Presentation Authors: Renee Rolston, Jamaica, NY, Alisa Stephens-Shields, Philadelphia , PA, J. Quentin Clemens, Ann Arbor, MI, John Krieger, Seattle , WA, Craig Newcomb, Philadelphia , PA, Jennifer Anger, Los Angeles, CA, Catherine Bradley, Bradley A. Erickson, Iowa City, IA, Henry Lai, St. Louis, MO, Larissa Rodriguez*, Los Angeles, CA
Introduction: Female sexual dysfunction (FSD) is associated with lower quality of life (QoL) in interstitial cystitis/bladder pain syndrome (IC/BPS). Our objectives were to: 1) compare the prevalence of FSD among IC/BPS, other non-urologic chronic pain conditions (positive controls, PCs) and healthy controls (HCs); 2) evaluate the role of psychosocial and urologic factors in FSD in all three cohorts; 3) correlate longitudinal changes in FSD with changes in IC/BPS symptoms.
Methods: Cross sectional analysis was performed on female participants in the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network. FSD was defined as a score < 26 on the Female Sexual Function Index (FSFI). Baseline data were compared by ANOVA and chi-squared tests. Multivariate logistic regression was used to assess associations between psychosocial variables [Self Esteem and Relationship (SEAR); Perceived Stress Scale (PSS); Hospital Depression and Anxiety Scale (HADS), International Personality Item Pool (IPIP), Current Symptoms Questionnaire (CSQ)] and FSD. In IC/BPS participants, 12 month change in sexual function was classified as improved, stable, or worse using a functional clustering algorithm. Ordinal logistic regression was used to assess the association of change in pain and urinary symptoms with change in FSD.
Results: There were 233 patients with IC/BPS, 156 PCs, and 233 HCs. IC/BPS participants reported lower mean FSFI scores than HCs and PCs (p=0.001). The proportion with FSD was higher in the IC/BPS group (65%) than PCs (35.7%) and HCs (14.7%) (p=0.001). Psychosocial factors such as depression, anxiety, personality traits, stress, and overall pain and urinary severity were shown to be associated with FSD in univariate analysis. Psychosocial factors, urinary and pain severity continued to be associated with FSD, after adjusting for age, spouse, ethnicity, number of genital sites with pain, and employment status (Table 1). In IC/BPS pain or urinary symptoms did not correlate with changes in FSFI scores.
Conclusions: FSD is largely impacted by psychosocial risk factors and genital pain. Assessment of and targeting treatment to these risk factors may improve sexual function and QoL in IC/BPS.
Source of Funding: Funding for the MAPP Research Network was obtained under a cooperative agreement from National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health (NIH) (DK82370, DK82342, DK82315, DK82344, DK82325, DK82345, DK82