BERKELEY, CA (UroToday.com) - The lack of a generalized case definition of IC in women is apparent when looking at the literature. Bogart and colleagues report on results of a literature review by the Rand Corporation done in preparation for a major population prevalence study of the syndrome. The overlap in symptoms between IC and other conditions proved to be very challenging.

A comprehensive literature search using the terms diagnosis and each of interstitial cystitis, painful bladder syndrome, urinary tract infection, overactive bladder, chronic urethral syndrome, vulvodynia, and endometriosis. Of 2680 screened titles, 604 articles proved relevant. The most commonly reported interstitial cystitis symptoms were bladder/pelvic pain, urgency, frequency, and nocturia. Interstitial cystitis and painful bladder syndrome, not surprisingly, share the same cluster of symptoms. Chronic urethral syndrome is an outdated term. Self-reports regarding symptoms and effective antibiotic use can distinguish recurrent urinary tract infections from interstitial cystitis in some, but not all women. Urine cultures may also be necessary. Pain distinguishes interstitial cystitis from overactive bladder. Vulvar pain may distinguish vulvodynia from interstitial cystitis. Dysmenorrhea distinguishes endometriosis from interstitial cystitis, although the diagnoses often occur in common.

The authors conclude that interstitial cystitis and painful bladder syndrome are indistinguishable for an epidemiologic survey. Future epidemiological research identifying the proportion of patients with IC and PBS who do not report pain as well as the proportion with overactive bladder who report pain is necessary to refine prevalence estimates of IC and overactive bladder.

Bogart LM, Berry SH, Clemens JQ

Journal of Urology, 177(2): 450-456, 2007

UroToday.com Painful Bladder Syndrome Section

Written by Philip M. Hanno, MD, a Contributing Editor with UroToday.

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