Validity of Pelvic Pain, Urgency, and Frequency questionnaire in patients with interstitial cystitis/painful bladder syndrome

Abstract

Objectives: To determine the validity of the Pelvic Pain, Urgency, and Frequency (PUF) questionnaire according to its correlation with cystoscopy with hydrodistension (C-HD) findings.

Methods: A prospective study of new patients with a clinical history consistent with interstitial cystitis/painful bladder syndrome (IC/PBS) was undertaken. All patients underwent history and physical examination, urinalysis, and urine culture and completed a PUF questionnaire before undergoing C-HD. The pertinent data collected included the preoperative PUF scores, bladder capacity, and cystoscopic findings consistent with IC/PBS (petechial hemorrhage and/or terminal hematuria). Statistical analysis was performed.

Results: From June 1, 2005 to December 31, 2005, 97 patients with a new clinical diagnosis of IC/PBS were prospectively evaluated. All patients completed a PUF questionnaire before C-HD. The average PUF score was 21 (range 8 to 35). The mean bladder capacity was 756 mL (range 250 to 1400). The C-HD was positive in 54 (56%) of 97 patients. Of these 54 patients, 27 had a PUF score of less than 20, 22 had a PUF score of 20 to 29, and 5 patients had a PUF score of greater than 30. When evaluated statistically, no correlation was apparent between the PUF questionnaire scores and the cystoscopic findings of IC/PBS (P <0.05).

Conclusions: As determined by the correlation with the C-HD, the PUF questionnaire appears to be neither a reliable predictor of IC/PBS nor a valuable predictor of disease severity. However, the inherent limitations of C-HD and the lack of a definitive diagnostic instrument for IC/PBS limit any authoritative conclusions. Therefore, the diagnosis of IC/PBS should remain one of exclusion and should depend on a constellation of widely recognized symptoms.