title: The overlap and distinction of self-reported symptoms between interstitial cystitis/bladder pain syndrome and overactive bladder: a questionnaire based analysis.
abstract: OBJECTIVE
  We compared symptoms between interstitial cystitis/bladder pain syndrome and overactive bladder based on patient self-reported symptoms on validated questionnaires.
  
  
  METHODS
  We prospectively recruited 26 patients diagnosed with interstitial cystitis/bladder pain syndrome, 53 diagnosed with overactive bladder and 30 healthy controls to participate in a questionnaire based study that inquired about lower urinary tract symptoms. The questionnaires used were GUPI, ICSI, ICPI, ICIQ-OAB, ICIQ-UI, IUSS, numerical rating scales of the severity of bladder pain, pressure or discomfort, and numerical rating scale of the severity of urgency and frequency symptoms.
  
  
  RESULTS
  On univariate analysis patients with interstitial cystitis/bladder pain syndrome reported significantly more severe pain symptoms than those with overactive bladder. Patients with overactive bladder reported significantly more severe urinary incontinence symptoms than those with interstitial cystitis/bladder pain syndrome. There was no difference in frequency and urgency severity between the groups. Surprisingly, 33% of patients with overactive bladder reported pain or discomfort when the bladder filled and 46% with interstitial cystitis/bladder pain syndrome reported urgency incontinence. On multivariate analysis ICIQ-UI total scores (p = 0.01) and bladder pain severity on the numerical rating scale (p <0.01) distinguished the 2 conditions with 90.6% sensitivity and 96.1% specificity. Overactive bladder had higher ICIQ-UI and lower numerical rating scale pain scores.
  
  
  CONCLUSIONS
  There is considerable overlap of self-reported symptoms between interstitial cystitis/bladder pain syndrome and overactive bladder. This overlap raises the possibility that the 2 conditions represent a continuum of a bladder hypersensitivity syndrome.
authors.affiliation: Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri. Electronic address: laih@wustl.edu.
authors.forename: H Henry
authors.initials: HH
authors.lastname: Lai
authors.affiliation: Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri.
authors.forename: Joel
authors.initials: J
authors.lastname: Vetter
authors.affiliation: Renal Division, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Jain
authors.affiliation: Department of Anesthesiology and Washington University Pain Center, Washington University School of Medicine, St. Louis, Missouri.
authors.forename: Robert W
authors.initials: RW
authors.lastname: Gereau
authors.affiliation: Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri.
authors.forename: Gerald L
authors.initials: GL
authors.lastname: Andriole
mesh_terms: D000328:Adult; D018856:Cystitis, Interstitial / Q000175:diagnosis*; D003937:Diagnosis, Differential; D059026:Diagnostic Self Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D053201:Urinary Bladder, Overactive / Q000175:diagnosis*
keywords: cystitis; diagnosis; interstitial; lower urinary tract symptoms; overactive; questionnaires; urinary bladder