Fact Or Fiction - Is Abuse Prevalent In Patients With Interstitial Cystitis? Results From A Community Survey And Clinic Population

Main Category: Urology / Nephrology
Also Included In: Women's Health / Gynecology;  Clinical Trials / Drug Trials
Article Date: 07 Oct 2007 - 0:00 PDT

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UroToday.com- Abuse in all of its forms is extremely prevalent in the United States. In 16 cross-sectional community sample surveys of women a 16.8% prevalence of childhood sexual abuse was calculated. Women with a history of abuse often report more physical problems and chronic pain in adulthood than women without a history of abuse. Peters and colleagues from Royal Oak, Michigan surveyed the English literature and found no articles on the relationship of IC and a history of abuse. They now report the results of a study they designed to obtain some baseline data on this issue.

The bulk of the study was a cross-sectional case-control design looking at 2 unique populations. These were 406 women with an established diagnosis of BPS/IC and 5000 case-matched controls in the community. This survey was an anonymous mailed questionnaire. The second part of the study comprised face to face interviews with 76 women previously diagnosed with IC.

Of 5406 individuals surveyed by mail, 1038 responses were returned. Symptom-free controls made up 464 of the responders, 121 showed a history suggestive of IC, and 215 were from established patients with IC. There were a statistically significant higher proportion of women with IC reporting any form of abuse compared to symptom-free controls (37.3% v. 23.7%). All abuse types (sexual, physical, and emotional) were reported by a significantly higher propx1ortion of cases than controls.

In the interviewed population a total of 37 women (49%) reported a history of abuse. Of those reporting abuse, 92% reported emotional abuse, 78% reported physical abuse, 68% reported sexual abuse, and 49% were victims of domestic violence.

The study is limited by the low response rate and retrospective self-reporting. However, there is no doubting that in 2 distinctly different patient populations with IC, the authors found a disturbing signal of the possibility of abuse contributing to the onset of the disease. Almost 2 of 5 women in a large IC population admitted abuse on an anonymous questionnaire and 1 of 2 women with IC reported a history of abuse when interviewed directly in the clinic by a health care provider. As in all patients, an abuse history should be taken by the health care provider.

Peters KM, Kalinowski SE, Carrico DJ, Ibrahim IA, Diokno AC

Journal of Urology, 178(3):891-895, September 2007
doi:10.1016/j.juro.2007.05.047

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

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