Clinical and Psychological Parameters Associated with Pain Pattern Phenotypes in Women with Interstitial Cystitis/Bladder Pain Syndrome

PurposeIt was recently suggested that 2 distinct clinical phenotypes can be described in patients with urological chronic pelvic pain syndrome, including pelvic pain only and pelvic pain beyond. We examined data on patients with interstitial cystitis/bladder pain syndrome, including body pain location mapping, and associated medical and psychosocial phenotyping to validate these body pain maps in a cohort of female patients with interstitial cystitis/bladder pain syndrome undergoing tertiary care.Materials and MethodsValidated questionnaires from 173 diagnosed outpatient female patients with interstitial cystitis/bladder pain syndrome included a body pain area diagram, demographics/history, pain assessment, interstitial cystitis/bladder pain syndrome symptoms, depression, anxiety, stress, fatigue, sexual functioning, catastrophizing, quality of life and data on other chronic pain conditions. Two pain phenotypes based on counts of body locations, pelvic pain only and pelvic pain beyond, were comprehensively examined.ResultsThe 157 patients (81%) identified with pelvic pain beyond reported more sensory type pain, poorer physical quality of life, and greater somatic depression and sleep disturbance than the 36 (19%) categorized with pelvic pain only. The sexual pain score was higher in the pelvic pain only group. Furthermore, patients with the pelvic pain beyond phenotype reported a higher prevalence of irritable bowel syndrome and fibromyalgia as well as more general fatigue symptoms and psychiatric conditions.ConclusionsTwo distinct pain location phenotypes, including pelvic pain only and pelvic pain beyond, were identified by our independent analysis of patients with interstitial cystitis/bladder pain syndrome. Assessing clinical phenotypes based on pain patterns has significant ramifications in our improved understanding of the etiology and treatment of female patients diagnosed with interstitial cystitis/bladder pain syndrome.