The Severity and Distribution of Nonurologic Pain and Urogenital Pain in Overactive Bladder are Intermediate Between Interstitial Cystitis and Controls

• Published in: Urology (Ridgewood, N.J.) Vol. 130; pp. 59 - 64
• Main Authors: Thu, James H.L., Vetter, Joel, Lai, H. Henry
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.08.2019
• Subjects: Adult; Cystitis, Interstitial - complications; Female; Humans; Male; Middle Aged; Pain Measurement; Pelvic Pain - epidemiology; Pelvic Pain - etiology; Severity of Illness Index; Urinary Bladder, Overactive - complications; Urinary Bladder, Overactive - diagnosis
• ISSN: 0090-4295; 1527-9995; 1527-9995
• DOI: 10.1016/j.urology.2019.03.030

(1) To compare the severity and distribution of nonurologic and urogenital pain between overactive bladder (OAB), interstitial cystitis/bladder pain syndrome (IC/BPS) and controls, and (2) To examine the relationships between the severity of urogenital pain and severity of urinary symptoms among patients with OAB. Fifty-one OAB patients, 27 IC/BPS patients, and 30 controls were recruited. Nonurologic pain was assessed using a whole body map and Brief Pain Inventory. Urologic pain was assessed using the Interstitial Cystitis Symptom and Problem indexes, Genitourinary Pain Index, and 0-10 pain scale. Urogenital pain was assessed using a genital map, and report of pain related to bladder filling and urination. Among OAB patients, 6% reported pelvic pain only while 28% reported pelvic pain and beyond. 18% reported widespread pain. The distribution of nonurologic pain and urogenital pain in OAB patients were intermediate between IC/BPS and controls (IC/BPS>OAB>controls, P all <.05). The intensity of pain reported by OAB patients was intermediate between controls and IC/BPS (average 2.3 vs 0.8 vs 4.3 out of 10, P <.001). Among OAB patients, the pain severity (GUPI-pain, ICSI-pain, ICPI-pain) was positively correlated with urinary severity (UDI-6, IIQ-7, OABq-SS, OABq-QOL, P all < .05). OAB patients with pelvic pain have worse urinary symptoms and psychosocial health (anxiety, depression) compared to OAB patients without pelvic pain. A subset of OAB patients has pain inside and/or outside the pelvis. The intensity and distribution of pain in OAB was intermediate between IC/BPS and controls. Systemic processes such as central sensitization should be examined in this population.