使用臨床特徵、膀胱鏡檢查結果和尿液生物標誌物來預測女性間質性膀胱炎/膀胱疼痛症候群的滿意治療效果

楊家誠、劉民慶、郭漢崇、江元宏、張嘉峰、游婉茹、黃子修、李雨霜

花蓮慈濟醫院 泌尿部

Use of clinical characteristics, cystoscopic findings, and urine biomarkers in predicting satisfactory treatment outcome in women with interstitial cystitis/ bladder pain syndrome

Chia-Cheng Yang, Min-Ching Liu, Hann-Chorng Kuo, Yuan-Hong Jiang, Jia-Fong Jhang,

 Wan-Ru Yu, Tsu-Hsiu Huang, Yu-Shuang Lee

Department of Urology, Buddhist Tzu Chi General Hospital, Tzu Chi University, Hualien, Taiwan

Purpose: Currently, there is no effective and durable treatment for all patients with interstitial cystitis/ bladder pain syndrome (IC/BPS). It is possible that multiple pathophysiology underlying this disease. This study investigated the association between clinical parameters and urine biomarkers and overall treatment outcome in women with IC/BPS.

Materials and Methods: Women with IC/BPS were retrospectively included in this study. The clinical symptoms, videourodynamic study, cystoscopic features under anesthesia, and urinary inflammatory and oxidative stress biomarkers were investigated and compared between patients who were satisfactory or unsatisfactory to different bladder therapy for IC/BPS. The clinical parameters were searched for predicting a satisfactory treatment outcome.

Results: A total of 315 IC/BPS patients including 291 non-Hunner’s IC (NHIC) and 24 Hunner’s IC were included, with a mean age of 53.3 ± 13.3 years and a median follow-up period of 10 years. Among the NHIC patients 167 (57.4%) had a satisfactory outcome (GRA 2 or 3) after treatment. NHIC patients with a baseline larger maximal bladder capacity (MBC) in hydrodistention and larger first sensation of filling (FSF) in videourodynamic study predict a satisfactory outcome after different bladder therapy. Patients with higher urinary biomarker levels had poor treatment outcome. The urinary levels of lower C-X-C motif chemokine ligand 10 (CXCL10), 8-hydroxydeoxyguanosine (8-OHdG), and 8-isoprostane also predict a satisfactory treatment outcome in patients with NHIC.

Conclusions: The results of this study revealed that patients with NHIC and had a larger FSF, MBC, lower urinary levels of CXCL 10, 8-OHdG, and 8-isoprostane might have a satisfactory outcome, indicating less bladder inflammation might have a better treatment result.