@article{ref1,
title="Interpersonal violence and painful bladder symptoms in community-dwelling midlife to older women",
journal="American journal of obstetrics and gynecology",
year="2021",
author="Raphael, Eva and Van Den Eeden, Stephen K. and Gibson, Carolyn J. and Tonner, Chris and Thom, David H. and Subak, Leslee and Huang, Alison J.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND: Women are more likely to present with genitourinary complaints immediately after exposure to interpersonal violence, but little is known about long-term effects on women's urologic health such as their susceptibility to bladder pain and infections. <br><br>OBJECTIVE: To determine whether lifetime interpersonal violence exposure and current post-traumatic stress disorder (PTSD) symptoms are associated with prevalence or severity of painful bladder symptoms as well as greater lifetime history of antibiotic-treated urinary tract infections in community-dwelling midlife and older women. STUDY DESIGN: We examined cross-sectional data from a multiethnic cohort of community-dwelling women aged 40-80 years enrolled in a northern California integrated healthcare system. Women completed structured self-report questionnaires about their past exposure to physical and verbal/emotional intimate partner violence as well as sexual assault. Symptoms of PTSD were assessed using the PSTD Checklist for DSM-IV, Civilian Version. Additional structured self-report measures assessed current bladder pain, other lower urinary tract symptoms, and history of antibiotic-treated urinary tract infections. Multivariable logistic regression models examined self-reported interpersonal violence exposure history and current PTSD symptoms in relation to current bladder pain and antibiotic-treated urinary tract infection history. <br><br>RESULTS: Among 1,974 women (39% non-Latina White, 21% Black, 20% Latina, and 19% Asian), 22% reported lifetime interpersonal violence exposure, 22% bladder pain, and 60% history of ever having an antibiotic-treated urinary tract infection. Lifetime experience of sexual assault (OR[95%CI] = 1.39 [1.02, 1.88]) and current PTSD symptoms (OR[95%CI] = 1.96 [1.45, 2.65]) were associated with current bladder pain. Lifetime experience of physical intimate partner violence was associated with ever having a urinary tract infection (OR[95%CI] = 1.38 [1.00, 1.86]), as was emotional IPV (OR[95%CI] = 1.88 [1.43, 2.48]), sexual assault (OR[95%CI] = 1.44 [1.09, 1.91]), and current PTSD symptoms (OR[95%CI] = 1.54 [1.16, 2.03]). <br><br>CONCLUSION: In this ethnically diverse, community-based cohort, lifetime interpersonal violence exposures and current PTSD symptoms were independently associated with current bladder pain and lifetime history of antibiotic-treated urinary tract infections in midlife to older women. <br><br>FINDINGS suggest that interpersonal violence and PTSD symptoms may be under-recognized markers of risk for urologic pain and infections in women, highlighting a need for trauma-informed care of these issues.<p /> <p>Language: en</p>",
language="en",
issn="0002-9378",
doi="10.1016/j.ajog.2021.09.017",
url="http://dx.doi.org/10.1016/j.ajog.2021.09.017"
}