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Childhood symptoms and events in women with interstitial cystitis/painful bladder syndrome
Kenneth M Peters1, Kim A Killinger, Ibrahim A Ibrahim
1Department of Urology, Ministrelli Program for Urology Research and Education, William Beaumont Hospital, Royal Oak, Michigan 48073, USA.
Insights
Childhood urinary tract infections and elimination difficulties are more common in women with interstitial cystitis/painful bladder syndrome (IC/PBS). Early diagnosis and monitoring of these symptoms may help prevent IC/PBS progression.
Area of Science:
- Urology
- Pediatrics
- Gynecology
Background:
- Interstitial cystitis/painful bladder syndrome (IC/PBS) is a chronic condition affecting the bladder.
- The early life origins of IC/PBS, particularly the role of dysfunctional voiding and bowel symptoms, remain unclear.
Purpose of the Study:
- To investigate the prevalence of childhood and adolescent urinary tract infections and elimination difficulties in adult women with IC/PBS.
- To explore the relationship between early life dysfunctional elimination symptoms and the development of IC/PBS.
Main Methods:
- A questionnaire was administered to 406 women with IC/PBS and 5000 community controls.
- Data collected included demographics, personal and family health history, and childhood, adolescent, and adult urinary and bowel symptoms.
- Statistical analyses included Student t test and multiple logistic regression.
Main Results:
- Significant differences were observed in recurrent urinary tract infections and frequent antibiotic use in childhood between patients and controls.
- Childhood and adolescent symptoms like urinary stream issues, urgency, retention, constipation, and painful defecation were more prevalent in the IC/PBS group.
- Logistic regression revealed childhood bladder infections and adolescent urinary urgency as significant predictors for developing IC/PBS.
Conclusions:
- Findings suggest a link between early life dysfunctional elimination symptoms and the development of IC/PBS.
- Longitudinal studies of children with these symptoms are needed to understand disease progression.
- Earlier diagnosis and potential prevention strategies for IC/PBS may be informed by this research.
Objectives:
To explore the prevalence of recurrent urinary tract infection and elimination difficulties experienced in childhood and adolescence in adult women with interstitial cystitis/painful bladder syndrome (IC/PBS) and community controls. The relationship between dysfunctional voiding and bowel symptoms in early life and the development of IC/PBS is not clear.
Methods:
A questionnaire was developed and mailed to 406 women with IC/PBS (patients) and 5000 community-dwelling controls. The demographic, personal, and family health history data and the urinary and bowel symptoms experienced in childhood, adolescence, and adulthood were collected. The data were analyzed using the Student t test and multiple logistic regression analysis.
Results:
A total of 215 patients (53%) and 823 controls (16%) returned the questionnaires (controls with a previous IC/PBS diagnosis or not meeting the inclusion criteria for either group were excluded from analysis). The 215 patients, 126 controls reporting IC/PBS symptoms but no diagnosis, and 464 asymptomatic controls were compared regarding symptoms and events experienced in childhood and adolescence. Statistically significant differences were seen among the groups for recurrent urinary tract infection (P < .0001) and frequent antibiotic use (P < .0001) in childhood and for all symptoms in childhood and adolescence, including trouble starting the urinary stream (P < .0001 for both), urgency (P < .0001 for both), retention (P = .0038 and P < .0001, respectively), constipation (P = .0006 and P = .0001, respectively), and painful defecation (P < .0001 for both). Multiple logistic regression analyses showed statistically significant differences between the patients and asymptomatic controls in childhood bladder infections (P = .006) and urinary urgency (P = .001) in adolescence.
Conclusions:
These results support the need for longitudinal prospective assessment of children with dysfunctional elimination symptoms to determine whether these symptoms progress to IC/PBS. Additional research will contribute to our understanding of the natural history of IC/PBS, promote its earlier diagnosis, and potentially prevent disease progression.
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