Significance of hematuria in patients with interstitial cystitis: Review of radiographic and endoscopic findings

Objectives. Hematuria may be found in up to 30% of patients with interstiti al cystitis (IC). However, few studies have described its etiology based on the findings of a complete evaluation. We reviewed the clinical significan ce of hematuria in the setting of IC. Methods. We retrospectively reviewed the records of 148 patients fulfilling the National Institute of Arthritis, Diabetes, Digestive and Kidney Diseas es inclusion criteria for IC. Patients with gross or microscopic hematuria were identified. Evaluation consisted of urine culture and cytology, cystos copy, and intravenous urography (or retrograde pyelography plus renal ultra sound). Patients with urinary tract infections were excluded. Results. Of 148 patients, 60 (41%) were found to have had at least one epis ode of hematuria during a mean follow-up of 18 months. Of 56 patients who a greed to be evaluated, 8 (14%) had positive urologic findings. Of these, no ne were highly significant; five were simple renal cysts (8.9%), one was a renal stone (1.8%), one was reflux nephropathy (1.8%), and one was medullar y sponge kidney (1.8%). Cystoscopy, cytology, and bladder biopsy did not de monstrate malignancy in any patient. No statistically significant differenc es were found in age (49.9 versus 46.7 years), sex (90% versus 91% female), bladder capacity (792 versus 808 mL), and the presence of Hunner's ulcers (5% versus 2.4%), glomerulations (60% versus 59.9%), or detrusor mastocytos is (55% versus 47.6%) between patients with hematuria and those without (P > 0.05). Conclusions. The incidence of hematuria in patients with IC may be higher t han previously reported. Nevertheless, although many of these patients pres ent with pelvic pain and irritative voiding symptoms, the hematuria evaluat ion is unlikely to reveal a life-threatening urologic condition. UROLOGY 57 : 262-265, 2001. (C) 2001, Elsevier Science Inc.