Glomerulations after bladder hydrodistension under local anesthesia: predictors and prognosis

Purpose Glomerulations are a significant observational indicator in patients with interstitial cystitis (IC) undergoing bladder hydrodistension (HD). This study aims to identify predictors of glomerulations during HD under local anesthesia and evaluate their impact on bladder function recovery. Methods 51 patients with clinical diagnosis of IC were enrolled and underwent cystoscopy and HD under local anesthesia. Among them, 34 patients exhibited glomerulations and had biopsies taken from their bladder mucosa, while 17 did not present with glomerulations. All were followed up for 3 months using the Visual Analogue Scale (VAS) for pain, the O'Leary-Sant Interstitial Cystitis Symptom Index (ICSI) and Problem Index (ICPI). Results ICSI, ICPI and VAS scores significantly decreased from baseline at both 1 week and 3 months postoperatively. At 1 week postoperatively, the glomerulations group had significantly lower ICSI and ICPI scores than the non-glomerulations group, with p-values of 0.035 and 0.019, respectively. This trend continued in the ICSI score at 3 months postoperatively (p-value of 0.027). Univariate analysis identified height as the sole significant predictor of glomerulations during cystoscopy and HD under local anesthesia. Conclusion Patients in the glomerulations group demonstrated significantly greater symptomatic improvement, suggesting that glomerulations may be a potential marker of surgical success. Trial registration Ethical Approval No.:CY2023-068-01, date of registration: 2023-10-23.