Improvement in Sexual Functioning in Patients with Interstitial Cystitis/Painful Bladder Syndrome

Queen's University-Urology, Kingston, Ontario, Canada.
Journal of Sexual Medicine (Impact Factor: 3.15). 02/2008; 5(2):394-9. DOI: 10.1111/j.1743-6109.2007.00686.x
Source: PubMed


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.

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    • "Nickel et al reported that sexual function was the key factor in determining the quality of life in elderly patients with interstitial cystitis [1]. The authors also noted that the goal of treatment should focus on sexual dysfunction and stated that the improvement of symptoms of IC/PBS should accompany improvement of sexual function [21]. In patients with sexual dysfunction presenting with IC/PBS, treatment should be approached in many directions, including psychological and social aspects; additionally, consultation with specialists in relevant fields may be beneficial. "
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    ABSTRACT: We investigated how the symptoms of interstitial cystitis/painful bladder syndrome (IC/PBS) are correlated with the sexual activity of these patients. A total of 87 patients were included in this study; 18 patients were diagnosed with IC and the other 69 had PBS. The diagnosis was made on the basis of the concept of IC/PBS proposed by the ICS in 2002. Patients were asked to fill in a Bristol female lower urinary tract symptom questionnaire, and symptoms were rated on a scale of from 1 to 4 or 5. Pearson's correlation coefficient was used to analyze the correlation of pain and urinary symptoms with quality of life and sexual activity. The average age of the patients was 51+/-14.7 years (range, 28-74 years). Age and vulvodynia were positively correlated with one another (r=0.232), and there was a negative correlation between age and dyspareunia (r=-0.302). Among the items regarding IC/PBS and sexual activity, frequency showed a positive correlation with vulvodynia (r=0.258) in addition to an inhibited sex life (r=0.403). Urgency showed a positive correlation with an inhibited sex life (r=0.346). Vulvodynia showed a positive correlation with an inhibited sex life (r=0.259) and dyspareunia (r=0.401). The main symptoms of IC/PBS (frequency, urgency, and pelvic pain) showed a positive correlation with almost all items related to quality of life (p<0.05). Frequency, urgency, and various types of pain are negatively correlated with the sexual activity of patients. This suggests that physicians should consider sexual function in the management of patients with IC/PBS.
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  • European Urology 03/2008; 54(5):1152. DOI:10.1016/j.eururo.2008.01.080 · 13.94 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.
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