Anxiety severity does not influence treatment outcomes in patients with interstitial cystitis/bladder pain syndrome

Abstract

Aims Patients with interstitial cystitis/bladder pain syndrome (IC/BPS) typically experience anxiety mood status, which is closely connected with physical and psychological status and treatment outcome. This study aimed to evaluate the impact of anxiety severity on therapeutic results in IC/BPS patients. Methods We prospectively enrolled IC/BPS patients who had previously undergone any kind of treatment for their disease. The primary endpoint was a change in Beck Anxiety Inventory (BAI) scores at 3 months after treatment. Secondary endpoints included changes in the Global Response Assessment (GRA), O'Leary‐Sant symptom score (OSS), and Numerical Rating Scale (NRS) at 3 months after treatment. Urodynamic studies were also compared with the clinical symptom scores. Results Overall, 85 IC/BPS patients (mean age, 53.1 ± 12.4 years) were included in the study. At 3 months, changes in the GRA were not significantly different among the different anxiety severity groups. At baseline, 55 (64.7%) patients had moderate or severe anxiety. We observed a significant positive correlation between the change in BAI and the change in OSS after treatment and a significantly negative correlation with GRA at 3 months. Moreover, improvements in OSS and NRS were associated with the change in GRA. Changes in IC symptoms, but not physiological outcomes, were associated with improved anxiety status after treatment. In addition, the change in BAI was significantly associated with age, baseline BAI, and changes in OSS and GRA after treatment. Conclusions Baseline anxiety severity does not influence treatment outcomes of IC/BPS. Patients should receive active treatment regardless of their baseline anxiety status.

Pelvic Floor Myofascial Pain Might Influence Treatment Outcome of Interstitial Cystitis/bladder Pain Syndrome

“…The self-report IC/BPS symptom and problem index (OSS) might be more related to the psychological condition rather than the bladder conditions, causing an increase in the patient's anxiety status score (BAI) with PFMP. 6 Likewise, the GRA score also has a signi cant association with different PFMP severities. This result has repeatedly demonstrated that self-report treatment outcomes are closely related to PFM conditions, such as in the ICSI (p = .029), ICPI (p = .007), and even GRA (p = .015).…”

“…5 Our previous study also demonstrated that stress is positively associated with pain in patients with IC/BPS, while stress reduction can lead to a simultaneous decrease in the severity of other symptoms. 6 Pelvic oor muscle (PFM) is often associated with urological, gynecological, gastrointestinal, and sexual problems and chronic pelvic pain. 8 Several researchers also noted that PFM hypertonicity (PFH), also called pelvic oor myofascial pain (PFMP), could affect treatment outcome and quality of life.…”

“…11,13 Until very recently, these hypotheses were di cult to study because a standardized, reproducible examination for PFMP did not exist. 6 In patients with IC/BPS, 85% were found to have PFMP and PFH. 14 However, PFMP has remained largely understudied and poorly recognized by women's health providers who are not typically trained to consider or assess for PFMP as a contributing factor to patients' IC/BPS symptoms.…”

“…14 However, PFMP has remained largely understudied and poorly recognized by women's health providers who are not typically trained to consider or assess for PFMP as a contributing factor to patients' IC/BPS symptoms. 6 This study aimed to explore the relationship between PFMP and treatment outcomes in women with IC/BPS.…”

Multimodal Treatment with Cognitive Behavioral Therapeutic Intervention Plus Bladder Treatment Is More Effective than Monotherapy for Patients with Interstitial Cystitis/Bladder Pain Syndrome—A Randomized Clinical Trial

“…Psychological stress had been shown to be associated with exacerbation of IC symptoms involving pain and inflammation, not only associated with physiological damage but also negatively affecting psychological stress, and leading to poor quality of life (QoL) due to the current absence of effective long-lasting treatment [ 4 ]. Appropriate treatment should be conducted hierarchically and should combine multiple approaches, starting from lifestyle modification, followed by bladder therapy, accompanied by psychological adjustment and coping support [ 2 , 4 , 5 , 6 ]. The goal of managing patients with IC/BPS is to provide symptom relief and help patients achieve acceptable QoL post-treatment [ 6 ].…”