title: Potential factors that can be used to differentiate between interstitial cystitis/painful bladder syndrome and bladder oversensitivity in women.
abstract: OBJECTIVE
  There is considerable overlap between symptoms of interstitial cystitis/painful bladder syndrome (IC/PBS) and bladder oversensitivity, thereby making it difficult to differentiate between the two based on symptoms alone. We investigated factors that could potentially be used to differentiate between IC/PBS and bladder oversensitivity in women.
  
  
  METHODS
  Video-urodynamic study (VUDS) results in women with lower urinary tract symptoms (LUTS) were retrospectively analysed. Patients classified as having increased bladder sensation (IBS) were selected for analysis. A potassium chloride (KCl) test was performed and pain or urgency elicited was considered positive response. Cystoscopic hydrodistention demonstrating glomerulation was considered diagnosis of IC/PBS; otherwise bladder oversensitivity was diagnosed. LUTS, urodynamic variables and results of the KCl test were used to predict IC/PBS in these women.
  
  
  RESULTS
  A total of 405 women with IBS and 272 symptomatic controls with normal VUDS findings were included. Among 227 IBS patients undergoing KCl test, a positive result was found in 190 and a negative test result was found in 37. Characteristic glomerulation was noted in 170 patients, including 165 with a positive and five with a negative KCl test. We found that storage symptoms and pain had a positive predictive value of 45.3% for IC/PBS. When a CBC ≤ 350 ml was added the positive predictive value was 65% for IC/PBS. A combination of storage symptoms, a CBC ≤ 350 ml, a positive KCl test result with an increase of ≥ 2 on the visual analogue pain scale (VAS) provided 100% predictive of IC/PBS.
  
  
  CONCLUSIONS
  A diagnosis of IC/PBS can be made without cystoscopic hydrodistention in women with increased bladder sensation, having storage symptoms, a CBC ≤ 350 ml, a positive KCl test result and a VAS score ≥ 2.
authors.affiliation: Department of Urology, Taipei City Hospital, Yangming Branch, Taipei, Taiwan.
authors.forename: Y-C
authors.initials: YC
authors.lastname: Kuo
authors.forename: H-C
authors.initials: HC
authors.lastname: Kuo
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D018856:Cystitis, Interstitial / Q000175:diagnosis* / Q000503:physiopathology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000175:diagnosis* / Q000503:physiopathology; D008875:Middle Aged; D010147:Pain Measurement; D011189:Potassium Chloride; D011237:Predictive Value of Tests; D012677:Sensation / Q000502:physiology; D053201:Urinary Bladder, Overactive / Q000175:diagnosis / Q000503:physiopathology; D053202:Urinary Incontinence, Urge / Q000175:diagnosis / Q000503:physiopathology; D014563:Urodynamics / Q000502:physiology
chemical_list: D011189:Potassium Chloride