Prevalence and impact of bacteriuria and/or urinary tract infection in interstitial cystitis/painful bladder syndrome
Friday, 02 July 2010
Department of Urology, Queen's University Kingston General Hospital, Kingston, Ontario, Canada.
Department of Urology, Cleveland Clinic, Cleveland, Ohio.
Nickel JC, Shoskes DA, Irvine-Bird K.
To determine the prevalence and clinical significance of documented bacteriuria and/or urinary tract infection in an interstitial cystitis/painful bladder syndrome (IC/PBS) population.
Urine 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).
A 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.
The 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.
Reference: Urology. 2010 Jun 21. Epub ahead of print.
doi: 10.1016/j.urology.2010.03.065
PubMed Abstract
PMID: 20573386
Bacteria and female bladder CPPS
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webslave
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Bacteria and female bladder CPPS
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gmccormack
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Re: Bacteria and female bladder CPPS
I see once again Nickel is on this study, I know from reading some of his work he is officially perplexed and just does study after study. Do you think now that he will now accept the non infection theory for most men?
I almost want to make the trip up to see him in Canada I would gladly pay out of pocket whatever the charge, but I have a feeling he is going to put me on the protocol of a good uro like Moldwin, try PT, try benzo's, try tramadol. After all these studies, what does he have to offer that's different from the run of the mill good uro do you think? Even Dr. Shoskes, he has done countless studies that granted have progressed the thinking on CPPS but what does he have to offer that's different? If I went to see him and told him I follow the WA protocol, am on Quercetin, and take benzo's when the pain is bad, would he say lets try this little known theory thats seemed to work in a decent amount patients in xyz trial, if that doesn't work then we'll try this theory, and continue to exhaust all the options he could possibly think of?
I see a uro now that I like, he thinks CPPS is an autoimmune disease but believes PT can help some men. When I see him every 2 months we have this intellectual/philosophical conversation about CPPS, but at the end of the day I go home with a refill of Klonopin and am told to make sure I only take when needed...
Has anyone here seen JC Nickel?
Web thanks for posting, I have some theories that stray from the board but infection is not one of them.
I almost want to make the trip up to see him in Canada I would gladly pay out of pocket whatever the charge, but I have a feeling he is going to put me on the protocol of a good uro like Moldwin, try PT, try benzo's, try tramadol. After all these studies, what does he have to offer that's different from the run of the mill good uro do you think? Even Dr. Shoskes, he has done countless studies that granted have progressed the thinking on CPPS but what does he have to offer that's different? If I went to see him and told him I follow the WA protocol, am on Quercetin, and take benzo's when the pain is bad, would he say lets try this little known theory thats seemed to work in a decent amount patients in xyz trial, if that doesn't work then we'll try this theory, and continue to exhaust all the options he could possibly think of?
I see a uro now that I like, he thinks CPPS is an autoimmune disease but believes PT can help some men. When I see him every 2 months we have this intellectual/philosophical conversation about CPPS, but at the end of the day I go home with a refill of Klonopin and am told to make sure I only take when needed...
Has anyone here seen JC Nickel?
Web thanks for posting, I have some theories that stray from the board but infection is not one of them.
Age: | Onset Age: | Symptoms: | Helped By: | Worsened By: | Other comments:
Re: Bacteria and female bladder CPPS
I did the Dr. Fugazzotto protocol when we did a soy broth culture. So was on antibiotics for a year. Got worse only sustained improvement has been myofascial. Now I struggle with thrush from years of antibiotics and a compromised gut. That is healing slowly but now I am on anti fungals all the time as well as candida diet.
In my case I think the nerves became sensitized from the original infections, back surgery etc etc, then from constant pain it became myofascial but there is nerve hypersensitivity still remaining that gets triggered with clenching and sitting. It was never an infection but its a long winding road to get answers as no one suggested it was myofascial in the first place.
In my case I think the nerves became sensitized from the original infections, back surgery etc etc, then from constant pain it became myofascial but there is nerve hypersensitivity still remaining that gets triggered with clenching and sitting. It was never an infection but its a long winding road to get answers as no one suggested it was myofascial in the first place.
CPP since 2005. Prior to CPP always overly fit and active. I am female. Had two natural births: singleton 1998 and twins 2000. 2002 emergency back surgery - L5S1 herniation. Then recurring UTIs. Usual antibiotic overload. Then constant debilitating burning bladder and reaction to many foods. Australian Pain Clinic 2007. Turning point was Dec 2009 Attended Wise Clinic in Santa Rosa USA.
Was helped by strict diet but now eating normally after years of restricted diet - wonderful. Helped by: stretching,relaxation, yoga, trigger point, warm baths. Worsened by: stress, sitting, abdominal or glute exercises and salicylates
Medication: Now off all pain clinic meds no more Endone or Elavil only Lyrica 50 mg as Dec 2010 just reherniated L5S1disc and had discectomy. Its taken years but I feel I am over it.
Was helped by strict diet but now eating normally after years of restricted diet - wonderful. Helped by: stretching,relaxation, yoga, trigger point, warm baths. Worsened by: stress, sitting, abdominal or glute exercises and salicylates
Medication: Now off all pain clinic meds no more Endone or Elavil only Lyrica 50 mg as Dec 2010 just reherniated L5S1disc and had discectomy. Its taken years but I feel I am over it.
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webslave
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Re: Bacteria and female bladder CPPS
FugazzottoSherradin wrote:I did the Dr. Fugazzotto protocol when we did a soy broth culture.
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gmccormack
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Re: Bacteria and female bladder CPPS
Thanks Sherradin, I wanted to know if anyone had seen JC Nickel especially if the member has seen him more than once, and I know there have been some Shoskes patients on this forum, did he offer anything that the usual good uro would not offer.
Are you saying that you tried their theories/studies? Or is this broth theory just Dr Fugazzotto's?
Are you saying that you tried their theories/studies? Or is this broth theory just Dr Fugazzotto's?
Age: | Onset Age: | Symptoms: | Helped By: | Worsened By: | Other comments:
Re: Bacteria and female bladder CPPS
I did the Fugazzotto protocol. As I like every one hoped it would be an infection. As taking a course of antibiotics would be so much easier than the hard work I have and am putting in. So did a soy broth culture (longer term culture) which grew a bacteria. So I went on long term antibiotics for a year. It made no difference. But if you google it a lot of women with IC try it in desperation. I am in Australia so I had a pathology lab follow the same method. More time and money going down the wrong path. Now if I just focus all day on relaxing my pelvis like today I was nearly symptom free.
CPP since 2005. Prior to CPP always overly fit and active. I am female. Had two natural births: singleton 1998 and twins 2000. 2002 emergency back surgery - L5S1 herniation. Then recurring UTIs. Usual antibiotic overload. Then constant debilitating burning bladder and reaction to many foods. Australian Pain Clinic 2007. Turning point was Dec 2009 Attended Wise Clinic in Santa Rosa USA.
Was helped by strict diet but now eating normally after years of restricted diet - wonderful. Helped by: stretching,relaxation, yoga, trigger point, warm baths. Worsened by: stress, sitting, abdominal or glute exercises and salicylates
Medication: Now off all pain clinic meds no more Endone or Elavil only Lyrica 50 mg as Dec 2010 just reherniated L5S1disc and had discectomy. Its taken years but I feel I am over it.
Was helped by strict diet but now eating normally after years of restricted diet - wonderful. Helped by: stretching,relaxation, yoga, trigger point, warm baths. Worsened by: stress, sitting, abdominal or glute exercises and salicylates
Medication: Now off all pain clinic meds no more Endone or Elavil only Lyrica 50 mg as Dec 2010 just reherniated L5S1disc and had discectomy. Its taken years but I feel I am over it.
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gmccormack
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Re: Bacteria and female bladder CPPS
Do you think the relaxation is actually decreasing the symptoms or because you are resting with the pain, it becomes more bearable psychologically?
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Re: Bacteria and female bladder CPPS
Both — its accepting how things are you know paradoxically...and consciously every time I press a lift button, or standing up or waiting for the lights to change walking to work ..relaxing my butt.
The mind is such a big part of it..stopping and allowing yourself to stop is important and resting with the pain saying its ok that your not perfect is part of it too with me.
The mind is such a big part of it..stopping and allowing yourself to stop is important and resting with the pain saying its ok that your not perfect is part of it too with me.
CPP since 2005. Prior to CPP always overly fit and active. I am female. Had two natural births: singleton 1998 and twins 2000. 2002 emergency back surgery - L5S1 herniation. Then recurring UTIs. Usual antibiotic overload. Then constant debilitating burning bladder and reaction to many foods. Australian Pain Clinic 2007. Turning point was Dec 2009 Attended Wise Clinic in Santa Rosa USA.
Was helped by strict diet but now eating normally after years of restricted diet - wonderful. Helped by: stretching,relaxation, yoga, trigger point, warm baths. Worsened by: stress, sitting, abdominal or glute exercises and salicylates
Medication: Now off all pain clinic meds no more Endone or Elavil only Lyrica 50 mg as Dec 2010 just reherniated L5S1disc and had discectomy. Its taken years but I feel I am over it.
Was helped by strict diet but now eating normally after years of restricted diet - wonderful. Helped by: stretching,relaxation, yoga, trigger point, warm baths. Worsened by: stress, sitting, abdominal or glute exercises and salicylates
Medication: Now off all pain clinic meds no more Endone or Elavil only Lyrica 50 mg as Dec 2010 just reherniated L5S1disc and had discectomy. Its taken years but I feel I am over it.