title: Interstitial cystitis is associated with vulvodynia and sexual dysfunction--a case-control study.
abstract: BACKGROUND
  Dyspareunia and sexual dysfunction are common in women with urological disorders. The study of comorbidity between interstitial cystitis (IC) and vulvodynia seems to be relevant to understand the mechanism generating pain in these conditions.
  
  
  OBJECTIVE
  To conduct a case-control study for evaluating vulvodynia and sexual dysfunction in women with IC.
  
  
  METHODS
  Forty-seven women with new diagnosis (National Institutes of Health [NIH]/National Institute of Diabetes and Digestive and Kidney Diseases [NIDDK] Criteria) of IC were compared with 188 age-matched, negative controls. Each woman completed a semi-structured interview and the Female Sexual Function Index (FSFI). A gynecological examination to assess vulvodynia (cotton swab testing) and genital health (vulvoscopy, Pap smear, culture, and vaginal health index score [VHIS]) was performed.
  
  
  METHODS
  Prevalence of vulvodynia, sexual function, and sociodemographic/gynecological variables significantly associated with IC.
  
  
  RESULTS
  Spontaneous or provoked vulvodynia was reported by 23.4% and 74.5% of IC cases, respectively. Sexual function was significantly impaired (median total FSFI score: IC cases 16.85 ± 8.73 vs. controls 27.34 ± 6.41; P<0.0001) in sexually active women, and 23.4% of IC cases as compared to 9% of controls reported no sexual activity in the year preceding the study (χ(2) for trend=38.2, P<0.0001). VHIS was highly impaired in women with IC in comparison with controls (P<0.0001). Variables significantly associated with IC were a diagnosis of menopause (odds ratio [OR]=31.2, 95% confidence interval [CI]=8.1-120.5), past (OR=4.6, 95% CI=1.74-12.1) or current (OR=6.9, 95% CI=2.1-22.1) oral contraceptive use, and a histologically confirmed diagnosis of endometriosis (OR=3.7, 95% CI=1.1-12.7).
  
  
  CONCLUSIONS
  We found an increased prevalence of vulvodynia among women with recently diagnosed IC; both conditions seem to have profound consequences on women's sexual function. A potential role for sex hormone-dependent mechanisms into the comorbidity of vulvar and bladder pain is proposed, but further research is warranted.
authors.affiliation: Department of Obstetrics and Gynecology, IRCCS San Matteo Foundation, University of Pavia, Pavia, Italy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Gardella
authors.forename: Daniele
authors.initials: D
authors.lastname: Porru
authors.forename: Rossella E
authors.initials: RE
authors.lastname: Nappi
authors.forename: Maria Diletta
authors.initials: MD
authors.lastname: Daccò
authors.forename: Alessia
authors.initials: A
authors.lastname: Chiesa
authors.forename: Arsenio
authors.initials: A
authors.lastname: Spinillo
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D018856:Cystitis, Interstitial / Q000175:diagnosis / Q000453:epidemiology*; D004414:Dyspareunia / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D008875:Middle Aged; D012307:Risk Factors; D012735:Sexual Dysfunction, Physiological / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D056650:Vulvodynia / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology