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Symptomatic overlap in overactive bladder and interstitial cystitis/bladder pain syndrome: development of a new
A Lenore Ackerman1, H Henry Lai2, Pooja S Parameshwar1
1Division of Urology, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
BJU International
|September 26, 2018
Summary
This study developed a new diagnostic algorithm to differentiate overactive bladder (OAB) and interstitial cystitis/bladder pain syndrome (IC/BPS), improving classification accuracy for storage lower urinary tract symptoms (LUTS). The novel nomogram achieved 94% accuracy in identifying these conditions.
Area of Science:
- Urology
- Clinical Diagnostics
Background:
- Storage lower urinary tract symptoms (LUTS) present diagnostic challenges due to significant symptomatic overlap between overactive bladder (OAB) and interstitial cystitis/bladder pain syndrome (IC/BPS).
- Accurate differentiation is crucial for effective patient management and treatment strategies.
Purpose of the Study:
- To define fundamental features distinguishing OAB and IC/BPS.
- To develop a novel clinical nomogram for improved screening and classification of storage LUTS.
Main Methods:
- Retrospective analysis of self-reported symptoms in women using validated questionnaires (fGUPI, OAB Questionnaire, O'Leary-Sant Indices).
- Univariate analysis to identify differentiating questions between OAB, IC/BPS, and control groups.
- Development and validation of a composite scoring system and nomogram in two cohorts (n=50 and n=150).
Main Results:
- No combined symptom scores significantly differed between OAB and IC/BPS groups, highlighting symptom overlap.
- Significant bladder pain present in 35% of OAB patients; urge incontinence in 25% of IC/BPS patients.
- The novel nomogram achieved 94% diagnostic accuracy, outperforming individual questionnaire domains.
Conclusions:
- A novel algorithm and nomogram effectively differentiate OAB and IC/BPS, improving diagnostic accuracy for storage LUTS.
- This tool aids in screening and classifying LUTS, particularly in patients presenting with other complaints.
- Future research should focus on symptom-based classification schemes for enhanced patient prognosis.
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