Comparison of Voiding Dysfunction Phenotypes in Women with Interstitial Cystitis/Bladder Pain and Myofascial Pelvic Pain: Results from the ICEPAC Trial - 30/07/19
Abstract |
Objective |
To evaluate whether voiding parameters differ in patients with the common overlapping pelvic pain disorders, interstitial cystitis/bladder pain syndrome (IC/BPS), and myofascial pelvic pain (MPP).
Methods |
Uroflow and voiding diary assessed voiding phenotypes in this prospective cohort study (ICEPAC) of women comparing IC/BPS, IC/BPS +MPP, MPP, and healthy control (HC) subjects.
Results |
In 36 HC, 24 IC/BPS, 37 IC/BPS + MPP, and 14 MPP subjects, the voiding diary measurements indicate lower voided volumes in IC/BPS and IC/BPS + MPP groups (185 ± 24 mL, 169 ± 20 mL, respectively) compared to HC and MPP groups (294 ± 24 mL, 226 ± 36 mL, respectively; P <.05, P <.05), as well as higher 24-hour voiding frequency (11.6 ± 0.8 and 11 ± 1.2 voids/24 hours, respectively; HC 7.1 ± 0.5 voids/24 hours; P <.05, P <.05; MPP group 9 ± 1.2 voids/24 hours; P <.05, P <.05). Uroflow showed higher HC average flow rate (12.87 ± 0.92) compared to IC/BPS, IC/BPS+MPP, and MPP (8.31 ± 1.20, 8.02 ± 0.80, 8.17 ± 1.38, respectively; P <.01, P <.01, P <.05) and peak flow rate (27.0 ± 1.83) and IC/BPS, IC/BPS+MPP and MPP (16.20 ± 2.2, 17.33 ± 1.64, 17.21 ± 2.69 respectively; P <.01, P <.01, P <.05).
Conclusion |
This quantitative evaluation of voiding diary and uroflow metrics reveals distinct voiding phenotypes, which can aid in the diagnosis of chronic pelvic pain syndromes. Patients with IC/BPS had more pain with a full bladder despite similar overall pain scores. Peak and average flow rates do not provide any differentiating power between IC/BPS and MPP patients. A longer time to peak flow may favor MPP though this finding needs confirmation.
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| Financial disclosure: The ICEPAC Study is funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) (R01DK083538). The following individuals are members of the ICEPAC Study Advisory Board and have helped shape the design and methodologies describe herein: Debra Erickson (Department of Surgery, University of Kentucky College of Medicine, Lexington, KY, USA), Kathleen Pajer (IWK Health Centre, Dalhousie University, Halifax, NS, Canada), Julian Thayer (Department of Psychology, The Ohio State University, Columbus, OH, USA), Ursula Wesselmann (Department of Anesthesiology, UAB School of Medicine, Birmingham, AL, USA) and Denniz Zolnoun (Department of Obstetrics and Gynecology, UNC School of Medicine, Chapel Hill, NC, USA). |
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| Drs Petrikovets and Veizi share in first authorship of this manuscript. |
Vol 126
P. 54-58 - avril 2019 Retour au numéro
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