Bladder tenderness as a physical sign for diagnosing cystitis in women

Abstract

There are few semiotic signs for the diagnosis of cystitis. The costovertebral angle tenderness (CVAT) and vaginal exam have a likelihood ratio (LR) close to 1. Some patients experience a different pain when their bladder is compressed during the vaginal exam. The objectives of this study are to verify the accuracy of bladder tenderness for making the diagnosis of cystitis and if a past history of cystitis or recent sexual intercourse are risk factors for current cystitis. One hundred and ninety female volunteers = 15 years old with or without urinary symptoms were analyzed. The exclusion criteria were recent use of antibiotics and pregnancy. After a standard questionnaire a clean catch midstream urine sample was obtained. Then bladder tenderness was performed using the index finger inside the vagina. It was slid over the upper third of the anterior wall of the vagina compressing the bladder against the opposite hand placed on the suprapubic area. If the patient experienced any kind of pain the test was positive; otherwise it was negative. Urine analysis and culture were standard. (excerpt)