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.
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ABSTRACT: OBJECTIVE: This study aimed to assess whether the domains identified by items on the Sexual Functioning Questionnaire (SFQ) apply to women with vulvodynia. MATERIALS AND METHODS: Forty-one women with vulvodynia and 43 asymptomatic controls, between the ages 18 and 70 years, were assessed with a physician evaluation and a written survey that included the SFQ. RESULTS: Women with vulvodynia had a higher likelihood of female sexual dysfunction than did controls as indicated by 5 of the seven individual SFQ domains (desire, arousal-lubrication, pain, enjoyment, and partner domains, p < .05). Scored on individual items relating to pain or penetrative sex differed more by vulvodynia presence than did items related to arousal and emotions. Compared with published SFQ psychometrics, factor analysis among women with vulvodynia demonstrated similar factor loadings in 6 of the 7 domains of the SFQ (desire, arousal-sensation, arousal-lubrication, orgasm, partner, and pain), but the enjoyment domain intermingled substantially with these other domains. CONCLUSIONS: The SFQ factor structure is generally valid among women with vulvodynia. However, vulvodynia may impact responses to individual items on questions about pain and/or penetration, which may potentially result in erroneous interpretations.Journal of Lower Genital Tract Disease 04/2013; · 1.21 Impact Factor
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ABSTRACT: Bladder pain syndrome (BPS) is an enigmatic condition, which can be debilitating for the patients, affecting their quality of life. Its prevalence is believed to have become markedly higher (100-300/100,000 women) than in previous years. Its etiology and pathogenesis remain unknown, and a number of theories based on clinical and experimental observations have been developed. It is difficult to be diagnosed and treated. There is a worldwide effort to standardize its nomenclature, definition, diagnosis, and treatment algorithm. The aim of this review is to critically appraise the current evidence on the diagnosis and management of BPS. We performed a review of the literature (Pubmed, Embase, Cochrane, Google Scholar, conference proceedings) as well as consensus statements and guidelines from relevant professional societies. We have critically compared these statements and guidelines with emphasis on the controversies. Patients may experience pain and lower urinary tract symptoms for a long time before diagnosis, affecting their mental health and work, causing stress, sleep disturbance, depression, and sexual dysfunction. BPS has been considered as one of a group of chronic pain syndromes rather than as primarily an inflammatory bladder disorder. Despite the wide range of treatments, most are empirical and inadequate, usually offering just symptom relief. There is often delay in commencing treatment, and this may result in worse prognosis. Efforts are focused on different pathways for the early identification of this syndrome, trying to elucidate the pathogenetic mechanism, as well as introducing effective treatments. Neurourol. Urodynam. 9999:XX-XX, 2013. © 2013 Wiley Periodicals, Inc.Neurourology and Urodynamics 08/2013; · 2.67 Impact Factor
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ABSTRACT: Intravesical instillation with a hyaluronic acid (HA) solution is an effective treatment for interstitial cystitis/bladder pain syndrome (IC/BPS), but its impact on sexual functioning of patients is not known. The aim of this study was to evaluate the changes in sexual function of women with refractory IC/BPS who underwent a second-line intravesical HA therapy. A total of 103 women diagnosed with refractory IC/BPS were enrolled in this prospective, multicenter study. Sexual function was evaluated using the short form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire (PISQ-9). Bladder-related symptoms and bother were assessed by the Interstitial Cystitis Symptom Index (ICSI) and Interstitial Cystitis Problem Index (ICPI), and a pain visual analog scale (VAS), respectively. Data were analyzed with univariate methods or multivariate logistic regression analysis accordingly. Changes in PISQ-9, ICSI, ICPI, and pain VAS scores after treatment were assessed. Mean age and duration of symptoms was 43.6 ± 11.8 and 5.1 ± 5.0 years, respectively. ICSI, ICPI, and pain VAS scores were significantly (P < 0.001) improved after 1 month and 6 months of treatment. Of the 87 (84.5%) sexually active women evaluated, PISQ-9 total scores improved significantly (P < 0.001) from the baseline (mean 18.9 ± 6.4), after 1 month (20.4 ± 5.8), and 6-months (21.5 ± 5.6) of treatment. Significantly improved PISQ-9 items included "dyspareunia" (P < 0.001) and "negative reactions" (P = 0.015) during sexual intercourse, and "intensity" (P < 0.001) of sexual orgasms. After a logistic regression analysis, we found that a baseline PISQ-9 score was negatively correlated with the duration of IC/BPS symptoms (P = 0.022). Meanwhile, the changes in PISQ-9 scores were positively correlated with the reduction in ICSI scores after treatment (P = 0.045). Intravesical HA is an effective treatment for refractory IC/BPS. A longer duration of IC/BPS symptoms may be a predictor of poor sexual function. However, intravesical HA may improve sexual function along with the reduction of IC/BPS symptoms. Hung MJ, Su TH, Lin YH, Huang WC, Lin TY, Hsu CS, Chuang FC, Tsai CP, Shen PS, and Chen GD. Changes in sexual function of women with refractory interstitial cystitis/bladder pain syndrome after intravesical therapy with a hyaluronic acid solution. J Sex Med **;**:**-**.Journal of Sexual Medicine 03/2014; · 3.51 Impact Factor