Ruling out other conditions needed with suspected interstitial cystitis

Efforts to rule out bladder tumors and tuberculosis are still essential in the follow-up of patients with suspected interstitial cystitis (IC), according to a study published online Aug. 11 in the International Journal of Gynecology & Obstetrics.

Hyun Ju Jeong, from the Seoul National University College of Medicine in South Korea, and colleagues reviewed the electronic medical records of 646 consecutive patients with pelvic pain diagnosed with IC between October 2005 and December 2019 to understand the impact of excluding confusable diseases.

The researchers found that 74.6% of patients underwent observational cystoscopy under the suspicion of IC; 2.2% (14 patients) had genitourinary tract malignancies, including bladder cancer (13 patients) and prostate cancer (one patient). Among individuals with bladder cancer, three patients were diagnosed during initial observation cystoscopy, while the remaining 10 patients were diagnosed during subsequent follow-up cystoscopic surgery.

Seven patients overall were diagnosed with urinary tuberculosis (1.1%); five of the six patients (0.8%) with suspected urinary tuberculosis at baseline imaging were positive for tuberculosis in the acid-fast bacillus test. Tuberculous granulomas in the bladder tissue developed in one patient after a cystectomy for intractable pelvic pain.

"Our results show that continuous efforts to rule out bladder tumors or tuberculosis are still essential in the follow-up of patients with suspected IC, even if these diseases are not excluded at the initial examination," the authors write. "Imaging studies are necessary to rule out tuberculosis."

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