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Urology Symposium: Diagnosis and Treatment of Interstitial Cystitis - ‘s-Hertogenbosch, 10 December 2004


The IC symposium, organised by the urology departments in ‘s-Hertogenbosch and Oss, was a practical, hands-on experience. Throughout the day, delegates watched live theatre sessions. These began early in the morning when Dr Jurjen Bade performed a cystoscopy on an IC patient under anaesthesia and laser coagulation of an IC bladder. Later in the day, Dr Paul Kil carried out a tined lead implantation for neuromodulation, explaining all the technicalities of this procedure as he went along. This was an instructive day for urologists and a fascinating insight for non-urologists and patient representatives into surgical procedures for IC patients.c
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Dr Bade performing laser coagulation

The delegates watched live theatre sessions


Professor Kristene Whitmore from Philadelphia gave an excellent overview of diagnosis and treatment in the USA, including the extensive pelvic floor investigations and therapy as carried out in her practice in the USA. Professor Whitmore has a unique knowledge and understanding of the specific problems of women with IC, including their sexual problems. At her clinic, it is consequently not only the bladder that receives treatment, but the whole patient. Examples of therapy include learning to cope better with pain with the help of psychologists, solving sexual problems that so often occur with IC patients with the help of sexologists and massage of different muscles in the pelvic floor using physiotherapists.

The presentation by Professor Jean-Jacques Wyndaele of Antwerp concerned bladder sensation and current knowledge of this complex aspect. In recent years, Professor Wyndaele has become an authority on pain in the bladder and pelvic floor and gave symposium participants a clear explanation of knowledge so far. He informed participants that if a patient has had pain for a long period of time, changes take place in the part of the brain known as the thalamus. This results in permanent ‘storage’ of the pain sensation. Even if the bladder is removed in these patients, the pain continues to be felt. We will undoubtedly be seeing more and more developments and deeper understanding in this field as research continues.
Dr Henry Bickerstaffe of Oss presented data from their longitudinal database on 200 patients diagnosed with IC. The diagnoses were re-analysed on the basis of 6 items: 1. Pain at bladder filling; 2. Nocturia (1x or more); 3. Bladder pain at vaginal examination; 4. Mucosal changes during cystoscopy; 5. Bladder biopsies; 6. Potassium sensitivity test. In two analyses, IC was diagnosed if 4 or 6 items were present. The results were compared with the number of patients that would have been diagnosed as having IC if the NIDDK criteria had been used. The NIDDK criteria were shown to be less sensitive that the criteria drawn up by the Oss team.
Laser treatment in IC with long-term follow-up results was discussed by Dr Josien Montfrans from Utrecht. Laser treatment often has to be repeated after an average of 6 months.

Dr Jurjen Bade concluded by speaking on the efficacy and prognostic factors of sacral neuromodulation in IC patients.

During the breaks, participants had a chance to look at the information tables, including that of the International IC Patient Network Foundation.

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Jane Meijlink with Professor J.J. Wyndaele who is examining the Afrikaans toilet card with great interest      

Thanks are due to the ‘s-Hertogenbosch and Oss urologists and especially Dr Jurjen Bade for organising this interesting and very instructive day.
 
Jane Meijlink
   
updated 09.02.2006 13:12 © 2006-2018 International Painful Bladder Foundation (IPBF). All rights reserved.