What is the role of potassium sensitivity testing in the diagnosis of interstitial cystitis/bladder pain syndrome (IC/BPS)?

Updated: Dec 04, 2020
  • Author: Eric S Rovner, MD; Chief Editor: Edward David Kim, MD, FACS  more...
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Answer

Some authors have found that certain subgroups of patients with interstitial cystitis have increased urothelial permeability to certain intravesical constituents. This potential property is exploited in the potassium sensitivity test as a diagnostic test for interstitial cystitis.

For this test, 40 mL of potassium chloride solution (40 mEq KCl/100 mL water) are instilled into the bladder for 5 minutes. [49] In patients with interstitial cystitis or other conditions of the bladder that affect urothelial permeability, the patient experiences acute and severe pain with intravesical instillation of the potassium chloride solution, and a diagnosis is made with an increase of 2 or more points on a pain or urgency scale. Patients who do not have interstitial cystitis may experience little or no pain from the solution. In patients who do experience pain, a rescue solution of heparin and lidocaine is instilled upon completion of the study. Because of its lack of sensitivity and specificity, this test does not usually alter clinical decision-making and thus is generally not used. [3]


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