Cystoscopic Hydrodistension Under Local Anesthesia: Therapeutic Implications in Non-Hunner IC Subtypes.

OBJECTIVE

This study aims to investigate the effect of hydrodistension under local anesthesia on clinical outcomes in subtypes of non-Hunner lesion interstitial cystitis (NHIC), categorized by hemorrhage severity.

METHODS

Based on a simplified bladder hemorrhage grading system, we enrolled 12 female patients with multiple or diffuse punctate hemorrhage (Group IC1) and 12 female patients with focal punctate hemorrhage only (Group IC2). All participants underwent cystoscopy with hydrodistension (CWH). Maximum bladder capacity (MBC), Interstitial Cystitis Symptom Index (ICSI), Interstitial Cystitis Problem Index (ICPI), and visual analogue scale (VAS) were recorded at baseline, and participants were followed up for 6 months.

RESULTS

Group IC1 exhibited significantly lower preoperative MBC (p<0.05). All outcome measures improved significantly at one week post-procedure in both groups (p<0.05), with no significant between-group difference in the magnitude of improvement (p>0.05). During subsequent follow-up, ICSI scores in Group IC1 increased significantly at 3 months (p<0.05), whereas ICPI scores in both groups increased significantly at 6 months (p<0.05).

CONCLUSION

NHIC patients with more severe bladder mucosal hemorrhage exhibited smaller baseline MBC and earlier ICSI score elevation following CWH under local anesthesia. These findings may inform individualized intervention strategies, support the development of efficacy prediction models, and optimize follow-up protocols and treatment escalation timing, thereby contributing to improved quality of life in this patient population.