New cystoscopic diagnosis for interstitial cystitis/painful bladder syndrome using narrow-band imaging system.
OBJECTIVE
Diagnosing the bladder lesions associated with interstitial cystitis/painful bladder syndrome (IC/PBS) is sometimes difficult for general urologists. We therefore aimed to develop an IC/PBS diagnosis method using a cystoscope with a narrow-band imaging (NBI) system that can detect mucosal angiogenic lesions.


METHODS
Fifty-two subjects suspected of having IC between October 2006 and June 2007 were included in this study. There were 49 women and three men, ranging in age from 19 through 85 with an average age of 59. First, conventional cystoscopy under spinal anesthesia was performed to examine the ulcerative lesions by a urological specialist. Then, other health care professionals made a separate observation of capillary-rich areas of the superficial layer of the bladder mucosa by cystoscopy with the NBI system.


RESULTS
Among the 52 patients, 37 cases were found to have ulcers by conventional cystoscopy, which were also recognized as capillary-rich brownish areas using the NBI system (100% accuracy); 13 cases were found to have NBI-positive areas without ulcer, which were coincided with those with petechial hemorrhages and glomerulations following subsequent hydrodistention; and two cases of normal mucosa were detected. Furthermore, six cases of bladder cancer (carcinoma in situ) were detected by biopsies that were obtained from the ulcerative lesions positively identified by NBI cystoscopy.


CONCLUSIONS
Examining the urinary bladder mucosa with a flexible cystoscope with the NBI system makes it possible to easily detect ulcers of bladder mucosa and areas with angiogenesis. Therefore, it is considered that the use of a flexible cystoscope with the NBI system is highly practical for the IC/PBS diagnosis.
Ueda
Tomohiro
T
Department of Urology, Kyoto City Hospital, Kyoto, Japan. tom-nobu@muf.biglobe.ne.jp
Nakagawa
Masayuki
M
Okamura
Motohiro
M
Tanoue
Hideki
H
Yoshida
Hiroshi
H
Yoshimura
Naoki
N
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018856:Cystitis, Interstitial / Q000175:diagnosis*; D003558:Cystoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D007089:Image Enhancement; D008297:Male; D008875:Middle Aged; D055815:Young Adult