Increased bladder wall thickness is associated with severe symptoms and reduced bladder capacity in patients with bladder pain syndrome

• Main Authors: Shu-Yu Wu, Jia-Fong Jhang, Yuan-Hong Jiang, Hann-Chorng Kuo
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2016-12-01
• Series: Urological Science
• Subjects: diagnosis; end-stage bladder disease; image study; pain
• Online Access: http://www.sciencedirect.com/science/article/pii/S1879522615002286
• ISSN: 1879-5226

Objective: Patients with interstitial cystitis (IC) and ketamine cystitis (KC) usually have similar symptoms, such as frequency, urgency, and bladder pain. In patients with IC, ulcer type and nonulcer type may have different cystoscopic features. This study investigated the clinical characteristics and bladder wall thickness (BWT) measured using computed tomography (CT) in patients with nonulcer IC, ulcer IC, and KC. Materials and methods: The detailed history and bladder condition of patients with a clinical diagnosis of IC and KC were retrospectively analyzed. An abdominal to pelvis CT scan with/without contrast was performed in every patient. Ulcer type IC was noted in nine patients, nonulcer IC in seven patients, and KC in 13 patients. The bladder mass volume and BWT were measured. Bladder CT images of 10 patients with nonmetastatic renal cancer served as controls. Results: The bladder wall was significantly thicker in all patients with ulcer type IC (8.91 ± 2.67 mm) and KC (10.7 ± 3.44 mm) than in those with nonulcer IC (2.89 ± 0.73 mm) or controls (2.65 ± 0.97 mm). Among KC patients, eight patients received augmentation enterocystoplasty. Moreover, the bladder wall was significantly thicker in patients who underwent augmentation enterocystoplasty (11.50 ± 3.21 mm) than those who did not (9.50 ± 3.81 mm). The bladder mass volume was increased in patients with KC who received augmentation enterocystoplasty (35.67 ± 11.19 mL) compared with those who did not (21.24 ± 7.25 mL). BWT significantly correlated with visual analogue scores for pain (R2 = 0.484, p < 0.001), functional bladder capacity (R2 = 0.31, p = 0.002), and maximum bladder capacity (R2 = 0.469, p < 0.001) in overall patients. Conclusion: There are obvious differences in bladder CT scans of patients with symptoms of bladder pain due to different etiology. Increased BWT was associated with increased pain scores and decreased bladder capacity in patients with KC and IC. BWT on a CT scan might be considered a marker for the severity of bladder inflammation.