Interpersonal violence and painful bladder symptoms in community-dwelling midlife to older women. American journal of obstetrics and gynecology Raphael, E., Van Den Eeden, S. K., Gibson, C. J., Tonner, C., Thom, D. H., Subak, L., Huang, A. J. 2021


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.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.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.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]).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. 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.

View details for DOI 10.1016/j.ajog.2021.09.017

View details for PubMedID 34555321