The presence of interstitial cystitis in patients with ovarian remnant syndrome or residual ovarian syndrome

Abstract

Objective: To determine the prevalence of interstitial cystitis in patients with ovarian remnant or residual ovary syndrome. Design: Prospective cohort study of 64 patients with a diagnosis of residual ovary syndrome and seven patients with ovarian remnant syndrome. Materials and Methods: All patients underwent a potassium sensitivity test (PST) and diagnostic cystoscopy with hydrodistention. All patients complained of lower abdominal/pelvic pain and pelvic examination revealed bladder base tenderness. Inclusion criteria required a negative urine culture and negative cervical cultures including Ureaplasma Urealyticum. Results: Initial mean pain, urinary frequency, and urgency score (PUF) was 14 in this cohort of patients. PST was found to be positive in 55 patients (78%). Of the 44 patients who underwent cystoscopic hydrodistention, 40 patients (91%) had findings consistent with interstitial cystitis as described by NIH criteria. Thirty-six patients (82%) were found to be positive for both PST and cystoscopic findings of IC. Conclusion: The majority of patients with the clinical diagnosis of residual ovary or ovarian remnant syndrome have either evidence of an uroepithelial defect (78% with a positive PST) or cystoscopic findings compatible with IC (91%). These findings suggest that a component of their pelvic pain is of bladder origin. The decision to remove ovaries or ovarian remnants in a patient with persistent or recurrent chronic pain must be carefully weighed against the risk of the surgery and its potential failure to relieve the pain. It is because of this that a nonsurgical approach is always recommended as first-line therapy. Treatment of bladder origin pain must be considered as an important part of the management of pain in these patients.