978-1-4419-6929-3_15
Download citation
DOI: https://doi.org/10.1007/978-1-4419-6929-3_15
Published:
Publisher Name: Springer, Boston, MA
Print ISBN: 978-1-4419-6928-6
Online ISBN: 978-1-4419-6929-3
eBook Packages: MedicineMedicine (R0)