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PubMed2006

Interstitial cystitis.

Interstitial cystitis is an enigmatic and frustrating condition to manage as a physician and to cope with as a patient. Traditionally, it has been defined as a chronic sterile inflammatory disease of the bladder of unknown aetiology. However, the International Continence Society prefers the term painful bladder syndrome and it has been decided to follow this terminology and refer to the disease as painful bladder syndrome/interstitial cystitis (PBS/IC). The condition is characterized by bladder pain, urinary frequency, urgency and nocturia. The quality of life of patients with PBS/IC is significantly degraded. Its aetiology is unknown, but might involve microbiologic, immunologic, mucosal, neurogenic and other yet unidentified agents. History, physical examination, urine analysis and culture as well as cystoscopy and hydrodistension are useful diagnostic tools but the final diagnosis tends to be a diagnosis of exclusion. This article will review the major theories of aetiology for PBS/IC and discuss diagnosis as well as the current treatment options with relevance to the proposed aetiologies.

Amitriptyline↗

PubMed2005

Will removal of anonymity influence the recruitment of egg donors? A survey of past donors and recipients.

The UK Government has determined that children born from egg donation have the same right to know their biological parent as adopted children on reaching the age of 18. There is concern as to the effect of loss of anonymity on egg donor recruitment, since a wait of 1 or 2 years is not unusual for couples awaiting treatment. Some fertility programmes have introduced egg-sharing to circumvent these delays. However, egg-sharing may involve a sub-fertile donor and thus is likely to be less successful overall than egg donation. Recently, the Human Fertilisation and Embryology Authority announced a consultation exercise to consider whether egg donors should receive increased payment or benefits in kind for their donation. To investigate whether or not removal of anonymity would have influenced or would influence their future participation, past egg donors and recipients have been surveyed. Questionnaires were sent to 867 former egg donors (n=504) and recipients (n=363), who were anonymous to each other. Response rates were similar between donors (32.7%) and recipients (39.1%). Of donors, 36.4% would not have participated had donor anonymity been waived, but 69.1% would donate anonymously again. Of recipients, 53.5% would not have proceeded had donor anonymity been waived, whereas 96.5% would receive anonymously donated eggs again. The results indicate that removal of anonymity for egg donors is likely to lead to a further restriction of an already unsatisfactory service to patients requiring donated eggs unless fundamental new initiatives are implemented.

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