Investig Clin Urol.  2017 Sep;58(5):353-358. 10.4111/icu.2017.58.5.353.

Evaluation of the incidence and risk factors associated with persistent frequency in interstitial cystitis/bladder pain syndrome and the efficacy of antimuscarinic treatment

• Kim A
• Hoe KO
• Shin JH
• Choo MS

• KMID: 2388052
• DOI: http://doi.org/10.4111/icu.2017.58.5.353

Abstract

PURPOSE
To investigate the incidence and risk factors associated with persistent urinary frequency, and to evaluate the efficacy of antimuscarinic treatment.
MATERIALS AND METHODS
Interstitial cystitis/bladder pain syndrome (IC/BPS) patients complaining of persistent urinary frequency despite improved pain were evaluated. Before initial conventional treatment, each patient completed a voiding diary and symptom questionnaires. After conventional treatment, patients were divided according to the presence of pain and frequency. Improved pain was defined as lesser than 3 points in visual analogue scale, and persistent urinary frequency as >10 times/d. Risk factors for persistent frequency were identified through multivariate analysis. The efficacy of antimuscarinic treatment was assessed by the mean change of frequency.
RESULTS
Of 171 IC/BPS patients treated with conventional therapy, 132 had improved pain after 3 months, but 72 had persistent frequency (72 of 132, 54.5%). Patients with persistent frequency had lower voided volume (p=0.008), lower maximal flow rate (p<0.001), lower maximal bladder capacity (p=0.003), and more frequent micturition (p<0.001) at baseline compared to those with improved frequency. Patients who took antimuscarinic agents showed slightly decreased urinary frequency, from 14.6 times/d to 13.5 times/d (p=0.438) after 3 months of medication. No patients showed more than a 20% decrease in frequency with antimuscarinics.
CONCLUSIONS
About half of the patients with IC/BPS showed persistent frequency, with poor voiding function identified as a risk factor; antimuscarinic treatment was not effective in these patients.

Keyword

Antimuscarinics; Epidemiology; Interstitial cystitis; Pain; Urine

MeSH Terms

Cystitis, Interstitial
Epidemiology
Humans
Incidence*
Multivariate Analysis
Muscarinic Antagonists
Risk Factors*
Urinary Bladder
Urination
Muscarinic Antagonists

Figure

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  Fig. 1 Selection process to identify the incidence of persistent frequency. IC/ BPS, interstitial cystitis/bladder pain syndrome.

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  Fig. 2 Identification of risk factors for persistent frequency through comparison of groups 1 and 2 with initial variables of bladder function. Group 1, persistent frequency patients; group 2, improved frequency. (A) Voided volume (mL), (B) maximum flow rate (m/s) in uroflowmetry, (C) maximum bladder capacity (mL), (D) frequency (number of micturitions per day) in 3-day voiding diary. All variables are significantly different between 2 groups.

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