The Potassium Sensitivity Test

[icnmgrjill]

IC Great Debates - The Potassium Sensitivity Test

This summer, Dr. Lowell Parsons (UC-San Diego) and Dr. Phil Hanno (Univ. of PA) squared off in the Journal of Urology to debate the merits of the potassium (KCL) sensitivity test. Dr. Parsons, well-known for his work with Elmiron, created the KCL test several years ago as a quick, fairly easy method of determining if a patient could have* interstitial cystitis. It works by introducing two solutions into the bladder, a water solution and a potassium solution. Water should not irritate a healthy bladder but potassium, when placed on a wound, creates discomfort. Thus, IC patients usually react and feel some discomfort when potassium is placed in their bladders. This result suggests that the bladder wall is not intact (aka damaged) and that IC is the likely suspect.

Dr. Phil Hanno has been a frequent critic of the KCL test. He correctly states that it does not differentiate beteween IC and other conditions of the bladder, could generate false positive or false negative results and that it is not reliable predictor for treatment responses.

Who is right? Well, they both are. The great thing about the KCL test is that it can help doctors, particularly Ob-Gyns, determine if pelvic pain is coming from the bladder. If a patient does have a reaction, then it's clear that they need to have a proper urological workup. I don't believe that Dr. Parsons has ever suggested that this is the perfect test for IC but it is, hands down, much easier to go through than a hydrodistention with cystoscopy. The debate continues!

We'd like to thank Dr. Parsons for sticking his neck out, yet again, to find new, innovative tools to help patients and clinicians working with IC. Dr. Hanno continues to be one of the most prolific and respected writers in the IC community.

Your thoughts?

Source: Parsons CL The potassium sensitivity test: a new gold standard for diagnosing and understanding the pathophysiology of interstitial cystitis. J Urol. 2009 Aug;182(2):432-43

Hanno P. Potassium sensitivity test for painful bladder syndrome/interstitial cystitis: con. J Urol. 2009 Aug;182(2):431-2, 434.

[wfarrell]

I am so happy to have the potassium test, my gyno did this and she was very sure I had IC and suggested to go to urologist or gyno/urologist. I did and still had a hydro done but I was so glad that she really saw the pain I was in from the potassium test she knew there were really issues going on.

[pacer1]

I had no reaction to this test so,therefore, the urologist dismissed me and sent me back to my internist. It was a year later and after months of agonizing pain that I went to Johns Hopkins and was diagnosed. If the test had been positive then I would have received treatment earlier. That is the reason that I feel that the test can
effect early treatment and is questionable.

[CindyLu]

When I finally found a urologist that was willing to test me for IC after 2 years of pain, he did the potassium sensitivity test. I didn't have an extreme reaction to the potassium but he diagnosed me as having mild IC. There was nothing mild about my pain, but because my bladder looked healthy to him and because I didn't feel an intense worsening of my pain from the potassium I guess that was a reasonable assumption. He started me on Elmiron right away, and after a year of Elmiron treatment, I can say that although I am not 100% or flare-free, I am certainly improved. So I would say that my diagnosis was more by exclusion than the PST.

[ddktt]

How much does this test cost?

Say you have a negative UTI culture so that's ruled out.

If you drink a glass of lemon juice or something acidic and your bladder burns would that not be telling you that there is a problem with the bladder? Would that not be the time to start with conservative treatment protocols suggested on this site (i.e. diet, supplements) to see if there is improvement.

I would agree with Hanno. This test does not sound that definitive to me.

Perhaps if the pain was totally diffuse and could not be pinpointed to the bladder then it might be useful.

[Lou]

My bladder burned for weeks after the "quick" potassium test, and even then my urologist wasn't "sure". I changed urologists, has a cystoscopy under anaesthetic and got a diagnosis due to hunner's ulcers. You usually end up having to have the cystoscopy anyway -- the potassium test is cruel, in my estimation.

[happymom]

The Potassium test can cause permanent damage!

I would advise carefully researching this test before haivng it done. When I had the PST, it was adminstered after a bladder distention and hydroscopy. The word test sounded so harmless that I didn't research it. One day I walked into the doctors office with minor bladder problems and left with excrutiating pain. I had to quit my job and have been on narcotic pain killers ever since! For some people, this test causes no problems and they go on to live regular lives. If I could do it again, I would have choosen a less invasive method to diagonse IC.

[CindyLu]

I live in Canada, so the test is free. All our health care is free. The medications are not.

[carlag]

I don't think the pain from this test is worth it. I've talked to others who say the same thing.

IC Great Debates - The Potassium Sensitivity Test

This summer, Dr. Lowell Parsons (UC-San Diego) and Dr. Phil Hanno (Univ. of PA) squared off in the Journal of Urology to debate the merits of the potassium (KCL) sensitivity test. Dr. Parsons, well-known for his work with Elmiron, created the KCL test several years ago as a quick, fairly easy method of determining if a patient could have* interstitial cystitis. It works by introducing two solutions into the bladder, a water solution and a potassium solution. Water should not irritate a healthy bladder but potassium, when placed on a wound, creates discomfort. Thus, IC patients usually react and feel some discomfort when potassium is placed in their bladders. This result suggests that the bladder wall is not intact (aka damaged) and that IC is the likely suspect.

Dr. Phil Hanno has been a frequent critic of the KCL test. He correctly states that it does not differentiate beteween IC and other conditions of the bladder, could generate false positive or false negative results and that it is not reliable predictor for treatment responses.

Who is right? Well, they both are. The great thing about the KCL test is that it can help doctors, particularly Ob-Gyns, determine if pelvic pain is coming from the bladder. If a patient does have a reaction, then it's clear that they need to have a proper urological workup. I don't believe that Dr. Parsons has ever suggested that this is the perfect test for IC but it is, hands down, much easier to go through than a hydrodistention with cystoscopy. The debate continues!

We'd like to thank Dr. Parsons for sticking his neck out, yet again, to find new, innovative tools to help patients and clinicians working with IC. Dr. Hanno continues to be one of the most prolific and respected writers in the IC community.

Your thoughts?

Source: Parsons CL The potassium sensitivity test: a new gold standard for diagnosing and understanding the pathophysiology of interstitial cystitis. J Urol. 2009 Aug;182(2):432-43

Hanno P. Potassium sensitivity test for painful bladder syndrome/interstitial cystitis: con. J Urol. 2009 Aug;182(2):431-2, 434.

[carlag]

You are so lucky to have free healthcare. And I know that your drugs are cheaper too because I get some from there and pay about half what I do here.

I live in Canada, so the test is free. All our health care is free. The medications are not.

[77amy]

boo to the potassium test

I had a terrible reaction to the potassium test. And by terrible I mean I simultaneously burst into tears and kicked the urologist. Worst pain ever.

If you think you have I.C. DO NOT GET THIS TEST. If you think you have a UTI, DO NOT GET THIS TEST. Get a cystoscopy under sedation. Or try the diet and see if you get better. Or any other option your doctor recommends.

[aritchie88]

False Positive

I agree that this particular test is a bad idea. I was given the test by my Gyno and she assessed from my sudden and intense bladder pain that I had a moderate case of IC. I have never had bladder pain before this, but after, I was in severe pain for two straight months. Meds nor diet did anything to help. I went to a Urologist who has determined that I do not have IC, rather the test put my bladder in a cronic state of inflamation. The teat gave a false positive for IC, when really I had some reaction to the potassium that my Uro had never seen before to this extent. I am now undergoing two "bladder coctails" a week to clear up the inflamation and I had instant releif after the first treatment. My Uro would not have given me the test based on my symptoms and not sure why the Gyno did. I would suggest that if a Gyno thinks you might have IC, go to a Uro for conformation, and do your reasearch.

[bluetou]

Canadians healthcare may look free....but we do pay through the sales taxes on items we buy in a store..... Each item we buy in the store is taxed, and it goes towards our healthcare. It is a good way to pay for our health care. (HST - health sales tax) is what it is called.

We do have the most high quality of health care, it is excellent, but we do pay for it through our taxes.

As far as medications go...depending on your health care plan from your "worK", we pay NOTHING for our meds....others pay 80 percent, some pay 50 percent....it all depends on what your work employment offers for health care benefits.

Peace
Blue

You are so lucky to have free healthcare. And I know that your drugs are cheaper too because I get some from there and pay about half what I do here.

[maryla]

Personally, I have never had one but I think they are barbaric!! At least with a hydro you are asleep and they tend to help with pain.

Hugs and blessings

[kathryn6443]

I would advise carefully researching this test before haivng it done. When I had the PST, it was adminstered after a bladder distention and hydroscopy. The word test sounded so harmless that I didn't research it. One day I walked into the doctors office with minor bladder problems and left with excrutiating pain. I had to quit my job and have been on narcotic pain killers ever since! For some people, this test causes no problems and they go on to live regular lives. If I could do it again, I would have choosen a less invasive method to diagonse IC.

i also feel that my pelvic pain is worse after i was diagnosed via potassium sensitivity test two weeks ago...can you give me more info...i tested positive for IC (from what doc told me), and ever since i have been in worse pain than i was before, and i dont know if it is the elmiron or did the test cause more harm than good? let me know...