Interstitial cystitis: clinical aspects, diagnosis and response to cimetidine
Fiche publication
Date publication
septembre 2009
Auteurs
Membres identifiés du Cancéropôle Est :
Pr JACQMIN Didier, Pr LANG Hervé
Tous les auteurs :
Mouracade P, Ej-Jennane A, Lang H, Jacqmin D, Saussine C
Lien Pubmed
Résumé
Describe the features characterising patients diagnosed with interstitial cystitis (IC). Assess the results of the various diagnostic tests and patient response to treatment with cimetidine (TagametA (R)). Cohort study of 139 female patients treated for IC between 1998 and 2007. Diagnosis was suspected during questioning and confirmed by bladder hydrodistention, urodynamic assessment, voiding diary, KCl test and an O'Leary-Sant questionnaire once other pathologies had been eliminated. First line therapy was cimetidine, 1 x 200 mg tablet morning and evening. We studied patient demographic characteristics, described the clinical aspects and determined the results of the various diagnostic tests and patient response to cimetidine treatment. Time elapsed between onset of symptoms and diagnosis averaged 7.5 years. Hundred percent of patients experienced troublesome urgency, 86% daytime pollakiuria, 65% nycturia and a pelvic burning sensation was experienced by 52%. The pain was felt in the perineum by 76% of patients, the genitals by 40% and above the pubic bone by 85%. Cystoscopy and/or histology were abnormal in 92% of patients and Hunner's ulcers were found in 2.2% of patients. At diagnosis, the median score on the O'Leary-Sant symptom questionnaire was 14.98 +/- 3.38 (7-20), the median score on the O'Leary-Sant problem questionnaire was 13.5 +/- 2.42 (8-16). Bladder capacity was over 350 cc in 20% of cases. The KCl test was positive in 80.5% of patients. Patients presenting abnormal cystoscopy/histology results received cimetidine as first-line treatment. During follow-up, 77 patients (60%) had improved O'Leary-Sant scores, with 38 patients (30%) showing an improvement of over 50%. Patients suffering from IC experience symptoms for an average of 7.5 years before the condition is diagnosed. Symptoms vary, but all patients experience troublesome feelings of urgency, which is thus the main symptom to suggest a diagnosis of IVC, rather than pain above the pubic bone. Cimetidine is an effective treatment for some patients.
Référence
Pelvi-perineologie. 2009 Sep;4(3):184-7