Blood Pressure And Heart Rate Response During Bladder Hydrodistention In Patients With Bladder Pain Syndrome

Purpose: We determined whether patients with bladder pain syndrome who havetypical interstitial cystitis endoscopic findings, including glomerulations and/or Hunnerulcer, have a distinct autonomic response during bladder hydrodistention.Materials and Methods: Included in the study were50consecutive patients (40females and10males) who met International Society for the Study of BPSrecommendations. All patients underwent the same clinical evaluation, consisting ofmedical history, physical examination, urine and blood tests, urine cytology and culture,urinary tract ultrasound and urodynamics. Bladder hydrodistention and biopsies wereperformed using general anesthesia. Systolic and diastolic blood pressure, and heart ratewere recorded after the induction of general anesthesia and at the end of the fillingphase. Patients were divided into2groups, including patients with and without typicalendoscopic findings, respectively. Clinical, histological and urodynamic variables, andautonomic parameters were compared between the2groups.Results: No significant differences in demographics, symptoms, pain severity,comorbidities, previous surgery, urodynamic variables, anesthetic bladder capacity orhistological findings were found between the2groups. In patients with endoscopicfindings average±SD systolic and diastolic blood pressure increased by25±19and21±12mm Hg, respectively, and average heart rate increased by12±11beats per minute.All hemodynamic changes were statistically significant (p <0.001). In patients withoutendoscopic findings a minor decrease in hemodynamic parameters was observed.Conclusions: Patients with bladder pain syndrome who have typical interstitialcystitis findings on endoscopy show a marked autonomic response during bladderhydrodistention, consisting of an increase in heart rate, and systolic and diastolic bloodpressure.