Sexual function is a determinant of poor quality of life for women with treatment refractory interstitial cystitis.
OBJECTIVE
Interstitial cystitis significantly negatively impacts quality of life. The demographic and clinical factors associated with decreased quality of life in these patients have not been well studied.


METHODS
Women with moderate/severe interstitial cystitis enrolled in a clinical trial of intravesical bacillus Calmette-Guerin were studied. Demographic data and responses to questionnaires were evaluated at baseline, including the O'Leary-Sant Interstitial Cystitis Symptom Index and Problem Index, University of Wisconsin Interstitial Cystitis Inventory, Medical Outcomes Study sexual functioning scale, and the physical composite and mental composite scales of the Medical Outcomes Study Short Form Health Status Survey. Three composite indexes were constructed (from the O'Leary-Sant Interstitial Cystitis Symptom Index, O'Leary-Sant Interstitial Cystitis Problem Index, pain/urgency Likert scales and 24-hour voiding diary) to document the severity, frequency and bother of pain, urinary urgency and frequency (frequency composite index). Linear and multivariate regression models were used to examine predictors of the physical composite and mental composite scales of the Medical Outcomes Study Short Form Health Status Survey. Medical Outcomes Study sexual functioning scale data were available for 163 of the 217 women in the trial.


RESULTS
Physical composite scale (median 36) and mental composite scale (median 42) were lower than the standard population value of 50. Multivariate models showed that employment, pain composite index and Medical Outcomes Study sexual functioning scale (all p<0.001) predicted physical composite scale, while only Medical Outcomes Study sexual functioning scale (p<0.001) remained a strong predictor of mental composite scale.


CONCLUSIONS
Sexual functioning, employment and pain issues predict mental and physical quality of life. In particular, this study identifies sexual functioning as a primary predictor of mental quality of life in women with long-standing interstitial cystitis. It is suggested that sexual functioning may be a salient therapeutic target in the multifaceted treatment of patients with interstitial cystitis.
Nickel
J Curtis
JC
Department of Urology, Queen's University, Kingston General Hospital, Kingston, Ontario, Canada. jcn@post.queensu.ca
Tripp
Dean
D
Teal
Valerie
V
Propert
Kathleen J
KJ
Burks
David
D
Foster
Harris E
HE
Hanno
Philip
P
Mayer
Robert
R
Payne
Christopher K
CK
Peters
Kenneth M
KM
Kusek
John W
JW
Nyberg
Leroy M
LM
D000276:Adjuvants, Immunologic / Q000008:administration & dosage / Q000627:therapeutic use*; D000283:Administration, Intravesical; D001500:BCG Vaccine / Q000008:administration & dosage / Q000627:therapeutic use*; D018856:Cystitis, Interstitial / Q000188:drug therapy / Q000503:physiopathology / Q000523:psychology; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D010147:Pain Measurement; D017699:Pelvic Pain / Q000503:physiopathology / Q000523:psychology; D011788:Quality of Life; D012720:Severity of Illness Index; D019529:Sexuality / Q000187:drug effects* / Q000502:physiology; D013997:Time Factors; D016896:Treatment Outcome; D014563:Urodynamics / Q000187:drug effects* / Q000502:physiology
D000276:Adjuvants, Immunologic; D001500:BCG Vaccine