Assessing urgency in interstitial cystitis/painful bladder syndrome.

Area of Science:

• Urology
• Clinical Medicine
• Patient-Reported Outcomes

Background:

• Interstitial cystitis/painful bladder syndrome (IC/PBS) is diagnosed based on symptoms.
• The Interstitial Cystitis Symptom Index (ICSI) assesses four cardinal symptoms: bladder pain, urgency, frequency, and nocturia.
• Current ICSI questions focus on symptom frequency rather than severity.

Purpose of the Study:

• To compare the ICSI with severity-based questions for assessing IC/PBS symptoms.
• To evaluate the accuracy of ICSI in capturing the sensation of urgency.
• To inform the development of a usable case definition for IC/PBS.

Main Methods:

• A case-control study enrolled women with recent-onset IC/PBS (symptoms ≤ 12 months).
• Pain, frequency, and urgency severity were assessed using Likert and categorical scales.
• ICSI symptom frequency scores were compared with severity scores using frequency distributions and interscale correlations.

Main Results:

• In 138 women, ICSI and severity scores for frequency were correlated; for pain, they were complementary.
• The ICSI question on urgency yielded lower scores than the severity question.
• Some patients denied urgency on ICSI but reported intense urgency on the severity scale.

Conclusions:

• The ICSI underestimates the prevalence and degree of urgency in IC/PBS patients.
• Urgency in IC/PBS may not be characterized by a sudden need to urinate, as suggested by the ICSI.
• Refining symptom descriptions, particularly for urgency, is crucial for a practical IC/PBS case definition.