Prevalence Of Painful Bladder Symptoms And Effect On Quality Of Life In Black, Hispanic And White Men And Women

Main Category: Urology / Nephrology
Also Included In: Public Health
Article Date: 07 Aug 2007 - 0:00 PDT

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UroToday.com- Using questionnaire data obtained from a community based sample of Black, Hispanic, and White men and women Clemens and coworkers from Northwestern University, the New England Research Institutes, and the National Institute of Diabetes and Digestive and Kidney Diseases examined the impact of varying definitions of painful bladder syndrome on its overall prevalence and its distribution by gender, race/ethnicity, age, and socioeconomic status as well as, symptom impact on quality of life.

The BACH survey comprises a population based cross-sectional survey of individuals using a multistage stratified cluster sample. Subjects agree to a 2 hour interview in person in their home. The questionnaire contained 3 questions about bladder pain, 3 about urinary frequency, 3 about urinary urgency, and 2 about nocturia. By necessity, data analysis used arbitrary definitions put together by the investigators based on answers to the 11 voiding questions, number of positive answers to each of the symptoms questions, and frequency of symptoms.

The prevalence of painful bladder syndrome symptoms was 0.83% to 2.71% in women and 0.25% to 1.22% in men depending upon the definition used. Symptoms were more common in women, middle-aged individuals, and lower socioeconomic status groups. Symptoms significantly impacted quality of life. The definition with the highest prevalence was the following, "The presence of pain that increases as the bladder fills or pain relieved by urination, reported as fairly often or greater for at least 3 months."

What is most interesting about this paper is the fact that definitions 7 and 8, O'Leary Sant IC symptom index score (ICSI) greater than 7 or 12 respectively, identified individuals who did not report bladder pain. Therefore, definitions relying on the ICSI were not employed as the authors felt they were picking up overactive bladder rather than painful bladder syndrome. The authors also note that their methodology may have overestimated the prevalence of painful bladder syndrome since some individuals may have had specific identifiable causes of symptoms such as recurrent episodes of bacterial cystitis, undiagnosed bladder cancer, and etc.

The authors conclude that painful bladder symptoms are reported by 1-2% of the population, which certainly seems a reasonable estimate.

Clemens JQ, Link CL, Eggers PW, Kusek JW, Nyberg Jr. LM, McKinlay JB, BACH Survey Investigators

J. Urol. 177(4):1390-1394, April 2007
doi:10.1016/j.juro.2006.11.084

Reported by UroToday.com Contributing Editor Philip M. Hanno, MD

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