Prevalence and Impact of Bacteriuria and/or Urinary Tract Infection in Interstitial Cystitis/Painful Bladder Syndrome

ObjectivesTo determine the prevalence and clinical significance of documented bacteriuria and/or urinary tract infection in an interstitial cystitis/painful bladder syndrome (IC/PBS) population.MethodsUrine cultures were obtained at the initial assessment (documentation of sterile urine mandatory at diagnosis) and during routine follow-up, at each active treatment visit, and during and after the presentation and treatment of symptom flares in consecutively assessed female patients with IC/PBS. At each visit, the following questionnaires were completed: the O'Leary-Sant IC Symptom and Problem Index, the Pain Urgency Frequency questionnaire, and pain, frequency, and urgency Likert scales (0-10).ResultsA total of 100 patients with IC were followed up for 2 years. Of these 100 patients, 31 (31%) had ≥1 documented positive urine culture with a traditional uropathogen (mean 1.8, range 1-5). No difference was seen in the patients identified with bacteriuria and those without bacteriuria in age, symptom duration, O'Leary-Sant IC Symptom and Problem Indexes, Pain Urgency Frequency questionnaire, or pain, frequency, and urgency Likert scales. No correlation was found between the number of bacteriuria episodes and any symptom index evaluated. No significant difference was seen in any of the symptom indexes evaluated at baseline, during the bacteriuria episodes, or after successful bacterial eradication in the group identified with bacteriuria.ConclusionsThe presence of bacteriuria can be documented in an IC/PBS population of women whose urine has frequently been cultured; however, the patients with bacteriuria did not differ from those without evidence of bacteriuria, the bacteriuria episodes did not appear to be associated with the symptom flares, and antibiotic treatment of documented bacteriuria was not associated with significant IC/PBS-related symptom amelioration.