El Khoudary, Samar R
(2008)
NEW THERAPEUTIC OPTION AND INSIGHTS INTO THE IMPACT OF SYMPTOM SEVERITY ON QUALITY OF LIFE IN WOMEN WITH INTERSTITIAL CYSTITIS.
Doctoral Dissertation, University of Pittsburgh.
(Unpublished)
Abstract
Background: Interstitial Cystitis (IC) is a poorly understood condition of urinary bladder characterized by pelvic pain, urinary frequency, urgency and nocturia in the absence of other obvious pathology. The public health significance of IC is related to its profound impact on patients' physical and emotional Quality of Life (QOL). The actual prevalence rate is unknown, and estimates range widely from 67/100,000 to 575/100,000. The majority of IC cases are females in the midlife age. This research addressed 1) the extent to which socio-demographic and clinical factors affect both symptom severity and QOL in IC patients, 2) the impact of symptom severity on QOL and 3) the efficacy of a combination of oral and intravesical Pentosan Polysulfate Sodium (PPS) as a new therapeutic option for IC. Methods: Forty one women with IC (age 20-71 years) were studied. Demographic, reproductive and clinical characteristics as well as QOL measures were evaluated in a cross-sectional design to assess the first two aims. To examine the third aim, participants were randomized to receive either a combination of oral plus intravesical PPS (treatment group) or oral PPS plus intravesical placebo (placebo group) in a clinical trial design. The main outcomes were the changes in subjective and objective measures of symptom severity, QOL and sexual functions. Results: Unmarried patients reported more severe symptoms compared to married patients. Being unemployed, obese, currently unmarried and never pregnant were associated with a decrement in at least one QOL domain. Moreover, symptom severity was associated with worse QOL on 4 domains, (p<0.05). On the other hand, the results from the clinical trial showed a greater significant reduction in symptom severity among the treatment group compared to the placebo group (46% reduction vs. 24% reduction respectively, p=0.04) and significant improvement in all QOL domains in the treatment group compared to the baseline (p<0.05). Conclusion: Being unmarried and symptom severity are important factors that may disturb the QOL in IC patients. Moreover, the use of intravesical PPS simultaneously with oral PPS is an effective therapeutic option. The findings of this research will open a new option for IC patients to reduce their devastating symptoms and to improve their quality of life.
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Details
| Item Type: |
University of Pittsburgh ETD
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| Status: |
Unpublished |
| Creators/Authors: |
|
| ETD Committee: |
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| Date: |
23 June 2008 |
| Date Type: |
Completion |
| Defense Date: |
28 January 2008 |
| Approval Date: |
23 June 2008 |
| Submission Date: |
10 April 2008 |
| Access Restriction: |
5 year -- Restrict access to University of Pittsburgh for a period of 5 years. |
| Institution: |
University of Pittsburgh |
| Schools and Programs: |
School of Public Health > Epidemiology |
| Degree: |
PhD - Doctor of Philosophy |
| Thesis Type: |
Doctoral Dissertation |
| Refereed: |
Yes |
| Uncontrolled Keywords: |
clinical trial; domains; efficacy; summary score |
| Other ID: |
http://etd.library.pitt.edu/ETD/available/etd-04102008-184015/, etd-04102008-184015 |
| Date Deposited: |
10 Nov 2011 19:35 |
| Last Modified: |
19 Dec 2016 14:35 |
| URI: |
http://d-scholarship.pitt.edu/id/eprint/6969 |
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