The relationship between sexual abuse and interstitial cystitis/painful bladder syndrome.
Interstitial cystitis/painful bladder syndrome (IC/PBS) is a chronic syndrome characterized by irritative voiding symptoms and pelvic pain or discomfort. IC/PBS represents localized bladder pathophysiologic changes and central nervous system upregulation. Patients exhibit bladder hyperalgesia and allodynia. Childhood sexual abuse occurs in up to 27% of females in the United States. Adults with a prior history of abuse or traumatization demonstrate hypothalamic-pituitary-adrenal (HPA) axis abnormalities, similar to IC/PBS patients. Childhood sexual abuse and physical traumatization are associated with subsequent lifelong risks of chronic pain syndromes. IC/PBS patients have increased rates of sexual abuse or physical traumatization histories compared with controls. IC/PBS patients with abuse histories tend to have greater pain intensity and lesser irritative voiding symptoms compared with nonabused IC/PBS patients. This article reviews the relationship between sexual abuse, HPA axis abnormalities, IC/PBS pathophysiology, and the role of sexual abuse on subsequent IC/PBS.
Mayson
Brian E
BE
Division of Urology, St. Paul's Hospital, Burrard Building C307, 1081 Burrard Street, Vancouver, British Columbia, V6Z 1Y6, Canada.
Teichman
Joel M H
JM
D000328:Adult; D002648:Child; D002650:Child Abuse, Sexual; D018856:Cystitis, Interstitial / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology; D005260:Female; D006801:Humans; D009422:Nervous System Diseases / Q000150:complications / Q000209:etiology