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The aim of this study was to identify if the cystoscopy approach impacts the biopsy results when investigating women presenting with symptoms of BPS\/IC.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We performed a single-centre retrospective analysis of 300 bladder biopsy reports from 2015 to 2018 from women undergoing cystoscopy for BPS\/IC. Biopsies obtained using closed cup forceps through a flexible (FC) or rigid cystoscope (RC) were compared.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Fifty-eight FC biopsies were compared with 242 RC biopsies. FC biopsies had a smaller mean diameter (1.6\u00a0mm vs 2.9\u00a0mm <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01) and volume (4.1\u00a0mm3 vs 9.6\u00a0mm<jats:sup>3<\/jats:sup><jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) compared with RC biopsies. There was no significant difference in the histological depth of sampling to the muscularis propria. A total of 292 samples had CD117 immunohistochemical staining for mast cell count (MCC) analysis. The MCC\/mm<jats:sup>2<\/jats:sup> was significantly lower in FC biopsies (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). Sixteen percent of FC samples compared with 60% of RC samples had a high MCC &gt;28\/mm<jats:sup>2<\/jats:sup> (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). There was no significant difference in positive microbiology culture between FC (21%) and RC (28%) sampling.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Rigid and flexible cystoscopy can be used to investigate BPS\/IC as recommended by international societies. However, the biopsy method impacts the mast cell count analysis, which can influence diagnosis and management. Therefore, RC would be the optimal investigation.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00192-020-04512-0","type":"journal-article","created":{"date-parts":[[2020,9,21]],"date-time":"2020-09-21T10:03:00Z","timestamp":1600682580000},"page":"1229-1235","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Does cystoscopy method affect the investigation of bladder pain syndrome\/interstitial cystitis?"],"prefix":"10.1007","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5367-4792","authenticated-orcid":false,"given":"Visha K.","family":"Tailor","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen","family":"Morris","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alka A.","family":"Bhide","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruwan","family":"Fernando","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guiseppe A.","family":"Digesu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vik","family":"Khullar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,9,21]]},"reference":[{"issue":"2","key":"4512_CR1","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1002\/nau.10052","volume":"21","author":"P Abrams","year":"2002","unstructured":"Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, et al. 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