Female Veterans With Diagnoses of Both Chronic Pelvic Pain and Overactive Bladder; How Do They Compare to Women Diagnosed With Interstitial Cystitis?

Abstract

Objective The objective of this study was to compare women with a known diagnosis of interstitial cystitis (IC) to a population that might be at risk for the diagnosis of IC, women with diagnoses of both chronic pelvic pain (CPP) and overactive bladder (OAB). Methods We conducted a retrospective study of data from the Veterans Affairs Corporate Data Warehouse. The cohort included all female veterans who had established care with a primary care provider from 1997 to present. International Classification of Diseases, Ninth Revision codes were used to identify women with a diagnosis of IC, CPP, and OAB. Demographic data and comorbidities were compared between groups. Results A total of 596,815 women were identified. Two thousand three hundred one women (0.4%) were diagnosed with IC; 4459 women (0.7%) were diagnosed with CPP and OAB. At baseline, women with OAB and CPP were more likely to identify as minority (P < 0.001). Anxiety (57.3% vs 49.5%), depression (39.0% vs 46.0%), and posttraumatic stress disorder (29.7 vs 26.4%) were all more common in the CPP and OAB group than in the IC group. In the multivariable model, women with CPP and OAB were more likely to identify as a minority, use tobacco, and carry a diagnosis of anxiety. Conclusions There were more patients diagnosed with CPP and OAB compared with patients diagnosed with IC in this population of female veterans. Given the high rate of comorbid anxiety and depression in both groups, further study is warranted to determine whether these women are misdiagnosed.

Prevalence of Overactive Bladder Symptoms Among Women With Interstitial Cystitis/Bladder Pain Syndrome

“…This can be explained by the fact that an IC/BPS diagnosis in itself is challenging. In previous studies, approximately 46% of women had received alternative diagnoses for the same symptoms before being given a diagnosis of IC/BPS 4 ; at the same time, some women are being misdiagnosed with IC/BPS while having other similar urinary conditions, such as OAB. 19 Clinically, we tend to differentiate between IC/BPS and OAB by the motivation to void: fear of leakage (OAB) versus discomfort and pain with filling (IC/BPS).…”

“…There are multiple hypotheses surrounding the etiology and pathophysiology of IC/BPS, although the cause remains unknown. Frequently, diagnosis is delayed or women are being misdiagnosed with other conditions such as overactive bladder (OAB), chronic pelvic pain, or endometriosis before a true diagnosis of IC/BPS is established because of the overlap between these conditions 1,2,4–7 …”

“…Frequently, diagnosis is delayed or women are being misdiagnosed with other conditions such as overactive bladder (OAB), chronic pelvic pain, or endometriosis before a true diagnosis of IC/BPS is established because of the overlap between these conditions. 1,2,[4][5][6][7] Overactive bladder is a condition described as urinary urgency, frequency, or nocturia, with or without urinary incontinence, in the absence of urinary tract infection or other pathology. 8 The prevalence of OAB is 13% among women and increases with age.…”

Racial and Ethnic Disparities in Reproductive Health Outcomes Among Women Veterans: A Research Note

“…In addition, Black non-Hispanic veterans and Hispanic veterans were found to have higher prevalence of pregnancy loss and complications than White veterans (Quinn et al, 2020; Wells et al, 2006). Finally, women veterans who identify as a racial minority are more likely to have chronic pelvic pain compared with a majority racial group (Volpe et al, 2020).…”