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NBI for interstitial cystitis
Editorial Comment Editorial Comment to Therapeutic efficacy of narrow band imaging-assisted transurethral electrocoagulation for ulcer-type painful bladder syndrome/ interstitial cystitis I agree with the authors that a controlled trial is necessary.1 It can be single-blinded, but I am not sure how it could be doubleblinded, as the surgeon will know the method used to carry out the procedure. Perhaps patients could be randomized to cystoscopy under anesthesia with standard endoscopic techniques and fulguration of any Hunner’s lesions versus using NBI techniques, and see if there is any difference in outcomes that would suggest that some lesions are being undertreated without the aid of NBI. If there were no outcome difference, I am not sure that the case for using NBI would be very convincing. Such a study would need a large number of patients and might lend itself to a multicenter design. A similar study carried out initially with only local analgesia and minimal distention would show if NBI can better diagnose Hunner’s lesions and the sensitivity and specificity of the technique when compared with the gold standard of hydrodistention under anesthesia.
Conflict of interest None declared.
Reference 1 Kajiwara M, Inoue S, Kobayashi K, Ohara S, Teishima J, Matsubara A. Therapeutic efficacy of narrow band imaging-assisted transurethral electrocoagulation for ulcer-type painful bladder syndrome/interstitial cystitis. Int. J. Urol. 2014; 21 (Suppl 1): 57–60.
Philip Hanno M.D., MPH. Professor of Urology, University of Pennsylvania, Philadelphia, Pennsylvania, USA [email protected] DOI: 10.1111/iju.12351
© 2014 The Japanese Urological Association
61
NBI for interstitial cystitis
Editorial Comment Editorial Comment to Therapeutic efficacy of narrow band imaging-assisted transurethral electrocoagulation for ulcer-type painful bladder syndrome/ interstitial cystitis I agree with the authors that a controlled trial is necessary.1 It can be single-blinded, but I am not sure how it could be doubleblinded, as the surgeon will know the method used to carry out the procedure. Perhaps patients could be randomized to cystoscopy under anesthesia with standard endoscopic techniques and fulguration of any Hunner’s lesions versus using NBI techniques, and see if there is any difference in outcomes that would suggest that some lesions are being undertreated without the aid of NBI. If there were no outcome difference, I am not sure that the case for using NBI would be very convincing. Such a study would need a large number of patients and might lend itself to a multicenter design. A similar study carried out initially with only local analgesia and minimal distention would show if NBI can better diagnose Hunner’s lesions and the sensitivity and specificity of the technique when compared with the gold standard of hydrodistention under anesthesia.
Conflict of interest None declared.
Reference 1 Kajiwara M, Inoue S, Kobayashi K, Ohara S, Teishima J, Matsubara A. Therapeutic efficacy of narrow band imaging-assisted transurethral electrocoagulation for ulcer-type painful bladder syndrome/interstitial cystitis. Int. J. Urol. 2014; 21 (Suppl 1): 57–60.
Philip Hanno M.D., MPH. Professor of Urology, University of Pennsylvania, Philadelphia, Pennsylvania, USA [email protected] DOI: 10.1111/iju.12351
© 2014 The Japanese Urological Association
61
