RAND Corporation, Santa Monica, California.90407-2138, USA.
J Urol. 2011 Aug;186(2):540-4. doi: 10.1016/j.juro.2011.03.132. Epub 2011 Jun 16.
Bladder pain syndrome/interstitial cystitis is a poorly understood condition that can cause serious disability. We provide the first population based symptom prevalence estimate to our knowledge among United States adult females.
We developed and validated 2 case definitions to identify bladder pain syndrome/interstitial cystitis symptoms. Beginning in August 2007 we telephoned United States households, seeking adult women with bladder symptoms or a bladder pain syndrome/interstitial cystitis diagnosis. Second stage screening identified those subjects who met case definition criteria. Each completed a 60-minute interview on the severity and impact of bladder symptoms, health care seeking and demographics. Data collection ended in April 2009. Using population and nonresponse weights we calculated prevalence estimates based on definitions spanning a range of sensitivity and specificity. We used United States Census counts to estimate the number of affected women in 2006. The random sample included 146,231 households, of which 131,691 included an adult female. Of these households 32,474 reported an adult female with bladder symptoms or diagnosis, of which 12,752 completed the questionnaire.
Based on the high sensitivity definition 6.53% (95% CI 6.28, 6.79) of women met symptom criteria. Based on the high specificity definition 2.70% (95% CI 2.53, 2.86) of women met the criteria. These percentages translated into 3.3 to 7.9 million United States women 18 years old or older with bladder pain syndrome/interstitial cystitis symptoms. Symptom severity and impact were comparable to those of adult women with established diagnoses. However, only 9.7% of the women reported being assigned a bladder pain syndrome/interstitial cystitis diagnosis.
Bladder pain syndrome/interstitial cystitis symptoms are widespread among United States women and associated with considerable disability. These results suggest bladder pain syndrome/interstitial cystitis may be underdiagnosed.
膀胱疼痛综合征/间质性膀胱炎是一种病因尚未完全明确的疾病,可能会导致严重的身体残疾。我们提供了目前为止美国成年女性中膀胱疼痛综合征/间质性膀胱炎的首个基于人群的症状流行率预估。
我们开发并验证了 2 种病例定义来识别膀胱疼痛综合征/间质性膀胱炎的症状。自 2007 年 8 月起,我们开始通过电话访问美国居民家庭,寻找有膀胱症状或膀胱疼痛综合征/间质性膀胱炎诊断的成年女性。第二阶段的筛选确定了那些符合病例定义标准的研究对象。每位研究对象都要完成一项时长为 60 分钟的关于膀胱症状严重程度、影响、就医情况和人口统计学的访谈。数据收集于 2009 年 4 月结束。我们使用人群和无应答权重来计算基于灵敏度和特异性范围的不同定义的流行率预估。我们使用美国人口普查数据来估计 2006 年受影响的女性人数。随机样本包括 146231 个家庭,其中 131691 个家庭有成年女性。这些家庭中有 32474 个报告有成年女性存在膀胱症状或诊断,其中 12752 个完成了问卷。
基于高灵敏度定义,有 6.53%(95%置信区间 6.28,6.79)的女性符合症状标准。基于高特异性定义,有 2.70%(95%置信区间 2.53,2.86)的女性符合标准。这些百分比转化为 330 万至 790 万美国 18 岁或以上有膀胱疼痛综合征/间质性膀胱炎症状的女性。症状严重程度和影响与确诊的成年女性相似。然而,只有 9.7%的女性报告被诊断为膀胱疼痛综合征/间质性膀胱炎。
膀胱疼痛综合征/间质性膀胱炎症状在美国女性中广泛存在,且与相当大的残疾有关。这些结果表明膀胱疼痛综合征/间质性膀胱炎可能被低估了。