Poster, Podium & Video Sessions
Presentation Authors: Lindsey McKernan*, Joshua Cohn, Stephen Bruehl, Roger Dmochowski, W. Stuart Reynolds, Nashville, TN
Introduction: Many clinical characteristics overlap between Overactive Bladder (OAB) and Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS) suggesting possible common pathophysiologic mechanisms. Central sensitization, which is an induced state of spinal hypersensitivity and well-recognized mechanism of centrally amplified pain perception, may be such a mechanism. Psychosocial and pain characteristics are important aspects of central sensitization disorders, but are often overlooked in women with OAB. Our aim was to examine whether these characteristics differ among OAB patients with a self-reported history of IC/BPS, OAB alone, and controls.
Methods: We enrolled 39 adult women initiating third-line OAB therapy and 25 healthy controls to complete clinical and psychosocial assessment. We identified a subset of women with OAB who self-identified as having a history of IC/BPS (n=13). Using Fischers exact test and linear regression, we then compared differences in bladder symptoms, psychosocial functioning, and pain sensitivity across these three groups (OAB = 26, OAB & IC/BPS = 13, and control = 25).
Results: Women with OAB with or without IC/BPS reported significantly greater urinary symptoms and psychosocial and pain burden than controls (Tables 1 and 2). The subset of women with IC/BPS demonstrated significantly increased symptom severity, higher rates of co-morbid somatic conditions, emotional distress, and poorer quality of life when compared to other groups. This group also reported a greater degree of widespread pain and symptoms attributable to central sensitization than those with OAB alone.
Conclusions: In this group of women undergoing third-line therapy for OAB, a personal history of IC/BPS was associated with worsened psychosocial, bladder, and pain function compared to those with OAB or controls. However, women with OAB alone also demonstrated similar characteristics, supporting the hypothesis that central sensitization may play a role in both conditions.
Source Of Funding: This study was supported by the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health under award number K23DK103910, the Society of Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction Foundati