Voiding urges perceived by patients with interstitial cystitis/painful bladder syndrome

Greenberg, Patty; Brown, Jessica; Yates, Teresa; Brown, Vivian; Langenberg, Patricia; Warren, John W.

doi:10.1002/nau.20516

Cited by 22 publications

(10 citation statements)

References 25 publications

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“…Consistent with these findings, positive relationships between S1 GM and both anxiety and urgency were observed in the present study. In a sample of patients with IC, urgency was found to be more related to fear of pain (65%), than fear of incontinence 27 . It is important to draw the distinction between the urgency experienced by patients with IC compared to that experienced by patients with overactive bladder (OAB).…”

Section: Discussionmentioning

confidence: 95%

Increased Brain Gray Matter in the Primary Somatosensory Cortex is Associated with Increased Pain and Mood Disturbance in Patients with Interstitial Cystitis/Painful Bladder Syndrome

et al. 2015

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Purpose Interstitial cystitis (IC) is a highly prevalent pain condition, estimated to affect 3-6% of women in the United States. Emerging data suggests there are central neurobiological components to the etiology of this disease. Here we report the first brain structural imaging findings from the Multidisciplinary Approach to Pelvic Pain (MAPP) network, with data on over 300 participants. Materials and Methods We used Voxel-Based Morphometry (VBM) to determine whether human patients with chronic IC display changes in brain morphology as compared to healthy controls (HCs). 33 female IC patients without comorbidities and 33 age- and sex-matched controls, taken from the larger sample, underwent structural magnetic resonance imaging at 5 different MAPP sites across the United States. Results When compared to controls, females with IC displayed significant increased gray matter (GM) volume in several regions of the brain including the right primary somatosensory cortex (S1), the superior parietal lobule bilaterally, and the right supplementary motor area. GM volume in the right S1 was associated with greater pain, mood (anxiety), and urological symptoms. We explored these correlations in a linear regression model and found independent effects of these three measures on S1 GM volume: clinical pain (McGill pain sensory total), a measure of “urgency,” and anxiety (HADS). Conclusions These data support the notion that changes in somatosensory GM may play an important role in pain sensitivity as well as affective and sensory aspects of IC. Further studies are needed to confirm the generalizability of these findings to other pain conditions.

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Section: Discussionmentioning

confidence: 95%

Increased Brain Gray Matter in the Primary Somatosensory Cortex is Associated with Increased Pain and Mood Disturbance in Patients with Interstitial Cystitis/Painful Bladder Syndrome

et al. 2015

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“…11 Greenberg et al reported that 21% of IC/BPS cases associated urgency to prevent incontinence. 10 Kim et al compared the objective response on 3-day voiding diaries between IC/BPS and OAB, and showed a difference in night-time frequency but not in day-time frequency. 24 …”

Section: Discussionmentioning

confidence: 99%

“…10, 11 These studies showed that OAB patients associated urgency to the fear of incontinence, while IC/BPS patients reported urgency due to pain, pressure, or discomfort. However, there was significant overlap, and the authors concluded that “urgency” could not be used to clearly distinguish OAB from IC/BPS.…”

Section: Introductionmentioning

confidence: 99%

The Overlap and Distinction of Self-Reported Symptoms between Interstitial Cystitis/Bladder Pain Syndrome and Overactive Bladder: A Questionnaire Based Analysis

et al. 2014

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Purpose To compare the self-reported symptoms between IC/BPS and OAB based on patient-reported symptoms on validated questionnaires. Materials and Methods Patients diagnosed with IC/BPS (n=26) or OAB (n=53), and healthy controls (n=30), were prospectively recruited to participate in a questionnaire-based study that inquired their lower urinary tract symptoms using the following questionnaires: 1) Genitourinary pain index, 2) Interstitial cystitis symptom index and problem index, 3) International consultation on incontinence – overactive bladder, 4) International consultation on incontinence – urinary incontinence short form (ICIQ-UI), 5) Urgency severity scale, 6) numeric rating scales (NRS) of the severity of their bladder “pain, pressure, or discomfort”, and 7) NRS of severity of their urgency and 8) frequency symptoms. Results In univariate analyses, IC/BPS patients reported significantly more severe pain symptoms compared to OAB. OAB patients reported significantly more severe urinary incontinence symptoms compared to IC/BPS. There were no differences in the severity of frequency and urgency between IC/BPS and OAB. Surprisingly, 33% of OAB patients reported pain or discomfort when the bladder filled, while 46% of IC/BPS patients reported urgency incontinence. In multivariate analyses, the total scores on the ICIQ-UI Short Form (p=0.01) and the severity (NRS) of bladder pain (p<0.01) distinguished OAB from IC/BPS with a sensitivity of 90.6% and a specificity of 96.1% (OAB has higher ICIQ-UI and lower pain scores on NRS). Conclusions There is considerable overlap of self-reported symptoms between IC/BPS and OAB. This overlap raises the possibility that IC/BPS and OAB represent a continuum of a bladder hypersensitivity syndrome.

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“…11 Notably, 2 recent studies have shown that, in 65% to 87% of female IC/BPS patients, the urge to urinate is primarily due to pain, pressure, or discomfort rather than to fear of leakage. 12, 13 …”

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confidence: 99%

Painful Bladder Filling and Painful Urgency are Distinct Characteristics in Men and Women with Urological Chronic Pelvic Pain Syndromes: A MAPP Research Network Study

et al. 2015

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Purpose To describe bladder-associated symptoms in patients with urologic chronic pelvic pain syndromes (UCPPS) and to correlate these symptoms with urologic, non-urologic, psychosocial, and quality of life measures. Methods Participants were 233 women and 191 men with interstitial cystitis/bladder pain syndrome or chronic prostatitis/chronic pelvic pain syndrome in a multi-center study. They completed a battery of measures, including items asking if their pain worsened with bladder filling (“painful filling”) or if their urge to urinate was due to pain, pressure, or discomfort (“painful urgency”). Participants were categorized into 3 groups: 1) “both” painful filling and painful urgency, 2) “either” painful filling or painful urgency, or 3) “neither.” Results Seventy-five percent of men and 88% of women were categorized as “both” or “either.” These bladder characteristics were associated with more severe urologic symptoms (increased pain, frequency, urgency), higher somatic symptom burden, depression, and worse quality of life (all p<0.01, 3-group trend test). A gradient effect was observed across groups (both > either > neither). Compared to those in the “neither” group, men categorized as “both” or “either” reported more frequent UCPPS symptom flares, catastrophizing, and irritable bowel syndrome, and women categorized as “both” or “either” were more likely to have negative affect and chronic fatigue syndrome. Conclusions Men and women with bladder symptoms characterized as painful filling or painful urgency had more severe urologic symptoms, more generalized symptoms, and worse quality of life than participants who reported neither characteristic, suggesting that these symptom characteristics might represent important subsets of UCPPS patients.

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Voiding urges perceived by patients with interstitial cystitis/painful bladder syndrome

Cited by 22 publications

References 25 publications

Increased Brain Gray Matter in the Primary Somatosensory Cortex is Associated with Increased Pain and Mood Disturbance in Patients with Interstitial Cystitis/Painful Bladder Syndrome

Increased Brain Gray Matter in the Primary Somatosensory Cortex is Associated with Increased Pain and Mood Disturbance in Patients with Interstitial Cystitis/Painful Bladder Syndrome

The Overlap and Distinction of Self-Reported Symptoms between Interstitial Cystitis/Bladder Pain Syndrome and Overactive Bladder: A Questionnaire Based Analysis

Painful Bladder Filling and Painful Urgency are Distinct Characteristics in Men and Women with Urological Chronic Pelvic Pain Syndromes: A MAPP Research Network Study

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