Incontinence & Female Urology & Neurourology(구연) Oral Session2 / Incontinence & female urology (O-013) Rm.203 10월 30일(수) 13:00-14:00 Natural History of Patients with Presumptive Diagnosis of Ulcerative Interstitial Cystitis: A 13-Year Experience in the Seoul National University Hospital 서울대학교병원 비뇨의학과, 서울의대 비뇨의학교실 강유진, 오승준 Objective: Interstitial cystitis (IC) is a chronic condition causing painful urinary symptoms. We attempted to analyze the natural history of patients with ulcerative IC. Materials and Methods: We retrospectively reviewed electronic medical records of consecutive patients between Jan 2006 and Aug 2018, who were presumptively diagnosed with IC. Patients with pelvic pain underwent baseline evaluation including careful history taking, physical examination, voiding diary, urinalysis, urine culture, urine Tbc culture, urine AFB PCR, urine cytology, PVR volume. Among the patients, observation cystoscopy was performed in those suspected with ulcerative IC. Bladder biopsy was taken together with hydrodistention and ulcer fulguration. During follow-up, further therapeutic hydrodistention, transurethral ulcer fulguration, or rarely cystectomy were performed according to the severity of subjective pain. Results: A total of 435 patients with 99 males (22.8%) and 336 (77.2%) females (mean age of 60.7± 12.2 years) were identified as having presumptive ulcerative IC. Meantime to diagnosis after the first pain was 20.8 (± 23.5) months. Pyuria (WBC> 5/HPF) and microhematuria (RBC>5/HPF) were detected in 100 (23.1%) and 44 (10.2%) patients, respectively. Twenty three (5.3%) patients showed positive for urine culture. Three (0.7%) patients were positive for urine AFB culture. Three patients (0.7%) showed atypical cells and another 3 showed positive for urine cytology. The first cystoscopic biopsy was performed in a total of 198 patients. Pathologic examination showed that 11 (5.6%) patients had bladder cancer and 2 patients (1.0%) had bladder tuberculosis. Repeat cystoscopic biopsy and therapeutic hydrodistention during further follow-up were performed in a total of 40 (20.2%) patients having persistent pain. Among them, an additional 3 patients were diagnosed as bladder cancer. Nineteen patients (9.6%) underwent cystectomy with either urinary diversion (6, 3.0%) or bladder replacement (13, 6.6%) for an intractable pain. Pathological examination in a cystectomy specimen showed bladder tuberculosis in 2 patients. Conclusion: Even though bladder cancer or tuberculosis were not diagnosed at initial cystoscopic biopsy, careful efforts to exclude bladder cancer and urinary tuberculosis on follow-up are still essential. keywords : Interstitial cystitis; natural history; bladder hydrodistention