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Copenhagen 2004: European physicians reach consensus    

Primary evaluation of patients suspected of having interstitial cystitis

In May 2003, 23 European physicians met in Copenhagen in an attempt to reach a consensus on how to perform the evaluation of patients with suspected IC. Entitled “Primary Evaluation of Patients Suspected of Having Interstitial Cystitis”, published in European Urology 2004;45:662-669, this paper puts forward a standard method of evaluating patients, including examples of a Voiding Chart and Voiding and Pain Indices.

At a meeting in Kyoto, Japan in the spring of 2003, aimed at producing an acceptable definition of IC, it became all too clear that there were substantial differences between centres regarding the method of evaluating IC patients. This naturally makes epidemiological and clinical investigations difficult to compare.

Just a few months later, the Copenhagen workshop succeeded in reaching consensus on diagnostic procedures including history taking, physical examination, laboratory tests, cystoscopy and morphological investigations on bladder biopsies. It was decided to use O'Leary's questionnaire for symptom evaluation supplemented by a sexual score still to be defined. A Visual Analogue Score (VAS) for grading of pain, and voiding diaries were chosen. In both women and men a filling cystometry should be performed, while men should also have a pressure-flow study provided the spontaneous maximum flow rate is less than 20 ml per second. A modified potassium test performed according to Daha et al is considered optional. Methods of performing cystoscopy, bladder distension and inspection and bladder biopsies were decided upon. The description and quantification of findings during cystoscopy were also determined. It was decided that bladder biopsies are recommended and must contain detrusor smooth muscle for the investigation of inflammation, fibrosis and mast cells.

It is hoped that the proposed recommendations for standard evaluation procedures will be accepted internationally and lead to greater uniformity.

No abstract is available for this paper on PubMed, but further information can be found on the ESSIC linked criteria site.

Reference: Nordling J et al. Eur Urol 2004;45:662-9

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