Autonomic Response During Bladder Hydrodistention Reflects the Severity of Symptoms in Patients with Bladder Pain Syndrome/Interstitial Cystitis

作者：Kim Sang Woon; Son Hee Seo; Troya Irela Soto; Kim Ji Yu; Kim Myoung Joo; Fraser Matthew O; Kim Jang Hwan

来源：Neurourology and Urodynamics, 2017, 36(3): 677-682.

DOI：10.1002/nau.22994

• autonomic nervous system
• bladder pain syndrome
• interstitial cystitis

Aims To evaluate the correlation between symptom severity of bladder pain syndrome/interstitial cystitis (BPS/IC) and autonomic nervous system activity, we examined autonomic responses during bladder hydrodistention.Methods Medical records were collected from a prospective database for patients who underwent bladder hydrodistention with a fixed protocol from March 2012 to December 2013. A total of 40 patients (16 males, 24 females) were included for the analysis. Hydrodistention was performed under general anesthesia (31 patients), spinal anesthesia (six patients), and both types of anesthesia (three patients) at different times. Twenty-five patients who underwent holmium laser enucleation of the prostate served as controls. Pulse rate (PR), systolic (SBP), and diastolic blood pressure (BP) were measured pre-hydrodistention, during hydrodistention, and after drainage.Results The spinal anesthesia and control groups exhibited little change in BP and PR during hydrodistention, while a significant increase was demonstrated in the general anesthesia group (e.g., SBP 4.894.80, 10.40 +/- 19.03, and 56.26 +/- 30.38mm Hg, respectively, P<0.001). Under general anesthesia, autonomic response during hydrodistention was more prominent in patients with preoperative visual analogue scale (VAS) pain score 7, Hunner's lesion, and glomerulation grade 4. Preoperative maximal cystometric capacity negatively correlated with changes in SBP during hydrodistention (R-2=0.294, P=0.009), while VAS score and interstitial cystitis problem index demonstrated a positive correlation with the changes (R-2=0.208, P=0.012; R-2=0.173, P=0.015).Conclusions Under general anesthesia, exaggerated autonomic responses to bladder hydrodistention were demonstrated in BPS/IC patients, which reflected the severity of symptoms. These results support the hypothesis of altered activity of autonomic system in BPS/IC.

• 出版日期2017-3
• 单位河北医科大学