Abstract:

Objective To assess the efficacy and safety of percutaneous hypogastric nerve block (HNB) in treating refractory interstitial cystitis/painful bladder syndrome (IC/PBS). Methods Clinical data of 78 female patients with refractory IC/PBS were retrospectively analyzed. Puncture needles were guided to both hypogastric sympathetic nerves by CT and electrical stimulation detector. Patients were injected with 20 mL 2% lidocaine, 0.25 mg methycobal and 20 mg triamcinolone acetonide. This treatment was performed once per 2 weeks with 3 times per course. Mean visual analogue scale (VAS) scores, O’LearySant interstitial cystitis patient symptom index (ICSI) scores and patient problem index (ICPI) scores, urination frequency in 24 hours and mean urinary output per time 1 week before treatment and 1 week, 1, 3, 6, 9 and 12 months after treatment were compared. Adverse events during the treatment were observed. Results All 78 patients completed 3 rounds of HNB. Effective rates 1 week, 1, 3, 6, 9 and 12 months after treatment were 795%, 79.5%, 67.9%, 55.1%, 30.8% and 16.7%, respectively. Efficacy was gradually decreased with time. Maintain time for symptom relief was 3-17 (8.5±2.8) months. Remission rate of bladder pain or discomfort was higher than that of frequent or urgent urination. The differences in VAS scores, ICSI scores, ICPI scores, urination frequency in 24 hours and mean urinary output per time between before treatment and 1 week, 1, 3, 6, 9 and 12 months after treatment were statistically significant (P=0.000 0). No significant adverse event was observed during the treatment. Conclusion Percutaneous HNB can alleviate clinical symptoms in some patients with refractory IC/PBS with less injury and adverse reactions.

Key words: hypogastric nerve, nerve block, interstitial cystitis/painful bladder syndrome, refractory