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
Bibliographic record
Abstract
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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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.035 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.004 | 0.004 |
| Open science | 0.004 | 0.002 |
| Research integrity | 0.022 | 0.027 |
| Insufficient payload (model declined to judge) | 0.016 | 0.015 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".