PubMed · 15217096
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Eric Lechevallier. 2004. [Interstitial cystitis: management].. https://pubmed.ncbi.nlm.nih.gov/15217096/
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Painful bladder syndrome (PBS) and interstitial cystitis (IC) often affect women of child-bearing age. This article includes information of interest to PBS/IC patients who are pregnant or contemplating pregnancy, and to the clinicians who care for them. One topic is how pregnancy affects PBS/IC symptoms, although little is known at this time. The article also describes the pregnancy risks associated with the most commonly used PBS/IC treatments. Finally, the current knowledge regarding genetic factors in IC is discussed.
We consider a longitudinal study of interstitial cystitis (IC) in women, in which the time between bouts of repeated measurements is large relative to the within-bout separation in time. Our outcome of interest is the number of nocturnal voids that we model via quasi-least squares (QLS) in the framework of generalized estimating equations (GEE). To account for potential intra-subject correlation, we directly apply a banded Toeplitz correlation structure that previously was only implemented in an ad hoc approach using GEE. We describe this structure, its appropriateness for data from the IC study, and the results of our analysis. We then demonstrate that correct specification of the underlying correlation structure versus incorrectly applying a simpler structure can prevent substantial losses in efficiency in estimation of the regression parameter. These comparisons involve the limiting values of the estimates of the correlation parameters, which are not consistent for the misspecification scenarios considered here. We therefore obtain the limiting values of the QLS estimates when the structure is incorrectly specified.
For years the bladder epithelium has been the focus for diagnosing and treating the frequency, urgency, and pelvic pain of interstitial cystitis. However, many patients have not found symptom relief with these therapies. Pelvic floor dysfunction is often present in these patients, yet it is often untreated. Pelvic floor dysfunction may be related to abuse, past surgeries, or other causes. It is important to look outside of the bladder and explore other causes and treatments for this condition. Pelvic floor therapies should be a first line of treatment for those women with chronic pelvic pain related to pelvic floor dysfunction.