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Peer-reviewedCC BY-NC-SACentral European journal of urology

Anti-inflammatory bladder hydrodistension combined with pudendal nerve block in interstitial cystitis.

  • Tibet Erdogru1
  • Biagio Barone2
  • Eleonora Razeto3
  • Roberta Corvino3
  • Valerio Santarelli3
  • Felice Crocetto2
  • Benjamin I Chung4
  • Rajesh Nair5
  • Ramesh Thurairaja5
  • Francesco Del Giudice3,4,5
5 affiliations
  1. 1Uro-Klinik, Istanbul, Turkey.
  2. 2Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Italy.
  3. 3Department of Maternal-Infant and Urological Sciences, "Sapienza" University of Rome, Umberto I Hospital, Rome, Italy.
  4. 4Department of Urology, Stanford University School of Medicine, Stanford, CA, United States of America.
  5. 5Guy's and St Thomas' NHS Foundation Trust, Guy's Hospital, London, United Kingdom.
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Abstract

Introduction

Interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic condition with unclear pathophysiology and limited standardized treatments. This retrospective analysis evaluates the association of a combined approach including prolonged hydrodistension, intravesical instillation, and bilateral pudendal nerve block with symptom improvement.Material and methods

Data from 64 patients, from December 2016 to June 2023, were analyzed, including demographic information, symptoms, intraoperative details, Interstitial Cystitis Symptoms Index (ICSI), Interstitial Cystitis Problem Index (ICPI), Visual Analogue Scale (VAS) for pain, and daily frequencies at baseline, 1 and 6 months. Patients underwent prolonged hydrodistension with intravesical prednisolone followed by instillation of NaHCO₃, bupivacaine, prednisolone, and heparin sulphate. A bilateral pudendal nerve block was then performed under fluoroscopic guidance.Results

Mean basal bladder capacity under general anaesthesia increased from 389.45mL to 537.34 ml and 629.91 ml after the first and second hydrodistension, respectively. Intravesical instillations and bilateral nerve block were performed in 90.6% and 95.3% of cases, respectively. ICSI decreased from 21.05 ±2.27 at baseline to 8.89 ±3.88 at 1 month and 13.87 ±5.42 at 6 months (p <0.0001). ICPI showed similar improvement. VAS pain scores significantly decreased at follow-up. Symptom improvement correlated with increased bladder capacity and higher baseline ICPI, while pain reduction was predicted by higher ICPI and diurnal frequency, lower baseline bladder capacity, and increased capacity after the second hydrodistension.Conclusions

The combined approach of prolonged bladder anti-inflammatory hydrodistension and bilateral pudendal nerve block shows a short-term association with improvement in the management of IC/BPS. The observed early improvements in symptoms warrant further prospective studies with larger cohorts to confirm durability and to evaluate the role of repeat procedures.

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Cite

BibTeXRIS
BibTeX
@article{erdogru2026antiinflammatory,
  title = {{Anti-inflammatory bladder hydrodistension combined with pudendal nerve block in interstitial cystitis.}},
  author = {Tibet Erdogru and Biagio Barone and Eleonora Razeto and Roberta Corvino and Valerio Santarelli and Felice Crocetto and Benjamin I Chung and Rajesh Nair and Ramesh Thurairaja and Francesco Del Giudice},
  journal = {Central European journal of urology},
  year = {2026},
  month = jul,
  doi = {10.5173/ceju.2026.0108},
  url = {https://europepmc.org/article/MED/42904097},
  note = {CC BY-NC-SA},
}
RIS
TY  - JOUR
TI  - Anti-inflammatory bladder hydrodistension combined with pudendal nerve block in interstitial cystitis.
AU  - Tibet Erdogru
AU  - Biagio Barone
AU  - Eleonora Razeto
AU  - Roberta Corvino
AU  - Valerio Santarelli
AU  - Felice Crocetto
AU  - Benjamin I Chung
AU  - Rajesh Nair
AU  - Ramesh Thurairaja
AU  - Francesco Del Giudice
PY  - 2026
DA  - 2026/07/28
JO  - Central European journal of urology
DO  - 10.5173/ceju.2026.0108
UR  - https://europepmc.org/article/MED/42904097
AB  - Introduction  Interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic condition with unclear pathophysiology and limited standardized treatments. This retrospective analysis evaluates the association of a combined approach including prolonged hydrodistension, intravesical instillation, and bilateral pudendal nerve block with symptom improvement.Material and methods  Data from 64 patients, from December 2016 to June 2023, were analyzed, including demographic information, symptoms, intraoperative details, Interstitial Cystitis Symptoms Index (ICSI), Interstitial Cystitis Problem Index (ICPI), Visual Analogue Scale (VAS) for pain, and daily frequencies at baseline, 1 and 6 months. Patients underwent prolonged hydrodistension with intravesical prednisolone followed by instillation of NaHCO₃, bupivacaine, prednisolone, and heparin sulphate. A bilateral pudendal nerve block was then performed under fluoroscopic guidance.Results  Mean basal bladder capacity under general anaesthesia increased from 389.45mL to 537.34 ml and 629.91 ml after the first and second hydrodistension, respectively. Intravesical instillations and bilateral nerve block were performed in 90.6% and 95.3% of cases, respectively. ICSI decreased from 21.05 ±2.27 at baseline to 8.89 ±3.88 at 1 month and 13.87 ±5.42 at 6 months (p <0.0001). ICPI showed similar improvement. VAS pain scores significantly decreased at follow-up. Symptom improvement correlated with increased bladder capacity and higher baseline ICPI, while pain reduction was predicted by higher ICPI and diurnal frequency, lower baseline bladder capacity, and increased capacity after the second hydrodistension.Conclusions  The combined approach of prolonged bladder anti-inflammatory hydrodistension and bilateral pudendal nerve block shows a short-term association with improvement in the management of IC/BPS. The observed early improvements in symptoms warrant further prospective studies with larger cohorts to confirm durability and to evaluate the role of repeat procedures.
SN  - 2080-4806
SN  - 2080-4873
ER  -