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Urgency Not A Reliable Diagnostic Symptom For IC/BPS
A review of data from the Rand Interstitial Cystitis Epidemiology Study (RICE) presented by J. Quentin Clemens and colleagues from Michigan, Massachusetts, and California confirms that “urgency” is not a well-defined and commonly understood symptom that can be utilized to clearly discriminate between IC/BPS and overactive bladder (OAB). This reinforces the clinical observation that it is often challenging to differentiate between these two conditions, especially on the basis of this common complaint.
Women with diagnoses of IC/BPS (n=194) and OAB (n=85) were recruited from the clinical practices of urologists and gynecologists considered reliable for making these diagnoses. Eleven questions about urinary urgency were included in the questionnaires. Responses were compared between the two groups. Responses to 5 of the 11 urgency questions were statistically different between the two patient groups. In IC/BPS patients fully 87% reported that the urgency was due to pain, pressure or discomfort while only 11% indicated the urgency was due to a fear of incontinence. By comparison, 43% of OAB patients reported that the urgency was due to pain, pressure, or discomfort, while 49% indicated the urgency was due to fear of incontinence.
The results indicate that current urinary urgency was a commonly reported symptom by women diagnosed with IC/BPS and OAB, and that there was considerable overlap in how these urgency symptoms are interpreted by women with each condition. The researchers make the cogent observation that urgency has not been included as a criterion for diagnosis for IC/BPS. The use of the term “sudden” is included in the International Continence Society definition of urgency in an attempt to separate the urgency of overactive bladder (sudden) from that of IC/BPS (more gradual onset). The data in this study clearly demonstrates that “sudden “can apply to both conditions.
Clemens JQ, Bogart LM, Liu K, Pham C, Suttorp M, Berry SH
Neurourol Urodyn. 2010 Nov 5. Epub ahead of print.
10.1002/nau.20974
PubMed Abstract
PMID: 21058364
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