Diagnostic and therapeutic cystoscopy in bladder pain syndrome/interstitial cystitis: systematic review of literature and consensus on methodology.

INTRODUCTION AND HYPOTHESIS: Cystoscopy has been routinely performed in patients suspected to be suffering from bladder pain syndrome/interstitial cystitis (BPS/IC) across the globe. The methodology reported by various guidelines appears to have differences in the techniques and hence there is a need for a review of all those techniques in order to arrive at a consensus. The aim was to review the literature describing the prevalent techniques of cystoscopy for patients of BPS/IC and try to evolve a consensus. METHODS: The group the Global Interstitial Cystitis, Bladder Pain Society (GIBS) has worked collectively to systematically review the literature using the key words, "Cystoscopy in Hunner's lesions, bladder pain syndrome, painful bladder syndrome and interstitial cystitis" in the PubMed, COCHRANE, and SCOPUS databases. A total of 3,857 abstracts were studied and 96 articles referring to some part of technique of cystoscopy were short-listed for review as full-length articles. Finally, six articles with a description of a technique of cystoscopy were included for final tabulation and comparison. The group went on to arrive at a consensus for a stepwise technique of diagnostic and therapeutic cystoscopy in cases of BPS/IC. This technique has been compared with the previously described techniques and may serve to be a useful practical guide for treating physicians. CONCLUSION: It is important to have a uniform standardized technique for performing a diagnostic and therapeutic cystoscopy in patients with BPS/IC. Consensus on one such a technique has been arrived at and described in the present article.

Predicting outcome of endoscopic management of urethral strictures: guideline for improving results.

The aim of this study of 56 cases was know the results of endoscopic management of urethral strictures. This study tries to give certain guidelines for improving the final results of endoscopic management. It includes the role of duration of urethral catheter, the role of anti-inflammatory agents, and the role of regular dilatations in preventing recurrence and ensuring a permanent cure.

Large vesical diverticulae with narrow neck, presenting with features of severe urinary tract infection managed surgically.

A case of multiple large urinary bladder diverticulae, with narrow neck, presented with features of severe urinary tract infection, with increased frequency of micturition, not treated since a long time. The muscular dehiscence that is at the origin of a diverticulum may be either congenital or degenerative. Two important complications of the diverticulum-that are sometimes interwoven-may occur: a draining defect and the development of an urothelial tumour in the diverticulum cavity. For such complicated diverticula, surgery is indicated. Results may be excellent, provided the surgical intervention focuses at the same time on the management of the associated subvesical obstacle in case of an acquired diverticulum.