title: Therapeutic efficacy of narrow band imaging-assisted transurethral electrocoagulation for ulcer-type interstitial cystitis/painful bladder syndrome.
abstract: OBJECTIVE
  Narrow band imaging cystoscopy can increase the visualization and detection of Hunner's lesions. A single-center, prospective clinical trial was carried out aiming to show the effectiveness of narrow band imaging-assisted transurethral electrocoagulation for ulcer-type interstitial cystitis/painful bladder syndrome.
  
  
  METHODS
  A total of 23 patients (19 women and 4 men) diagnosed as having ulcer-type interstitial cystitis/painful bladder syndrome were included. All typical Hunner's lesions and suspected areas identified by narrow band imaging were electrocoagulated endoscopically after the biopsy of those lesions. Therapeutic efficacy was assessed prospectively by using visual analog scale score of pain, O'Leary-Sant's symptom index, O'Leary-Sant's problem index and overactive bladder symptom score.
  
  
  RESULTS
  The mean follow-up period was 22 months. All patients (100%) experienced a substantial improvement in pain. The average visual analog scale pain scores significantly decreased from 7.3 preoperatively to 1.2 1 month postoperatively. A total of 21 patients (91.3%) who reported improvement had at least a 50% reduction in bladder pain, and five reported complete resolution. Daytime frequency was significantly decreased postoperatively. O'Leary-Sant's symptom index, O'Leary-Sant's problem index and overactive bladder symptom score were significantly decreased postoperatively. However, during the follow-up period, a total of six patients had recurrence, and repeat narrow band imaging-assisted transurethral electrocoagulation of the recurrent lesions was carried out for five of the six patients, with good response in relieving bladder pain.
  
  
  CONCLUSIONS
  Our results showed that narrow band imaging-assisted transurethral electrocoagulation could be a valuable therapeutic alternative in patients with ulcer-type interstitial cystitis/painful bladder syndrome, with good efficacy and reduction of recurrence rate.
authors.affiliation: Department of Urology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Hiroshima, Japan.
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Kajiwara
authors.forename: Shougo
authors.initials: S
authors.lastname: Inoue
authors.forename: Kanao
authors.initials: K
authors.lastname: Kobayashi
authors.forename: Shinya
authors.initials: S
authors.lastname: Ohara
authors.forename: Jun
authors.initials: J
authors.lastname: Teishima
authors.forename: Akio
authors.initials: A
authors.lastname: Matsubara
mesh_terms: D000368:Aged; D018856:Cystitis, Interstitial / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D003558:Cystoscopy / Q000009:adverse effects / Q000379:methods; D004564:Electrocoagulation / Q000009:adverse effects / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D061705:Image-Guided Biopsy / Q000379:methods; D008297:Male; D062048:Narrow Band Imaging / Q000379:methods; D010147:Pain Measurement; D017699:Pelvic Pain / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D012008:Recurrence; D012086:Reoperation; D016896:Treatment Outcome; D014456:Ulcer / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D001743:Urinary Bladder / Q000473:pathology
keywords: Hunner's lesions; bladder pain; cystoscope; electrocoagulation; narrow band imaging