805 PREDICTIVE FACTORS OF PAIN SEVERITY IN PATIENTS WITH INTERSTITIAL CYSTITIS/BLADDER PAIN SYNDROME

Abstract

You have accessJournal of UrologyInfections/Inflammation of the Genitourinary Tract: Interstitial Cystitis1 Apr 2011805 PREDICTIVE FACTORS OF PAIN SEVERITY IN PATIENTS WITH INTERSTITIAL CYSTITIS/BLADDER PAIN SYNDROME Jennifer Rothschild, Marguerite Thomer, Susan Messing, and Robert Mayer Jennifer RothschildJennifer Rothschild Rochester, NY More articles by this author , Marguerite ThomerMarguerite Thomer Rochester, NY More articles by this author , Susan MessingSusan Messing Rochester, NY More articles by this author , and Robert MayerRobert Mayer Rochester, NY More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.623AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Patients with the visceral hypersensitivity syndrome Bladder Pain Syndrome/Interstitial Cystitis (IC) present with a wide spectrum of severity of pain as well as urinary frequency. The causes of such diversity is complex but the severity of pain does impact the distress experienced as well as the modalities of therapy needed to control suffering. Finding correlates of pain severity may allow better insight into etiology and therapy. METHODS Institutional approval was obtained for data review of 186 patients with a clinical diagnosis of BPS/IC who completed an intake form including characteristics of their IC/BPS as well as comorbid illnesses and report of current pain on a 0-to-10 scale. Statistics were performed using SAS Statistical software with P<0.05 as possibly clinically significant. RESULTS Pain severity did not appear to correlate by age or gender, duration of symptoms, rapidity of onset, report of dietary food sensitivities or exacerbation of symptoms during menstrual cycle. Increased pain scores were associated with reported dysmenorrhea, IC onset with a precipitating event of pelvic surgery, any history of pelvic surgery, more than 5 vaginal infections a year, abuse, asthma, and migraine. A logistic regression model looked at the association of severe (7–10) vs mild (0–3) pain with history of abuse, dysmenorrhea and history of onset of IC symptoms following pelvic surgery. The patients with history of abuse, dysmenorrhea, and pelvic surgery have an 82% (95%CI, 49–96%) predicted probability of a severe pain score (> 7) while those having none of these factors have a predicted probability of 5% (95%CI, 1–20%). CONCLUSIONS Although the causes of BPS/IC are unknown and likely multifactorial, the findings suggest that once the bladder does develop a hypersensitive state, those with a history of prior pelvic noxious stimuli will be at risk for experiencing substantial pain possibly related to sacral sensitization and in contrast, actual duration of IC itself does not appear to be significant. Risk factors for dysfunctional coping (social stress and history of abuse) also predict more severe pain though likely by different mechanisms. Finally, those patients with migraines and/or asthma also have increased pain profiles and possible mechanisms for this are worthy of additional investigation although these do not appear to be strong independent indicators of severe pain. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e324 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jennifer Rothschild Rochester, NY More articles by this author Marguerite Thomer Rochester, NY More articles by this author Susan Messing Rochester, NY More articles by this author Robert Mayer Rochester, NY More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...