1551 UTILIZATION AND TECHNIQUE OF HYDRODISTENSION FOR INTERSTITIAL CYSTITIS OUTCOMES OF A SOCIETY FOR URODYNAMICS AND FEMALE UROLOGY SURVEY

INTRODUCTION AND OBJECTIVES: To our knowledge the indications for and technique of hydrodistension (HD) for the diagnosis and treatment of interstitial cystitis/bladder pain syndrome (IC/BPS) are not standardized. We surveyed members of the Society for Urodynamics and Female Urology (SUFU) to assess the variability of this technique amongst the subspecialty’s experts. METHODS: With SUFU approval, a 16 item, multiple choice email-based survey was confidentially distributed to 518 members of SUFU. The questions focused on indications for and the technique of HD. The results were analyzed using web-based survey software. RESULTS: The response rate for the survey was 28.6%. Eighty-nine percent of the respondents were urologists. Of those in practice 1-5 years 92% were fellowship trained versus 26% of those in practice greater than 20 years. Eighty-six percent believe that HD has a role in the diagnosis and management of IC, but only 49% routinely perform it. Urodynamic studies are not routinely performed prior to HD in 70.6% of those surveyed. Eighty-nine percent use general anesthesia when performing HD and 91% raise the height of the fluid bag to generate the distension pressure. The pressure to distend the bladder varies with 39.6% and 34.5% distending to 60-80 and 80-100 cm of water respectively. The duration of distension also varies from 2 minutes to 10 minutes, with the majority (42.5%) distending for 2-5 minutes. Thirty-nine percent distend the bladder once, while 56.3% distend twice during a single operative session. Twenty-one percent perform a biopsy in the presence of normal appearing bladder mucosa, and 30.6% instill rescue solution of varying components at the end of the distension. There is no difference in HD technique or utilization between members in practice 1-5 years versus those in practice 20 years. CONCLUSIONS: Despite the utilization of this practice for decades, the indications for and the technique of HD vary greatly amongst the experts in the field of female urology, and are just as varied for younger versus older, and fellowship trained versus nonfellowship trained physicians. Standardization of the indications for and the technique of HD will allow comparison of diagnostic and therapeutic studies, thereby allowing us to serve those patients who suffer from IC/BPS more effectively.