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Transcript of Evaluation of the 2 x 24hour voiding diary Sandor LOVASZ MD. PhD. Hungary, Semmelweis Medical...
![Page 1: Evaluation of the 2 x 24hour voiding diary Sandor LOVASZ MD. PhD. Hungary, Semmelweis Medical University, Budapest ESSIC Annual Meeting Philadelphia, June.](https://reader035.fdocuments.net/reader035/viewer/2022070400/56649f115503460f94c24802/html5/thumbnails/1.jpg)
Evaluation of the 2 x 24hour voiding diary
Sandor LOVASZ MD. PhD.Hungary, Semmelweis Medical University, Budapest
ESSIC Annual MeetingPhiladelphia, June 13-15, 2014
THE GAG-LAYER INTEGRITY THE GAG-LAYER INTEGRITY TESTTEST
THE GAG-LAYER INTEGRITY THE GAG-LAYER INTEGRITY TESTTEST
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Pathogenesis of BPS/IC:
Abnormal epithelial permeability, epithelial leak, increased potassium absorption…
Corrupted GAG layer integrity /insufficiency
Emerging need of objective and quantitative testing of GAG layer integrity (uncertain and difficult diagnosis)
Parsons CL.: J Urol, 1998
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Potassium sensitivity test (PST) - Parsons test Sensitivity – 69,5%
Specificity – 50% (Chambers GK et al: J Urol 1999)
Invasive (catheterization, bladder filling twice, painful, non-quantitative: yes or no)
Absence of potassium sensitivity in normal controls
Not used as a routine clinical test in monitoring of BPS/IC treatment efficacy.
Parsons CL.: Urology. 2001
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Modified potassium sensitivity-test (0,2M KCl) Comparing C (max) using Saline vs. Potassium solution
Painless examination yet invasive and time consuming
(catheterization + repeated cystometry)
Cut off value at 30% growth
Non-quantitative (=> or <30%)
Although theoretically capable of quantitative measurement - clinically rarely used
Daha LK, Riedl CR et al: Eur Urol 2005
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Our observation is based on anamnestic data of 106 BPS/IC patients:
Symptoms usually worsen in summer period
Increased liquid consumption leads to remarkably reduced symptoms (pain, urgency)
Is there a role of concentration of urine?
Can these observations be used for quantitative testing?
![Page 6: Evaluation of the 2 x 24hour voiding diary Sandor LOVASZ MD. PhD. Hungary, Semmelweis Medical University, Budapest ESSIC Annual Meeting Philadelphia, June.](https://reader035.fdocuments.net/reader035/viewer/2022070400/56649f115503460f94c24802/html5/thumbnails/6.jpg)
We asked patients to make a voiding diary by recording total urine volume and average urine portion
One patient recorded these data over 14 consecutive days from misunderstanding.
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Another sample of a 15 day voiding diary
![Page 9: Evaluation of the 2 x 24hour voiding diary Sandor LOVASZ MD. PhD. Hungary, Semmelweis Medical University, Budapest ESSIC Annual Meeting Philadelphia, June.](https://reader035.fdocuments.net/reader035/viewer/2022070400/56649f115503460f94c24802/html5/thumbnails/9.jpg)
Patients were asked to calculate and record
Average daily urine portion
24 hours full urine volume
Throughout 2 consecutive days
Day 1 - max 800ml drinking (max. concentrated)
Day 2 - min 3000ml fluid intake (max. diluted)
The growth of mean daily urine portion was observed
The 2 x 24 hour voiding diary
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Our hypotheses(based on these observations)
There is a linear correlation between total urine volume (concentration of urine) and average portion
The rate of change in average portion corresponds to severity of symptoms in IC/PPS
Average urine portion is constant in healthy people, independently from urine volume (concentration)
5 healthy volunteers:
Vol. constant
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www.bladderpain.eu
Continuous follow up on the website
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Continuous follow up on the website
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Continuous follow up on the website
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Continuous follow up on the website
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Continuous follow up on the website
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Impressive correlation between - IC symptoms - Changes of mean urine portions
By proving this correlation we could get a test for GAG layer
integrity• Noninvasive • Painless • Quantitative • Not bound to the presence of investigator• Suitable for diagnostic purposes• Appropriate for long term follow up
Continuous follow up on the website
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We are seeking for partners for a prospective, multicenter clinical trial
To collect pre- and post-treatment data of IC/BPS patients andTo statistically prove correlation betweenQuantitatively measurable values ofSymptoms and GAG integrity-test.