Clinical phenotyping of urologic pain patients

Kartha, Ganesh; Kerr, Hannah; Shoskes, Daniel A.

doi:10.1097/mou.0b013e3283652a9d

Cited by 24 publications

(18 citation statements)

References 32 publications

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“…The neurological/systemic domain included patients with IBS, FM, CFS or another systemic pain syndrome. IC/HBS patients with more UPOINT‐positive domains experienced more symptom severity and duration as determined by the IC symptom index . Nickel et al .…”

Section: Discussionmentioning

confidence: 99%

Non‐bladder conditions in female Taiwanese patients with interstitial cystitis/hypersensitive bladder syndrome

Fan

Lin

et al. 2014

Int J of Urology

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Abbreviations & AcronymsObjectives: To detect non-bladder conditions in patients with interstitial cystitis/ hypersensitive bladder syndrome. Methods: A total of 122 female interstitial cystitis/hypersensitive bladder syndrome patients and a control group of 122 age-matched female patients with stress urinary incontinence completed screening questionnaires for irritable bowel syndrome, temporomandibular disorder, multiple chemical sensitivities, tension and migraine headache, localized myofascial pain disorder, and fibromyalgia. Interstitial cystitis/hypersensitive bladder syndrome patients also completed questionnaires on interstitial cystitis/hypersensitive bladder syndrome symptom severity, including the O'Leary-Sant symptom index, and the visual analog scale for pain and urgency. Results: Interstitial cystitis/hypersensitive bladder syndrome patients were more likely to meet diagnostic criteria for irritable bowel syndrome than controls (37.5% vs 11.5%), and tension/migraine headache (38.7% vs 15.7%; all P < 0.001). The prevalence of temporomandibular disorder, multiple chemical sensitivities, localized myofascial pain disorders and fibromyalgia did not reach a statistical significant difference between the two groups. In the multivariate model, associations were also observed for irritable bowel syndrome (odds ratio 2.546; 95% confidence interval 1.136-5.704) and tension/migraine headache (odds ratio 2.684; 95% confidence interval 1.233-5.842). Patients with more comorbid conditions had more severe and bothersome interstitial cystitis/hypersensitive bladder syndrome symptoms as measured by the visual analog scale of pain (P = 0.008) and O'Leary-Sant bother index (P = 0.035). Conclusions: Interstitial cystitis/hypersensitive bladder syndrome patients are more likely to have multiple non-bladder conditions. These conditions correlate with the severity of interstitial cystitis/hypersensitive bladder syndrome symptoms.

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Section: Discussionmentioning

confidence: 99%

Non‐bladder conditions in female Taiwanese patients with interstitial cystitis/hypersensitive bladder syndrome

Fan

Lin

et al. 2014

Int J of Urology

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“…Rather, therapy individualized to the specific symptom(s) may be preferable. 67 The UPOINT (Urinary, Psychosocial, Organ-specific, Infection, Neurological/systemic, and Tenderness) scoring system includes 6 domains: 1) irritative or obstructive urinary symptoms, 2) psychosocial issues, 3) organ-specific (bladder or prostate) symptoms (pain associated with bladder filling and relieved with voiding, prostate tenderness, and leukocytosis in expressed prostatic specimens), 4) infections (positive prostatic fluid cultures in absence of urinary tract infection, urethritis), 5) neurologic/systemic symptoms (pain outside the pelvis, systemic pain syndromes [eg, fibromyalgia, irritable bowel syndrome]), and 6) tenderness (pelvic floor spasm, muscle trigger points in abdomen/pelvis). 68 Limited evidence from a noncontrolled prospective study of 100 patients in which management was guided by the UPOINT assessment indicated that symptoms improved significantly in 84% of patients and by 50% or more in 51%.…”

Section: Methodsmentioning

confidence: 99%

“…5 Indeed, the UPOINT system can also be used for IC/BPS. 67 Women with IC undergo significantly more pelvic surgeries (eg, hysterectomy) than controls. 90 …”

Section: Methodsmentioning

confidence: 99%

Anorectal and Pelvic Pain

Bharucha

Lee

2016

Mayo Clinic Proceedings

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Although pelvic pain is a symptom of several structural anorectal and pelvic disorders (eg, anal fissure, endometriosis, and pelvic inflammatory disease), this comprehensive review will focus on the three most common nonstructural, or functional, disorders associated with pelvic pain: functional anorectal pain (ie, levator ani syndrome, unspecified anorectal pain, and proctalgia fugax), interstitial cystitis/bladder pain syndrome, and chronic prostatitis/chronic pelvic pain syndrome. The first two conditions occur in both sexes, while the latter occurs only in men. They are defined by symptoms, supplemented with levator tenderness (levator ani syndrome) and bladder mucosal inflammation (interstitial cystitis). Although distinct, these conditions share several similarities, including associations with dysfunctional voiding or defecation, comorbid conditions (eg, fibromyalgia, depression), impaired quality of life, and increased health care utilization. Several factors, including pelvic floor muscle tension, peripheral inflammation, peripheral and central sensitization, and psychosocial factors, have been implicated in the pathogenesis. The management is tailored to symptoms, is partly supported by clinical trials, and includes multidisciplinary approaches such as lifestyle modifications and pharmacologic, behavioral, and physical therapy. Opioids should not be avoided, and surgery has a limited role, primarily in refractory interstitial cystitis.

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“…One can utilize traditional IC/BPS treatments, whilst the urinary domain lower urinary tract symptoms (LUTS) can be targeted by anticholinergics, dietary changes, and/or alpha-blockers [19].…”

Section: Diagnosismentioning

confidence: 99%

Update in Diagnosis and Treatment of Chronic Pelvic Pain Syndromes

Shah

Ginzburg

Morrissey

et al. 2015

Curr Bladder Dysfunct Rep

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The diagnosis and treatment of chronic pelvic pain have shifted from organ-specific to multifactorial, multidisciplinary, and individualized approach. While many organizations have had diverse outlooks on classification and treatment plans, new research has identified varied clinical phenotypes and updated classification systems. These phenotypes are based on pain, gender, symptomatology, and comorbid pain syndromes. These new classification systems allow a multimodal therapeutic approach and evaluation of patients. Multidisciplinary care, including urology, gynecology, gastroenterology, neurology, psychology, physiotherapy, and pain medicine, is also further recognized for adequate management of patients with chronic pelvic pain because of its variable etiology. The purpose of this review is to emphasize these changes and discuss management strategies.

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Clinical phenotyping of urologic pain patients

Abstract: Domain characterization of urologic pain conditions via phenotype mapping can be used to better understand causes of chronic pain and hopefully provide more effective, targeted and multimodal therapy.

Cited by 24 publications

References 32 publications

Non‐bladder conditions in female Taiwanese patients with interstitial cystitis/hypersensitive bladder syndrome

Non‐bladder conditions in female Taiwanese patients with interstitial cystitis/hypersensitive bladder syndrome

Anorectal and Pelvic Pain

Update in Diagnosis and Treatment of Chronic Pelvic Pain Syndromes

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