Phenotype-directed Management of Interstitial Cystitis/Bladder Pain Syndrome
Phenotype-directed Management of Interstitial Cystitis/Bladder Pain Syndrome
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DOI：
10.1016/j.urology.2014.03.001
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发表时间：
2014-07-01
期刊：
影响因子：
2.1
通讯作者：
Shoskes, Daniel A.
中科院分区：
文献类型：
--
作者：
Nickel, J. Curtis;Irvine-Bird, Karen;Shoskes, Daniel A.
目的评估一种灵活的治疗策略，用于转诊到专门的间质性膀胱炎/膀胱疼痛综合征（IC/BPS）诊所的患者，使用基于临床的泌尿、心理社会、器官特异性、感染、神经或非膀胱和骨盆底压痛（UPOINT）分类的个体化表型导向治疗计划，而不是传统的算法逐步的方法。方法连续的患者提到一个专门的三级IC/BPS诊所，至少有1个后续-根据UPOINT状态对治疗后访视进行分类，并根据先前发表的基于表型的个体化治疗计划进行治疗。患者在基线和长达2年的有效症状评分（间质性膀胱炎症状评分[ICSI]和疼痛紧迫性频率问卷）以及疼痛和排尿assessment.Results随访访问数据为93例（平均年龄，45.2岁，中位年龄，44岁，平均ICSI，13.2 +/- 3.6）进行了评估。患者报告了4个UPOINT域的中位数（平均值，3.7 ± 0.94），分布如下：U = 100%; P = 31.2%; O = 97.8%; I = 45.2%; N = 39.8%; T = 55.9%。ICSI平均下降3.4分。与初始基线访视相比，在46.2%的患者中观察到显著的临床改善（ICSI减少>30%）。疼痛紧迫性频率以及疼痛和紧迫性评分变化具有可比性。症状的严重程度和数量的域和ICSI减少之间没有相关性observed.CONCLUSION几乎50%的患者提到的第三IC/BPS诊所，无论复杂性或严重程度的条件，经历了临床显着改善使用个性化的表型导向的治疗方法。(C)2014爱思唯尔公司
OBJECTIVE To assess a flexible therapeutic strategy for patients referred to a specialized interstitial cystitis/bladder pain syndrome (IC/BPS) clinic using an individualized phenotype-directed treatment plan based on clinically based urinary, psychosocial, organ-specific, infection, neurologic or nonbladder, and tenderness of pelvic floor (UPOINT) categorization, instead of the traditional algorithmic stepwise approach.METHODS Consecutive patients referred to a specialized tertiary IC/BPS clinic with at least 1 follow-up posttreatment visit were categorized according to their UPOINT status and treated according to previously published individualized phenotype-based treatment plan. Patients were assessed at baseline and up to 2 years with validated symptom scores (interstitial cystitis symptom score [ICSI]; and pain urgency frequency questionnaire) as well as pain and voiding assessments.RESULTS Follow-up visit data were available for 93 patients (mean age, 45.2 years; median age, 44 years; mean ICSI, 13.2 +/- 3.6). Patients reported a median of 4 UPOINT domains (mean, 3.7 +/- 0.94) with the following distribution: U = 100%; P = 31.2%; O = 97.8%; I = 45.2%; N = 39.8%; and T = 55.9%. The mean decrease in ICSI was 3.4 points. Significant clinical improvement (>30% decrease in ICSI) was observed in 46.2% compared with initial baseline visit. Pain urgency frequency, and pain and urgency scoring changes were comparable. No correlation between severity of symptoms and number of domains and ICSI decrease was observed.CONCLUSION Almost 50% of patients referred to a tertiary IC/BPS clinic, regardless of the complexity or severity of condition, experienced clinically significant improvement using an individualized phenotype-directed therapeutic approach. (C) 2014 Elsevier Inc.