Date of Award


Document Type



Edith Cowan University

Degree Name

Doctor of Philosophy


Faculty of Computing, Health and Science

First Supervisor

Professor Linda Kristjanson

Second Supervisor

Associate Professor Geoffrey Littlejohn

Third Supervisor

Stan Wisniewski


Urinary tract sensory symptoms provide an additional symptomatic burden for women with fibromyalgia. The urogenital symptoms of both fibromyalgia and interstitial cystitis have been described as non-infective sensory disorders, suggesting the existence of substantial clinical overlap between the two conditions. Research suggests that although interstitial cystitis has been treated as a specific bladder condition, it may be part of the disorder of central processing of sensory information as seen in fibromyalgia.

The interstitial cystitis symptom index and problem index (ICSI/ICPI) have been used to measure lower urinary tract symptoms and to examine the impact of these symptoms in patients with interstitial cystitis. This current two phase study was designed to test the ICSI/ICPI for use within a population of women diagnosed with fibromyalgia known to be experiencing sensory bladder symptoms.

Phase I involved focus group interviews and discussions with women who reported fibromyalgia and bladder irritability (N=lO). This phase was designed to identify whether the key indicators and the way in which women experienced bladder irritability were indexed by the ICSI/ICPI instrument. The second phase of the study tested the ICSI/ICPI within the fibromyalgia population for reliability and validity.

Phase II data was derived via a self-administered questionnaire issued to women (N=90) who had been diagnosed with fibromyalgia by a rheumatologist and who were experiencing lower urinary tract sensory symptoms. Data analysis revealed two separate components in urinary symptom/problem combinations within the fibromyalgia population. These components were distinct from those described in the ICSI/ICPI. Subsequently, two separate subscales were developed to form the Fibromyalgia Bladder Index (FBI). The development and testing of the FBI within the fibromyalgia population has provided an accurate measure for assessing the symptoms and symptom impact of urinary symptoms for women with this condition. The FBI has been developed as an adjunct to clinical assessment and as an outcome measure for intervention therapies for patients with fibromyalgia and bladder irritability.

Outcomes of this study form the basis to the following recommendations: further refinement of the FBI; utilisation of the index in fibromyalgia assessments; development of fibromyalgia educational, support and self help programs; pelvic fitness awareness and intervention studies.