title: Changes in urine markers and symptoms after bladder distention for interstitial cystitis.
abstract: OBJECTIVE
  We evaluated changes in urine markers and symptom scores after bladder distention in patients with interstitial cystitis.
  
  
  METHODS
  Study subjects were 33 new patients who had undergone no prior interstitial cystitis treatment. Urine specimens were taken before and 1 month after bladder distention. University of Wisconsin symptom scores were done the same day as the urine specimen collection. Urine marker levels and symptom scores before and after distention were compared. Changes in markers were tested for associations with changes in symptom scores and other markers. Markers and specific symptoms before distention were tested for their association with post-distention symptom improvement.
  
  
  RESULTS
  After distention the median total University of Wisconsin score decreased significantly (28.5 before, 20 after, p <0.001). A total of 12 patients (36%) had at least 30% improvement in University of Wisconsin score, and 8 patients (24%) had at least 50% improvement. No pre-distention markers or symptoms predicted which patients would have a good response. There were 2 urine markers that improved significantly after distention: anti-proliferative factor activity (median -96% before, -17% after, p <0.001) and heparin-binding epidermal growth factor-like growth factor levels (median 0.34 ng/mg creatinine before, 4.1 after, p <0.001). None of the changes in urine markers associated with changes in symptom scores.
  
  
  CONCLUSIONS
  The median symptom score for newly diagnosed patients with interstitial cystitis decreased after distention, but only a minority of patients had at least 30% symptom improvement. Bladder distention altered urine anti-proliferative factor activity and heparin-binding epidermal growth factor-like growth factor levels toward normal, but the mechanism of symptom relief after distention is still unknown.
authors.affiliation: Department of Surgery, Division of Urology, University of Kentucky College of Medicine, Lexington, Kentucky 40536-0298, USA. dreric2@email.uky.edu
authors.forename: Deborah R
authors.initials: DR
authors.lastname: Erickson
authors.forename: Allen R
authors.initials: AR
authors.lastname: Kunselman
authors.forename: Christina M
authors.initials: CM
authors.lastname: Bentley
authors.forename: Kenneth M
authors.initials: KM
authors.lastname: Peters
authors.forename: Eric S
authors.initials: ES
authors.lastname: Rovner
authors.forename: Laurence M
authors.initials: LM
authors.lastname: Demers
authors.forename: Marcia A
authors.initials: MA
authors.lastname: Wheeler
authors.forename: Susan K
authors.initials: SK
authors.lastname: Keay
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000652:urine; D018856:Cystitis, Interstitial / Q000628:therapy* / Q000652:urine*; D005260:Female; D006801:Humans; D007327:Insufflation; D008297:Male; D008875:Middle Aged
chemical_list: D015415:Biomarkers