Síndrome de dolor vesical : prevalencia y práctica clínica habitual en mujeres que acuden a Unidades de Urología Funcional y Urodinámica en España

espanolIntroduccion y objetivos El sindrome de dolor vesical (SDV) esta catologado como enfermedad rara y su diagnostico representa un desafio debido al solapamiento de sus sintomas con los asociados al sindrome de vejiga hiperactiva. El objetivo fue estimar la prevalencia del SDV y conocer el perfil de sintomas y la practica clinica en pacientes que acuden a unidades de Urologia Funcional y Urodinamica. Material y metodos Estudio epidemiologico en el cual participaron 37 unidades de Urologia Funcional y Urodinamica de Espana. La prevalencia se estudio considerando ambos sexos. Se evaluo la practica clinica en 319 mujeres con SDV (nuevo diagnostico o en revision). Se recogieron retrospectivamente datos clinicos y sociodemograficos. Se analizaron los resultados de analisis de orina, cistoscopia, biopsia, exploracion fisica, diario miccional, asi como de los 4 cuestionarios disponibles: Patient Perception of Bladder Condition; Bladder Pain/Interstitial Cystitis Symptom Score; EuroQoL-5 Dimensions-5L y Patient Global Impression of Severity. Resultados El 5,4% (503) de los pacientes que acudieron a estas unidades (9.312) tenian diagnostico de SDV (90% [453] mujeres). Las pruebas mas realizadas segun historia clinica y anamnesis fueron: analisis de orina, ecografia vesical y cistoscopia. Los sintomas/comorbilidades mas frecuentes fueron: dolor en la region vesical, frecuencia miccional aumentada, nicturia, ansiedad y depresion. La evaluacion diagnostica determino dolor en hidrodistension (86,9%), biopsia positiva (59,2%), dolor miofascial pelvico (28,4%), fenotipo urologico (97,8%) y frecuencia miccional aumentada (88,7%). Los cuestionarios reflejaron el elevado grado de afectacion de la calidad de vida de estos pacientes. Conclusiones La prevalencia del SDV en las unidades de Urologia Funcional y Urodinamica en Espana es baja. No se observa homogeneidad en cuanto al diagnostico entre los diferentes centros participantes. Por ello, seria necesario establecer una metodologia comun de manejo de pacientes con SDV en estas unidades, con herramientas especificas para esta patologia. EnglishIntroduction and objectives Bladder pain syndrome (BPS) is classified as a rare chronic debilitating disease and its diagnosis presents a challenge because its symptoms overlap with those associated with overactive bladder syndrome. The aim of the routine study was to estimate the prevalence of BPS and discover to study the profile of symptoms and clinical practice for patients attending functional urology and urodynamics units. Material and methods An epidemiological study in which 37 functional urology and urodynamics units in Spain participated. The prevalence was studied in both sexes. Clinical practice was evaluated for 319 women with BPS (new diagnosis or under review). Clinical and sociodemographic data were collected retrospectively. The results were studied of urine tests, cystoscopy, biopsy, physical examination, bladder diary, and those of the four available questionnaires: Patient Perception of Bladder Condition; Bladder Pain/Interstitial Cystitis Symptom Score; EuroQoL-5 Dimensions-5L and Patient Global Impression of Severity. Results Five point four percent (503) of the patients who attended these units (9,312) had a diagnosis of BPS (90% [453] females). The tests that were performed most according to the clinical history and anamnesis were: urine test, bladder ultrasound and cystoscopy. The most common symptoms/comorbidities were: pain in the bladder region, increased urinary frequency, nocturia, anxiety and depression. Diagnostic assessment determined pain on hydrodistension (86.9%), positive biopsy (59.2%), myofascial pelvic pain (28.4%), urological phenotype (97.8%), and increased urinary frequency (88.7%). The questionnaires reflected how much the quality of life of these patients was affected. Conclusions The prevalence of BPS in functional urology and urodynamics units in Spain is low. No homogeneity was observed in terms of diagnosis between the different participating centres. Therefore, a common methodology is required for the management of patients with BPS in these units, with tools specific to this disorder.