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Keywords:

  • interstitial cystitis;
  • painful bladder syndrome;
  • prognostic factors;
  • chronic fatigue syndrome

Study Type – Prognosis (case series)

Level of Evidence 4

What's known on the subject? and What does the study add?

Interstitial cystitis/painful bladder syndrome (IC/PBS) comprises pain perceived to be from the bladder, urinary urgency and frequency, and nocturia. As diagnosed at present, it is primarily identified in adult women. It is a chronic disease yet its natural history has not been well studied.

In a prospective study of 304 incident female IC/PBS cases followed for a median of 33 months after onset, women with baseline chronic fatigue syndrome had a worse prognosis for IC/PBS. Mild IC/PBS at baseline was the only variable that was directly associated with a good prognosis.

OBJECTIVE

  • • 
    To identify baseline variables that predict the prognosis of interstitial cystitis/painful bladder syndrome (IC/PBS) in women seeking medical care for recent onset of this syndrome.

SUBJECTS AND METHODS

  • • 
    In a prospective study of women with incident IC/PBS (≤12 months of symptoms), we contacted patients at intervals and asked standardized questions about IC/PBS symptoms in the previous week.
  • • 
    Logistic regression analyses assessed baseline variables as predictors of mild vs more severe IC/PBS at the last follow-up.

RESULTS

  • • 
    Median length of follow-up was 33 months after onset of IC/PBS; 304 (97%) patients had at least one follow-up assessment.
  • • 
    Mild IC/PBS at baseline was the only variable that was directly associated with a mild IC/PBS endpoint.
  • • 
    Conversely, a history of chronic fatigue syndrome (CFS) was inversely associated with a mild endpoint of IC/PBS (i.e. individuals with CFS had a worse prognosis for their IC/PBS symptoms).

CONCLUSIONS

  • • 
    At a median of nearly 3 years after onset, baseline mild IC/PBS was directly associated with a milder disease severity.
  • • 
    Baseline co-morbid CFS was associated with more severe disease.
  • • 
    Whether CFS was uniquely associated or represented several co-morbid non-bladder syndromes (NBSs) could not be determined.