Interstitial cystitis and female sexual dysfunction.

OBJECTIVES: To use the Female Sexual Function Index (FSFI) to compare female sexual dysfunction in patients with interstitial cystitis/painful bladder syndrome (IC) with that in controls. METHODS: Consecutive patients with IC and asymptomatic controls were tested for voiding diary voided volumes, Pelvic Pain and Urgency/Frequency Questionnaire scores, and FSFI scores. RESULTS: Of the 97 subjects, 75 had IC and 22 were controls. The mean age was 38 and 43 years (P = 0.09), the voided volume was 165 mL and 294 mL (P <0.0001), and the Pelvic Pain and Urgency/Frequency Questionnaire score was 18 versus 3 (P <0.0001) for the IC and control groups, respectively. The total adjusted FSFI scores differed between patients with IC and the controls (20.2 +/- 9.6 versus 29.0 +/- 6.8, respectively, P <0.001). Using 26.55 as the cutpoint, 51 patients with IC (68%) had an abnormal FSFI score versus 3 controls (14%; P <0.001). Patients with IC scored worse on all domains of female sexual dysfunction than did the controls (P <0.01). CONCLUSIONS: The results of our study have shown that female patients with IC have sexual dysfunction, including pain, more commonly than do controls.

What is the value of cystoscopy with hydrodistension for interstitial cystitis?

OBJECTIVES: To determine the utility of cystoscopy with hydrodistension for the diagnosis and therapy of interstitial cystitis. Cystoscopy with hydrodistension is the most commonly performed diagnostic test and procedure in patients with interstitial cystitis. METHODS: Eighty-four consecutive patients with interstitial cystitis (68 women and 16 men) were studied retrospectively. The patients underwent history and physical examination, urinalysis, and urine culture and filled in a voiding diary and pain urgency frequency questionnaire. Cystoscopy with hydrodistension was performed in 47 patients. Patients who had and had not undergone hydrodistension were compared. Patients who underwent hydrodistension were characterized and followed up for response. RESULTS: The mean patient age was 41 years, mean daily voided volume was 98 mL, mean number of nocturnal episodes was 3, and pain urgency frequency score was 21. Comparing patients undergoing versus not undergoing hydrodistension, pain was reported in 61% versus 25% (P = 0.03), vaginal pain in 62% versus 32% (P = 0.02), and dyspareunia or ejaculatory pain in 67% versus 29% (P < 0.01), respectively. All other parameters were statistically similar. Of the patients undergoing hydrodistension, 43 had follow-up and 24 (56%) reported improvement (mean duration of 2 months). Of the patients with and without improvement, no difference was found in mean age (40 versus 46 years, P = 0.20), duration of symptoms (7 versus 7 years, P = 0.92), anesthetic capacity (722 versus 721 mL, P = 0.99), or glomerulation grade (P = 0.61), respectively. CONCLUSIONS: Cystoscopy with hydrodistension provided little useful information above and beyond the history and physical examination findings. As therapy, 56% of patients reported improvement, but the duration was short lived.

Xanthogranulomatous pyelonephritis in a 1-year old boy.

Xanthogranulomatous pyelonephritis (XGP) is a rare, chronic inflammatory lesion of the kidney associated with both chronic infection and obstruction. Most common in middle-aged females, it is important to recognize in children because it may be confused with childhood renal malignancies particularly Wilms' tumor. We report a case of a 1-year old male with antenatally detected and postnatally confirmed hydronephrosis. Further investigation revealed a left incomplete duplex collecting system with obstructing lower pole stones, pelvicaliectasis and widespread foci of calcification. He underwent a left nephroureterectomy with the pathological report noting XGP.