The epidemiology of interstitial cystitis: Is it time to expand our definition?

Very few epidemiologic studies of interstitial cystitis ([C) have been publ ished over the past 5 years. One population-based study focused only on wom en and suggested that the prevalence of the IC symptom complex in the Unite d States is much higher than previously reported. Future epidemiologic stud ies of TC must overcome major obstacles to obtain more accurate population- based estimates. The National Institute of Diabetes and Digestive and Kidne y Diseases (NIDDK) criteria used to assist in identifying patients with IC have proven to be cumbersome and too restrictive. Other obstacles include ( l)the relative infrequency of the condition; [2] the long duration between development of symptoms and diagnosis; and (3) the perception that the diso rder occurs predominantly in white women. Evidence suggests men with the IC symptom complex are often misdiagnosed by physicians and identified as hav ing chronic prostatitis (also called the chronic pelvic pain syndrome) or b enign prostatic hyperplasia. Children who present with the IC symptom compl ex are often thought to have voiding dysfunction. We propose that the more inclusive, less restrictive term chronic pelvic pain of the bladder (CPPB) be used in future epidemiologic studies of persons with the characteristic IC symptoms of urinary frequency, urgency, and pain. Early studies of chron ic pelvic pain in general suggest that it is most common in women, of unkno wn etiology, and, in many patients, is associated with urinary bladder symp toms. It is necessary to develop case definitions for CPPB to accurately id entify those patients with symptoms currently identified as IC. (C) 2001, E lsevier Science Inc.