OBJECTIVES: To evaluate further the intravesical potassium sensitivity test (PST) as an indicator of the epithelial leak of interstitial cystitis (IC) and determine whether successful pentosan polysulfate (PPS; Elmiron) treatment is associated with a change in PST results. Most individuals with IC appear to have an abnormally permeable epithelium that allows urinary solutes such as potassium to penetrate to the bladder interstitium, provoking symptoms. METHODS: Data were from an optimal dose trial of PPS in IC. Patients underwent a PST before and after a 32-week trial of 300, 600, or 900 mg PPS/day. The response to PPS treatment was measured using the Patient Overall Rating of Improvement in Symptoms scale. The before and after treatment PSTs and Patient Overall Rating of Improvement of Symptoms scores were compared. RESULTS: Of 377 patients with IC at 28 centers, 302 (80%) had a positive PST at entry. Of the 198 patients who completed the study, 153 were PST positive at entry and 92 (60%) showed clinical improvement at exit. Clinically improved patients had significant improvement on the PST analog pain and urgency scales (3.2 to 1.3 and 3.6 to 1.9, respectively; P <0.0001). In contrast, patients with no clinical improvement had no significant change in pain (3.1 to 2.7) or urgency (3.6 to 3.2). CONCLUSIONS: PST shows abnormal epithelial permeability in most patients with IC and a significant reduction in this permeability after successful PPS therapy. PST appears to be a valid indicator of epithelial abnormality and a reliable test in the diagnosis of IC.
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机译：目的：进一步评估膀胱内钾敏感性试验（PST）作为间质性膀胱炎（IC）上皮泄漏的指标，并确定成功的戊聚糖多硫酸盐（PPS; Elmiron）治疗是否与PST结果的改变有关。大多数患有IC的人似乎具有异常可渗透的上皮，可让尿溶质（如钾）渗透到膀胱间质，引起症状。方法：数据来自IC中PPS的最佳剂量试验。在每周进行300、600或900 mg PPS的32周试验之前和之后，患者接受PST。使用症状改善患者总体评分量表测量对PPS治疗的反应。比较治疗前后的PST和患者症状改善的总体评分。结果：在28个中心的377例IC患者中，有302例（80％）在进入时PST阳性。在完成研究的198位患者中，有153位在入院时PST阳性，而92位（60％）在出院时表现出临床改善。临床上得到改善的患者在PST类似物疼痛和尿急量表上有显着改善（分别为3.2至1.3和3.6至1.9; P <0.0001）。相反，没有临床改善的患者的疼痛（3.1至2.7）或尿急（3.6至3.2）没有明显变化。结论：PST在大多数IC患者中表现出异常的上皮通透性，并且在成功进行PPS治疗后该通透性显着降低。 PST似乎是上皮异常的有效指标，并且是诊断IC的可靠测试。
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