Intravesical ethanol test: an ineffective measure of bladder hyperpermeability.
OBJECTIVE
To evaluate the intravesical ethanol test as a quantitative measure of bladder hyperpermeability in patients with interstitial cystitis.


METHODS
Patients with a clinical diagnosis of interstitial cystitis and a positive result on the Parsons potassium test were enrolled in the study. The intravesical ethanol test was conducted after completion of the Parsons potassium test. Dose escalation (10% to 20% ethanol) was performed in an attempt to achieve detectable levels of ethanol. Breathalyzer data were recorded in 5-minute intervals for 30 minutes using a calibrated Intox Breathalyzer Model IV Alcosensor. The bladder was then drained, and volume recovered was recorded. The breathalyzer data were recorded for an additional 30 minutes after removal of the catheter at 5-minute intervals.


RESULTS
The 3 patients studied demonstrated significant qualitative evidence of bladder hyperpermeability, with pain and urgency scores ranging from 4 to 5 on the Parsons potassium test. No detectable levels of ethanol were identified in any of the 3 patients after the intravesical ethanol test, with up to 50 mL of 20% ethanol instilled for 30 minutes. Intravesical ethanol instillation was not associated with significant pain or irritative voiding symptoms.


CONCLUSIONS
The intravesical ethanol test did not prove to be a useful clinical adjunct in the diagnosis and management of interstitial cystitis. The evaluation of higher concentrations of ethanol may be warranted.
Gordon
Zachary
Z
Division of Urology, University of California, San Diego, School of Medicine, San Diego, California, USA.
Parsons
C Lowell
CL
Monga
Manoj
M
D000283:Administration, Intravesical; D000328:Adult; D001944:Breath Tests; D018856:Cystitis, Interstitial / Q000175:diagnosis* / Q000378:metabolism; D004305:Dose-Response Relationship, Drug; D000431:Ethanol / Q000097:blood* / Q000493:pharmacokinetics; D005260:Female; D006801:Humans; D008875:Middle Aged; D010539:Permeability / Q000187:drug effects; D011188:Potassium / Q000494:pharmacology; D013997:Time Factors; D001743:Urinary Bladder / Q000187:drug effects / Q000378:metabolism*; D001745:Urinary Bladder Diseases / Q000175:diagnosis* / Q000378:metabolism; D014554:Urination / Q000187:drug effects / Q000502:physiology
D000431:Ethanol; D011188:Potassium