Improvement in sexual functioning in patients with interstitial cystitis/painful bladder syndrome
ABSTRACT Sexual functioning is one of the strongest predictors of poorer quality of life (QOL) in patients diagnosed with interstitial cystitis/painful bladder syndrome (IC/PBS).
To examine the relationship between symptom reduction and sexual functioning in patients with IC/PBS.
Patients with IC/PBS were treated with 300 mg/day pentosan polysulfate sodium for 32 weeks.
Patients completed the O'Leary-Sant Interstitial Cystitis Symptom Index, Short Form-12 QOL, and Medical Outcomes Study Sexual Functioning Scale at baseline, and at 8, 16, 24, and 32 weeks. Treatment responders were defined as those achieving a >/=30% reduction in symptom index from baseline.
A total of 128 patients were included in the analyses. At baseline, mean symptom index, QOL (physical and mental), and sexual functioning scores were 12.3, 41.7, 45.9, and 56.1, respectively. Patients showed statistically significant improvement in symptom and sexual functioning scores at weeks 8, 16, 24, and 32. At week 32, the mean change in symptom index score from baseline was -2.97 (standard deviation [SD] = 4.66, P < 0.0001), and the mean change in sexual functioning score from baseline was 8.9 (SD = 32.9, P = 0.0054). Reduction in symptom index score was moderately correlated with improvement in sexual functioning score at the end of study (r = -35, P = 0.0002). Positive correlation was observed at the end of the study between the mean change scores of sexual functioning score and physical and mental QOL components (r = 0.46, P < 0.0001 and r = 0.29, P = 0.0023, respectively). Patients achieving a >/=30% reduction in symptom index (responder, N = 47; 44%) had an adjusted mean change in sexual functioning score of 19.8 (standard error [SE] = 4.69), while nonresponders (N = 59, 56%) had an adjusted mean change -0.49 (SE = 4.17) (between groups, P = 0.0020).
Sexual dysfunction is moderate to severe in patients with IC/PBS and impacts significantly on QOL. Reduction in symptoms was associated with improvement in the patient-reported outcomes of sexual function.
- European Urology 03/2008; 54(5):1152. DOI:10.1016/j.eururo.2008.01.080 · 12.48 Impact Factor
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ABSTRACT: To study the association of sexual dysfunction with quality of life (QOL) while simultaneously examining the shared influence of empirically supported variables that are also associated with diminished interstitial cystitis/painful bladder syndrome (IC/PBS) QOL (ie, pain, catastrophizing, depression). Previous research has indicated that sexual dysfunction is prevalent, bothersome, and an important predictor of diminished QOL in patients with IC/PBS. However, the deleterious association between sexual dysfunction and QOL has not been investigated in more inclusive models that use validated measures. Women were recruited from 3 North American centers who agreed to the study and completed measures of QOL, pain severity, IC/PBS symptoms and bother (IC Symptom Index, IC Problem Index), pain catastrophizing, depression, and sexual dysfunction. Hierarchical multivariate regression was executed to test both unique and combined effects. A total of 115 women, with a mean age of 50 years, participated in this study. Regression modeling showed that diminished QOL physical composite scores were predicted by a longer symptom duration (P = .013), unemployment (P = .017), and greater pain severity (P = .004). In regard to the diminished QOL mental composite scores, the lone predictors included age (P = .029) and pain catastrophizing (P = .002). In disagreement with previous research, sexual functioning was not associated with diminished physical or mental composites of patient QOL. Furthermore, these data suggest that demographic factors and pain might be predictive of poorer QOL outcomes, and that anxious worry about pain (ie, catastrophizing) is a target for future research and clinical intervention.Urology 06/2009; 73(5):987-92. DOI:10.1016/j.urology.2008.11.049 · 2.13 Impact Factor
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ABSTRACT: A clinical guideline and algorism for interstitial cystitis and hypersensitive bladder syndrome has been developed by a group of East Asian urologists as a revised form of the Japanese guideline for interstitial cystitis. The guideline defines interstitial cystitis (IC) as a disease of the urinary bladder diagnosed by 3 requirements; 1) a characteristic complex of lower urinary tract symptoms, 2) bladder pathology such as Hunner's ulcer and bladder bleeding after overdistension, and 3) exclusions of confusable diseases. The characteristic symptom complex is termed as hypersensitive bladder syndrome (HBS), which is defined as bladder hypersensitivity, usually associated with urinary frequency, with or without bladder pain. For the definite diagnosis of IC, cytoscopy or hydrodistension is crutial; HBS is the diagnosis when IC is suspected but not confirmed by the 3 requirements. Numerous therapeutic options are available; however, most of them lack in high level of evidence, leaving a few as recommended therapies. Etiology of IC are multifactorial; the interaction among nervous, immune and endocrine factors forms a vicious cycle, provocating and maintaining inflammatory reactions in the bladder. The inclusion and efficacy criteria for clinical trials should be standardized to enhance the clinical research for this disabling disease, which has proved to be more prevalent than previously believed.International Journal of Urology 06/2009; 16(7):597 - 615. DOI:10.1111/j.1442-2042.2009.02326.x · 1.80 Impact Factor