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The purpose of a preliminary assessment of the clinical incidence of the the Nanjing hospital outpatient bladder pain syndrome / interstitial cystitis (painfulbladder syndrome, PBS / interstitial cystitis, IC) to improve the detection rate of painful bladder syndrome / interstitial cystitis, Meanwhile, in order to further improve the urologists lower urinary tract symptoms of painful bladder syndrome / interstitial cystitis incidence of awareness, analysis of the results from epidemiological research, clinical diagnosis and treatment of this disease epidemic Foundation, to explore ways of effective diagnosis and treatment. The proportion of patients diagnosed intervention therapy observed intravesical instillation sodium hyaluronate (sodiumhyaluronate,, HS), intravesical injection of botulinum toxin type A (botulinum toxin A, BTX-A) on the effectiveness of women PBS / IC security. Method 1. November 2008 to December 2010 in Nanjing Urology outpatient non-urinary tract infections, non-prostatic hyperplasia but with frequent urination, urgency, bladder filling suprapubic pain or pelvic pain The main symptoms of the patient based on population, conducted a questionnaire survey, screening suspected patients, the establishment of a database of patients, the use of PUF (pelvic Pain and urgency / frequency the Patient symptomscale, pelvic pain and urgency / frequent urination Symptom Scale) and NIDDK (the national the institute ofdiabetes and Digestive and Kidney Diseases, National Institute of Diabetes, Digestive and Kidney Diseases Research Institute) diagnostic criteria, and urine culture, urine find exfoliated cells, urine for AFB, urodynamics, urinary B-, potassium sensitivity test (potassium sensitive test, PST), anesthesia water expansion and the bladder mucosa random biopsy examination, to explicitly exclude urinary and reproductive tract infections, cancer, tuberculosis disease caused by lower urinary tract symptoms, and analysis may be related to the occurrence of the risk factors. 41 female patients with bladder pain syndrome / interstitial cystitis intravesical sodium hyaluronate group (group A, n = 22) and bladder injection of type A botulinum toxin group (B group, 19 cases were randomly divided into ). The patient is asked to record voiding diary, regular follow-up assessment of patients before treatment and 3 and 6 months after treatment, clinical symptoms (daily frequency of urination, pain scores), O Leary-Sant questionnaire score and urodynamic indicators and record the occurrence of adverse reactions. The two groups were compared efficacy and adverse reactions to assess the efficacy and safety of the two groups. Results received 278 valid questionnaires patients, male 82, female, 196, the PUF score greater than 15, 84, urine culture, urine looking exfoliated cells, urine for AFB, urodynamic study , urinary B-6 exclude the remaining 78 patients underwent PST test results of 71 cases of positive the PST positive rate was 91.0%, the last line of anesthetic into the water expansion and random biopsy of the bladder mucosa, diagnosed 52 cases of bladder pain syndrome / interstitial cystitis cases were female, age 21-67 years, average (32.5 ± 10.7) years, duration of 40-120 months, the average duration (58.6 ± 12.1) months, the incidence compared to The more population concentrated in the age group of 51-60 years and 41-50 years, respectively, accounted for 42.3% and 30.8%, the detection rate of 18.7%. PBS / IC in the study population occurred may be larger with age (≥ 40 years) (P lt; 0.01, OR = 3.37), eating spicy food (P lt; 0.01, OR = 2.70), a history of gynecological infections ( P lt; 0.01, OR = 3.24). The differences were statistically significant (P lt; 0.05) after the treatment of the two groups of patients at each time point indexes for evaluation and treatment before. Before treatment and 1 month after treatment in two groups of patients in clinical symptoms and O Leary-Sant score difference was significant (P gt; 0.05), 3 months and 6 months after treatment, the two groups compared to the difference There are significant (P lt; 0.05). Before treatment and 1 month, 3 months, two groups in urodynamic indicators compare the difference was not statistically significant (P gt; 0.05), 6 months after treatment between the two groups the difference was statistically significant (P lt ; 0.05). A group of patients does not appear serious adverse reactions. 3 patients in group B 3 dysuria, gradually improve, no other adverse reactions. A, B groups were 2 cases, 1 patient minor gross hematuria line anesthetic into the water after the expansion, after gradually disappear. Group A patients discontinuing treatment due to medical examination found that heart disease, and the remaining patients completed the treatment and follow-up. Conclusion painful bladder syndrome / interstitial cystitis multiple women, more common in middle-aged women, high average age, eating spicy food and previous history of gynecological infections may increase the risk of the disease. The main clinical symptoms of urinary frequency and bladder filling related to the pubic area pain or pelvic pain mainly after voiding symptoms. Urinary frequency and degree of pain varies. The vast majority of patients potassium sensitivity test result is positive, prompt pain from the bladder, increased permeability of the bladder mucosa. Potassium sensitivity test has a high positive rate and the sensitivity of the clinical diagnosis of the PUF score, NIDDK diagnostic criteria and potassium sensitivity test together, can improve the accuracy of diagnosis. 2 intravesical sodium hyaluronate can effectively alleviate the PBS / IC patients with clinical symptoms, increased bladder capacity, improve their quality of life, patient tolerance and safety are good. Intravesical injection of botulinum toxin type A short term to alleviate the symptoms, but the effects decreased over time, and accompanied by a small amount of adverse events, adverse reactions gradually improved with the decrease of efficacy. Comparison of both efficacy and safety of intravesical sodium hyaluronate is superior to intravesical injection of botulinum toxin type A.
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