Hormonal manipulation in women with chronic, cyclic irritable bladder symptoms and pelvic pain

Lentz GM, Gretchen M Lentz, Bavendam T, Tamara Bavendam, Morton A Stenchever, Stenchever MA, Miller JL, Jane L Miller, Jackie Smalldridge, Smalldridge J
American Journal of Obstetrics and Gynecology · 2002 · vol. 186(6) , pp. 1268–1273 · doi:10.1067/mob.2002.123729 · PMID:12066108 · W2017223311
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This study investigated the effects of hormonal manipulation on chronic, cyclic irritable bladder symptoms and pelvic pain in women.

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Abstract

ObjectiveChronic, painful bladder symptoms are diagnostic and therapeutic challenges for urologists and gynecologists. The aims of this study were to evaluate women with menstrual cycle-related changes in their interstitial cystitis symptoms, to treat them with hormonal manipulation, and to follow them long term.Study designThe cases of women who were referred to a tertiary care center with interstitial cystitis and menstrual cycle exacerbation of symptoms were evaluated in a retrospective study. Fifteen women had undergone laparoscopy that was followed immediately by cystoscopy and bladder hydrodistension. Patients were then treated with leuprolide acetate or oral contraceptive pills.ResultsPatient age ranged from 23 to 48 years. The duration of symptoms ranged from 1 to 26 years. Ten patients (67%) had findings of both interstitial cystitis and peritoneal endometriosis. Five of 15 patients (33%) had interstitial cystitis, but no endometriosis was found. Symptoms improved for 8 of 9 women who were treated with leuprolide acetate and for 5 of 6 women who were treated with oral contraceptive pills. Patients were followed up for an average of 55 months.ConclusionDiagnostic laparoscopy should be considered together with hydrodistension of the bladder for women with pelvic pain and irritative bladder symptoms that are exacerbated premenstrually. Endometriosis is often present in patients with these complex symptoms. This is the first report of hormonal treatment for chronic, cyclic irritative bladder symptoms; improvement appears to occur even when endometriosis is not identified by laparoscopy.

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Condition tags

endometriosischronic_pelvic_pain

MeSH descriptors

Contraceptives, Oral Cystitis, Interstitial Cystitis, Interstitial Leuprolide Menstrual Cycle Pelvic Pain Adult Chronic Disease Contraceptives, Oral Cystitis, Interstitial Cystitis, Interstitial Cystitis, Interstitial Cystoscopy Dilatation Dilatation Endometriosis Endometriosis Female Follow-Up Studies Humans

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