The Overlap and Distinction of Self-Reported Symptoms between Interstitial Cystitis/Bladder Pain Syndrome and Overactive Bladder: A Questionnaire Based Analysis

Abstract

Purpose To compare the self-reported symptoms between IC/BPS and OAB based on patient-reported symptoms on validated questionnaires. Materials and Methods Patients diagnosed with IC/BPS (n=26) or OAB (n=53), and healthy controls (n=30), were prospectively recruited to participate in a questionnaire-based study that inquired their lower urinary tract symptoms using the following questionnaires: 1) Genitourinary pain index, 2) Interstitial cystitis symptom index and problem index, 3) International consultation on incontinence – overactive bladder, 4) International consultation on incontinence – urinary incontinence short form (ICIQ-UI), 5) Urgency severity scale, 6) numeric rating scales (NRS) of the severity of their bladder “pain, pressure, or discomfort”, and 7) NRS of severity of their urgency and 8) frequency symptoms. Results In univariate analyses, IC/BPS patients reported significantly more severe pain symptoms compared to OAB. OAB patients reported significantly more severe urinary incontinence symptoms compared to IC/BPS. There were no differences in the severity of frequency and urgency between IC/BPS and OAB. Surprisingly, 33% of OAB patients reported pain or discomfort when the bladder filled, while 46% of IC/BPS patients reported urgency incontinence. In multivariate analyses, the total scores on the ICIQ-UI Short Form (p=0.01) and the severity (NRS) of bladder pain (p<0.01) distinguished OAB from IC/BPS with a sensitivity of 90.6% and a specificity of 96.1% (OAB has higher ICIQ-UI and lower pain scores on NRS). Conclusions There is considerable overlap of self-reported symptoms between IC/BPS and OAB. This overlap raises the possibility that IC/BPS and OAB represent a continuum of a bladder hypersensitivity syndrome.

Does central sensitization help explain idiopathic overactive bladder?

“…In the pelvis, central sensitization has also been implicated in chronic pelvic pain, endometriosis, vulvodynia, and dysmenorrhea as well as interstitial cystitis/bladder pain syndrome (IC/BPS) 7,27–31 . Several additional painful genitourinary conditions characteristically involve abnormal and heightened processing of sensory information, including dyspareunia, orchalgia, chronic epididymitis, and chronic prostatitis/chronic pelvic pain syndrome, and some have hypothesized a role for central sensitization in these as well 7 .…”

Systemic Nonurological Symptoms in Patients with Overactive Bladder

“…2, 4, 7 The caveat of these population studies was that they lacked a clinical evaluation to distinguish OAB from other diagnosis such as IC/BPS. Since OAB and IC/BPS shared many overlapping symptoms (e.g., frequency, urgency), 5 it was not easy to distinguish between these conditions using symptom-based questionnaires without a clinical evaluation. This is an important consideration since previous studies have also demonstrated systemic presentation among IC/BPS patients, and association between IC/BPS and fibromyalgia and irritable bowel syndrome.…”

“…4 The difficulties with these studies were two-fold: 1) they were both population-based community surveys that lacked clinical evaluation to distinguish OAB from IC/BPS (interstitial cystitis/bladder pain syndrome). As we know, IC/BPS symptoms can mimic OAB (both have frequency and urgency symptoms), 5 and IC/BPS is known to be associated with fibromyalgia and irritable bowel syndrome. 6 2) the symptom score threshold used by the two studies to categorize subjects as having OAB (OAB-SS 3 ≥3 out of a total score of 15) was deemed too lax and lacked specificity.…”

Sleep Disorder in Children With Overactive Bladder

“…There is a considerable overlap of self-reported symptoms between interstitial cystitis/bladder pain syndrome and overactive bladder. This overlap raises the possibility that the two conditions represent a continuum of a bladder hypersensitivity syndrome [13].…”

“…Additionally, taking into account that each of these problems can greatly influence each other, and delayed intensification treatment can cause irreparable damage to children's future education and career. Consequently, this study was performed to examine the relationship between sleep disturbances and daily urinary disorders and to present new strategies for its treatment [13].…”