Abstract: PD01-11
Sources of Funding: self-founding

Introduction

The aim of this study is to investigate the association between the electron microscopic (EM) urothelium characteristics and clinical symptoms severity in patients with interstitial cystitis (IC) and ketamine cystitis (KC).

Methods

IC and KC patients who were admission for hydrodistention were enrolled. The cold-cup biopsy bladder specimens were taken during hydrodistention for transmission EM (TEM) and scanning EM (SEM). In TEM, the urothelium cell layers number, integrity of umbrella cells and tight junction complexes were investigated. In the SEM, the umbrella cell intact, uniform and deep folding were evaluated. All of these EM findings were grading with a 4 point scale (0: normal, 1: mild defect, 2: moderate defect, 3: severe defect). Visual Analogue Scale (VAS) pain score, cystometric bladder capacity (CBC) and maximal bladder capacity under general anesthesia (MBC) in these patients were recorded. Chi-square test was used to evaluate the association between symptoms severity and EM findings. Bladder biopsies were also taken from the patients with stress urinary incontinence and were considered as normal control.

Results

A total of 9 KC and 9 IC patients were enrolled. In the IC patients, the EM revealed inconsistence of umbrella cells size, decreased urothelium cell layers, decreased umbrella cell folding and tight junctional complexes. In the patients with severe KC, the EM showed almost totally denuded urothelium and exposure collagen. (Figure 1 A and B ). In TEM, the KC patients with more VAS pain score have more severe defect of urothelium cell layers and integrity of umbrella cells (p=0.018). The IC patients with more severe VAS pain score have more severe defect of tight junctional complexes in TEM (Table 1.) The CBC and MBC in KC and IC patients were not significantly associated with EM findings.

Conclusions

In EM, the urothelium defects were more severe in KC than IC. Urothelium defect in TEM may be associated with bladder pain severity in KC and IC patients.

Funding

self-founding