Editorial Comment from Dr Morley and Dr Zaslau to Non‐bladder conditions in female <scp>T</scp>aiwanese patients with interstitial cystitis/hypersensitive bladder syndrome
Notice bibliographique
Résumé
The Society for Urodynamics and Female Urology defines interstitial cystitis/hypersensitive bladder syndrome (IC/HBS) as “an unpleasant sensation (pain, pressure, discomfort) perceived to be related to the urinary bladder, associated with lower urinary tract symptoms of more than 6 weeks' duration, in the absence of infection or other identifiable causes”.1 The disease is more common in women than men. The RAND Interstitial Cystitis Epidemiology study showed a prevalence of 2.7–6.5% in USA women.2 However, despite its high prevalence, the disease is still not completely understood. The authors of the present study highlight the importance of screening for other comorbidities in patients with IC/HBS, as this correlates with the severity of their bladder symptoms.3 Through their questionnaires they have found both irritable bowel syndrome (IBS) and tension/migraine headaches to be more common in patients with IC/HBS. Also, patients with more comorbidities have more bothersome IC/HBS symptoms. Nickel et al. found similar findings in Canadian women, along with associations with fibromyalgia and chronic fatigue syndrome. Likewise, as the number of comorbid conditions increased, so did the severity of IC/HBS symptoms.4 These findings emphasize the need to treat both bladder and non-bladder symptoms. Many studies have tried to identify the linking factors between IC/HBS and other comorbidities without the exact cause known. As the authors of the present study pointed out, there are several hypotheses. One interesting pathway is the shared motor and sensory innervation with IBS. We have found success in treating patients with IC/HBS and IBS with sacral neuromodulation. Some patients' experienced relief of both their gastrointestinal and genitourinary symptoms, and this had a profound impact on their quality of lives. Similar effects were seen in patients with concomitant fecal incontinence. One patient was a 14-year-old female who had tried multiple treatments for these problems. An in-office percutaneous sacral neuromodulation trial produced >50% improvement in both her genitourinary and gastrointestinal symptoms. She has since undergone stage I/II implantation of the device and continues to do well. Further research into the pathophysiology of IC/HBS linkage to other comorbidities will be essential to guide future treatments for these challenging patients. None declared.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,001 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,001 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».