Comparison of cystoscopic and histological findings in patients with suspected interstitial cystitis

Purpose: Although the exact etiology of interstitial cystitis remains elusi ve, bladder inflammation appears to be common in many patients. The Nationa l Institutes of Health (NIH) have established diagnostic criteria for inter stitial cystitis based on the presence of irritative voiding symptoms in th e absence of other identifiable pathology. Cystoscopic examination with hyd rodistention performed in patients under anesthesia is part of the NIH diag nostic criteria. We determine if the severity of cystoscopic findings corre lated with histological evidence of inflammation in patients with suspected interstitial cystitis. Materials and Methods: A total of 69 patients who met NIH symptom criteria for interstitial cystitis and underwent cystoscopy, hydrodistention and bla dder biopsy under anesthesia were reviewed. There were 2 investigators blin ded to the histological data who independently reviewed operative reports. A urological pathologist blinded to the clinical data reviewed biopsies for inflammation severity. Cystoscopic and histological findings were then con verted to a numeric scale. Numeric data were analyzed using the Pearson cor relation coefficient. Results: Cystoscopic examination revealed no evidence of interstitial cysti tis in 6 patients (9%), mild changes in 27 (39%), moderate changes in 23 (3 3%) and severe changes in 13 (19%). Histological examination revealed no in flammation in 21 patients (30%), mild inflammation in 28 (41%), moderate in flammation in 11 (16%) and severe inflammation in 9 (13%). Histological sco res correlated poorly with total and scaled cystoscopic severity scores (r = 0.295 and 0.349, respectively). Conclusions: Severity of cystoscopic findings observed during hydrodistenti on with anesthesia does not appear to correlate with the degree of inflamma tion identified histologically in patients with suspected interstitial cyst itis.