Problems in Female Urology: Interstitial Cystitis/Bladder Pain Syndrome, Pelvic Floor Disorders, and Pelvic Organ Prolapse

2020 ◽  
pp. 309-343
Author(s):  
Giulia I. Lane ◽  
Lindsey Cox
Keyword(s):  
Pelvic Organ Prolapse ◽  
Pelvic Floor ◽  
Interstitial Cystitis ◽  
Pelvic Floor Disorders ◽  
Pain Syndrome ◽  
Pelvic Organ ◽  
Bladder Pain Syndrome ◽  
Female Urology ◽  
Bladder Pain

scholarly journals Pelvic Floor Myofascial Pain Might Influence Treatment Outcome of Interstitial Cystitis/bladder Pain Syndrome

2021 ◽  
Author(s):  
Wan-Ru Yu ◽  
Fei-Chi Chuang ◽  
Wei-Chuan Chang ◽  
Hann-Chorng Kuo
Keyword(s):  
Pelvic Floor ◽  
Interstitial Cystitis ◽  
Myofascial Pain ◽  
Pelvic Floor Muscle ◽  
Pain Syndrome ◽  
Response Assessment ◽  
Bladder Capacity ◽  
Bladder Pain Syndrome ◽  
Bladder Pain ◽  
The Relationship

Abstract IntroductionIn patients with interstitial cystitis or bladder pain syndrome (IC/BPS), 85% were found to have pelvic floor myofascial pain (PFMP) and hypertonicity (PFH). However, they are not typically trained to consider or assess PFMP as a contributing factor to patients’ IC/BPS symptoms. This study aimed to explore the relationship between PFMP and treatment outcomes in women with IC/BPS.MethodsPatients with IC/BPS who received any type of treatment were prospectively enrolled. They underwent vaginal digital examination at baseline. PFMP severity was quantified on the visual analog scale (VAS). Subject assessment items included O’Leary-Sant symptom score (OSS), Global Response Assessment (GRA), and Beck’s anxiety inventory. Object assessment items included bladder computed tomography (CT), urodynamic parameters, maximum bladder capacity, and grade of glomerulation.ResultsA total of 65 women with IC/BPS (mean age, 57.1 ± 11.3 years) were enrolled in the study. Patients with more severe PFMP had significantly higher rate of dyspareunia (p = .031); more comorbidities (p = .010); higher number of PFMP sites (p < .001); and higher OSS (p = .012). PFMP severity was not significantly correlated with bladder conditions, whether subjective or objective. Moreover, PFMP severity (VAS) was significantly negatively associated with GRA score.ConclusionPFMP might affect the subjective results of IC/BPS treatment but not the bladder condition. Therefore, in the future treatment of patients with IC/BPS, digital vaginal examinations of pelvic floor muscles should be performed and focused more on the PFM-related conditions, and necessary PFM treatments, such as the vaginal pelvic floor muscle message, should be scheduled.

High-Density Surface Electromyography Assessment of Pelvic Floor Dysfunction in Women with Interstitial Cystitis/Bladder Pain Syndrome

2020 ◽  
Vol 204 (6) ◽  
pp. 1275-1283
Author(s):  
Nicholas Dias ◽  
Chuan Zhang ◽  
Theresa Spitznagle ◽  
H. Henry Lai ◽  
Yingchun Zhang
Keyword(s):  
Pelvic Floor ◽  
Interstitial Cystitis ◽  
Surface Electromyography ◽  
Pelvic Floor Dysfunction ◽  
Pain Syndrome ◽  
Bladder Pain Syndrome ◽  
High Density ◽  
Bladder Pain ◽  
Density Surface

Interstitial Cystitis/Bladder Pain Syndrome

2020 ◽  
Author(s):  
Patrick J Hensley ◽  
H. Henry Lai ◽  
Deborah R Erickson
Keyword(s):  
Pelvic Floor ◽  
Interstitial Cystitis ◽  
Stress Reduction ◽  
Botulinum Toxin Injection ◽  
Pain Syndrome ◽  
Bladder Pain Syndrome ◽  
Bladder Pain ◽  
Recommended Treatment ◽  
Proven Efficacy ◽  
Second Tier

This article describes a practical framework for the evaluation and treatment of interstitial cystitis/bladder pain syndrome (IC/BPS), based on and expanding from the American Urological Association (AUA) guideline. The key points in evaluation are (1) to recognize confusable diseases or comorbid disorders that require separate treatments, and (2) to recognize patient subtypes that require specialized treatment approaches (eg, pelvic pain and beyond, polysymptomatic and polysyndromic types, and patients with Hunner lesions). Treatment begins with education, including diet, stress reduction, and other self-care strategies, which have proven efficacy and are first line in the AUA guideline. Second-tier treatments include oral and intravesical medications. Further, the AUA guideline states that physical therapy should be offered to patients with pelvic floor tenderness if a qualified therapist is available.  For Hunner lesions, the initial recommended treatment is cystoscopy with fulguration or triamcinolone injection. Higher-tier treatments, which involve more risks, include hydrodistention, bladder botulinum toxin injection, sacral nerve stimulation, and oral cyclosporine A. The article includes a practical algorithm to help clinicians organize their thoughts while evaluating and starting therapy for patients with IC/BPS.   This review contains 4 figures, 4 tables, and 64 references. Key Words: bladder pain syndrome, Hunner lesion, interstital cystitis,   polysymptomatic, polysyndromic, pelvic floor dysfuction, vulvodynia

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