BERKELEY, CA (UroToday.com) - This tertiary care center for IC/PBS determined by a retrospective study that in regards to age on presentation, pain symptoms of dyspareunia, dysuria, and genital pain are more predominant in the younger age group, whereas nocturia is a symptom more associated with advancing age.
Urgency and frequency were also more prominent in the younger patients. The findings reported are of interest in regards to attempts at defining subpopulations within the syndrome of bladder-pain syndrome/interstitial cystitis, which may help us improve diagnosis and therapy. Significant heterogeneity in both age of onset, as well as associated symptoms, are reported. There appears to be a bimodal pattern in age presentation, which may give some insight as to possible etiologic events and mechanisms, and the effects of aging on pelvic pain syndromes.
As with most retrospective studies, there are limitations in the strength of conclusions, but the results do help clinicians in their thoughts about their approach to IC and treatment options. Patients with IC and dyspareunia often demonstrate pelvic floor dysfunction for which appropriate physical therapy can significantly improve overall quality of life. As expected, there was an increase in the number of patients with ulcers with age, although, even in their youngest subgroup, 12% of patients were described as having ulcers. As recent guidelines for IC indicate stronger evidence for the likelihood of a response to ulcers with endoscopic therapy, physicians should not completely avoid cystoscopic evaluation in younger patients since a treatable lesion might be missed. However, the risks and benefits of any therapy should still be carefully considered, and cystoscopy with hydrodistension is not the first recommended therapy for a recently diagnosed patient with this syndrome.
Robert Mayer, MD.,1 as part of Beyond the Abstract on UroToday.com. This initiative offers a method of publishing for the professional urology community. Authors are given an opportunity to expand on the circumstances, limitations etc... of their research by referencing the published abstract.
1Professor of Urology, University of Rochester Medical Center