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Background: Adhesive capsulitis (AC), more commonly known as "frozen shoulder", is a painful shoulder condition. The illness progresses through three phases: freezing, frozen and thawing. A gold standard treatment for adhesive capsulitis is not defined. The goal of any treatment is to reduce pain and restore shoulder movement. Objective: Objective of the present study is to evaluate the efficacy of gleno-humeral hydrodistension associated with physical therapy in patients with diagnosed adhesive capsulitis comparing the outcomes in term of pain and range of motion in patients with a phase 1 and a phase 2 disease. Method: Between January 2022 and April 2023, We evaluated 87 patients with adhesive capsulitis, 47 were excluded for others concomitant pathologies, finally 40 patients were enrolled for the study, of whom 23 had capsulitis in stage 1 and 17 in stage 2. Patients were evaluated at baseline and at 2, 4 and 6 months after infiltration recording range of motion in all planes, pain and functionality scores. Results: A significant improvement was recorded in shoulder range of motion in all planes with the except of extension in both groups. Phase 2 patients were able to regain shoulder range of motion in all planes except internal rotation which was recovered with more difficulty. Pain and functionality scores improved significantly between baseline and follow-up visits. Conclusion: Ultrasound-assisted hydrodistention of the glenohumeral joint combined with targeted exercise has been successful in improving pain relief, reducing disability, and increasing range of motion in subjects with stage 1 and 2 adhesive capsulitis, especially if diagnosed before phase 2 (when the range of motion is completely reduced). [ABSTRACT FROM AUTHOR]

Purpose: We analyzed the long-term efficacy of simultaneous transurethral resection (TUR) and therapeutic hydrodistention in patients with ulcerative interstitial cystitis (IC) who did not experience recurrence on long-term follow-up. Methods: We studied 132 female patients (mean age = 56.45 ± 11.56 years) who underwent TUR followed by hydrodistention to treat ulcerative IC between January 2010 and January 2017, and who were available for follow-up, for more than 36 months (mean = 52.3 ± 10.51 months). Of the 132 patients, those who did not suffer recurrence within 36 months after surgery were allocated to group I and those who had a recurrence within the same period were assigned to group II. Preoperative factors, including age, were compared between the groups. In group I, improvements in pain and voiding symptoms were recorded using a 10-point visual analog pain scale (VAS) and a 3-day micturition chart. A global response assessment (GRA) was used to evaluate patient satisfaction. Results: In group II, the maximum functional bladder capacity (FBC) was smaller, and voiding frequency was higher, than in group I. Follow-up of patients in group I for more than 3 years showed that pain decreased after surgery. The 10-point VAS scores were 9.68 before surgery, and 1.54, 0.93, 0.55, and 0.46 at 1, 6, 12, and 36 months after surgery (p < 0.001), respectively. Maximum FBCs were 174.82 mL before surgery and 237.14, 250.71, and 254.46 mL at 1, 12, and 36 months after surgery (p < 0.001), respectively; thus, FBC increased after surgery. Urination frequency decreased significantly after surgery; the number of daily urinations was 12.77 before surgery, and 9.88, 9.21, and 9.25 at 1, 12, and 36 months after surgery (p < 0.001), respectively. Overall patient satisfaction improved after surgery; the GRA scores were 2.39, 2.71, and 2.8 points at 1, 12, and 36 months after surgery (p < 0.001), respectively. Conclusion: Upon simultaneous performance of TUR and therapeutic hydrodistention in patients with ulcerative IC, 49.2% showed favorable outcomes for 3 years. [ABSTRACT FROM AUTHOR]

Hydrodistention is one of the effective procedures for the diagnosis as well as treatment of interstitial cystitis and painful bladder syndrome and interstitial cystitis/painful bladder syndrome (IC/PBS). The present study was aimed to investigate the factors affecting the symptom-free period after hydrodistention in females with IC/PBS. In the present study, 32 IC/PBS females with symptom recurrence after hydrodistention who needed further management were included. Clinical information including age, duration suffered from the disease, preoperative functional bladder capacity (FBC), and the distended bladder volume during hydrodistention was investigated. Also, the symptom-free period after hydrodistention and the volume difference between preoperative FBC and distended bladder volume during the hydrodistention (ΔBV) was calculated for the analysis. As the result, ΔBV was the only factor that significantly elongated the symptom-free period after hydrodistention (p < 0.001). Thus, the larger volume difference between preoperative FBC and distended bladder volume during the first hydrodistention elongated the symptom-free period of IC/PBS females after receiving hydrodistention. [ABSTRACT FROM AUTHOR]

Introduction and hypothesis: To evaluate the efficacy and safety of the intravesical injection of Chinese botulinum toxin A (BTX-A) in patients with interstitial cystitis/bladder pain syndrome (IC/BPS). Methods: Between January 2003 and June 2013, 124 women with IC/BPS were studied. Of these 124 patients, 66 were treated with BTX-A and 58 underwent bladder hydrodistention plus sodium hyaluronate (Cystistat) instillation. Intravesical injection of 100 U of Chinese BTX-A was immediately followed by cystoscopic hydrodistention under intravenous general anesthesia. The patients were evaluated using the O'Leary-Saint score, a visual analog scale pain score, a urinary frequency record and a quality of life questionnaire before treatment and 1 week, and 1, 3, 6 and 12 months after treatment. Results: Of the patients who received BTX-A injection, only 2 had acute urinary retention, 23 received a repeat injection, and 20 were lost to follow-up. Of the patients treated with hydrodistention plus Cystistat instillation, 2 had urinary tract infection, 11 switched to BTX-A injection at 6 months, and 23 were lost to follow-up. BTX-A was shown to remain effective for up to 6 months after treatment. After repeated Chinese BTX-A injections, symptoms improved significantly. Hydrodistention plus Cystistat remained effective for up to 3 months after treatment. Conclusions: Intravesical injection of Chinese BTX-A is a safe and effective therapeutic option for patients with IC/BPS. The average duration of the effect of one dose of Chinese BTX-A amongst the responders was 6 months. Repeated injection of Chinese BTX-A is safe and effective. [ABSTRACT FROM AUTHOR]

Introduction and hypothesis: The purpose of this study was to investigate change in bladder capacity as a measure of response to combined intravesical dimethyl sulfoxide (DMSO) and triamcinolone instillations for the treatment of newly diagnosed bladder pain syndrome/interstitial cystitis (BPS/IC). Methods: 141 newly diagnosed women were identified retrospectively. 79 were treated with weekly DMSO/triamcinolone instillations. Change in bladder capacity with bladder retrofill, daytime urinary frequency, nocturia episodes per night, and Likert scale symptom scores were reviewed. Wilcoxon signed-rank tests, Wilcoxon rank-sum tests, Spearman's rank correlations, COX regression analysis, and a Kaplan-Meier survival curve were performed. Results: Significant changes (median (25-percentile to 75-percentile) were noted for bladder capacity (75 mL (25 to 130 mL), p < 0.0001), inter-void interval (0 hrs (0 to 1 hour), p < 0.0001), nocturia episodes per night (−1 (−2 to 0), p < 0.0001), and aggregate Likert symptom scores (−2 points (−5 to 0), p < 0.0001). Percent change in bladder capacity correlated positively with percent change in inter-void interval (p = 0.03) and negatively with percent changes in nocturia (p = 0.17) and symptom scores (p = 0.01). Women without detrusor overactivity (DO) had greater percent changes in capacity than women with DO (62.5 % vs. 16.5 %, p = 0.02). 61.3 % of patients were retreated with a 36 weeks median time to retreatment and no difference in time to retreatment based upon DO. Greater capacity was protective against retreatment (hazard ratio = 0.997 [95 % CI 0.994,0.999], p = 0.02). Conclusions: Percent change in bladder capacity is a useful objective measure of response to intravesical DMSO/triamcinolone for newly diagnosed BPS/IC. Clinical outcomes do not differ based upon presence of DO. [ABSTRACT FROM AUTHOR]