Biopsychosocial predictors of suicide risk in patients with interstitial cystitis/bladder pain syndrome

Introduction: The impact of interstitial cystitis/bladder pain syndrome (IC/BPS) is prevalent and severe. Studies examining the IC/BPS prevalence and predictors of suicide risk are limited by their lack of theoretically relevant suicide research variables. This research reports suicide risk prevalence its biopsychosocial predictors for a community IC/BPS sample. Methods: Self-identified female patients suffering from IC/BPS (N=813; 18–80 years, M= 46.60, standard deviation [SD] 14.10) recruited from online IC/BPS support groups completed measures of demographic, pain, symptoms, and psychosocial variables. Descriptive statistics, correlations, and multivariable logistic regressions examined prevalence, variable associations, and suicide risk prediction. Results: Suicide risk prevalence was 38.1%. Suicide risk was associated with greater odds for exposure to suicide, psychache, hopelessness, and perceived burdensomeness to others. Further, examining suicide risk by levels of pain showed that exposure to suicide and hopelessness were consistent suicide risk predictors across pain levels; psychache for lower levels of pain, perceived burdensomeness in moderate and severe pain levels, and depression in moderate levels of pain. Conclusions: The high prevalence of suicide risk is alarming and signifies an imperative for recognizing this risk within the IC/BPS population. The identified psychosocial risk factors may be used in refining screening and treatment and in directing future IC/BPS research.

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Clinical and histological findings in bladder pain syndrome/interstitial cystitis: The implication of time of symptoms

Journal of Clinical Urology ◽

10.1177/2051415817747474 ◽

2018 ◽

Vol 11 (4) ◽

pp. 248-253

Author(s):

Daniele Porru ◽

Valentina Bobbi ◽

Carmelo Di Franco ◽

Alessandra Viglio ◽

Mattia Novario ◽

...

Keyword(s):

Interstitial Cystitis ◽

Symptom Onset ◽

Bladder Wall ◽

Pain Syndrome ◽

Bladder Pain Syndrome ◽

Detrusor Muscle ◽

Level Of Evidence ◽

Bladder Pain ◽

Bladder Biopsy ◽

The Impact

Objective: To find out whether a correlation exists between denudation of urothelium and time of symptom onset in patients with bladder pain syndrome/interstitial cystitis (BPS/IC), and to search for a correlation between the impact of symptoms. Patients and methods: Fifty-seven consecutive patients underwent cystoscopy under anaesthesia to classify those cases suspected of being affected with BPS/IC. The time elapsed between onset of symptoms and diagnosis at the time of bladder biopsy was also defined as BPS/IC duration. Bladder biopsies were taken including detrusor muscle, three deep cold biopsies of posterior, anterior and lateral bladder wall. Results: Statistical analysis showed significant correlation between BPS/IC duration and the presence of Hunner’s lesions ( P<0.023). Hunner’s lesion with cystoscopy and histological evidence of urothelial denudation with bladder biopsy appear to be related to BPS/IC duration. Thus an early diagnosis allows an appropriate therapeutic approach to be started to prevent a more severe evolution of this multifaceted painful syndrome. Conclusions: Our study shows a correlation between the time of symptom onset and evidence of urothelial denudation and with detrusor mast cell count in the whole group of patients. BPS/IC duration did not seem to correlate with the severity of symptoms, but rather with the presence of associated diseases. Level of evidence: Not applicable for this multicentre audit.

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Notch1 Signaling Contributes to Mechanical Allodynia Associated with Cyclophosphamide-Induced Cystitis by Promoting Microglia Activation and Neuroinflammation

Mediators of Inflammation ◽

10.1155/2021/1791222 ◽

2021 ◽

Vol 2021 ◽

pp. 1-9

Author(s):

Jialiang Chen ◽

Honglu Ding ◽

Bolong Liu ◽

Xiangfu Zhou ◽

Xin Zhou ◽

...

Keyword(s):

Interstitial Cystitis ◽

Mechanical Allodynia ◽

Pain Syndrome ◽

Bladder Pain Syndrome ◽

Microglia Activation ◽

Bladder Pain ◽

Withdrawal Threshold ◽

Notch1 Signaling ◽

Tnf Α ◽

The Impact

Aims. Notch1 signaling regulates microglia activation, which promotes neuroinflammation. Neuroinflammation plays an essential role in various kinds of pain sensation, including bladder-related pain in bladder pain syndrome/interstitial cystitis (BPS/IC). However, the impact of Notch1 signaling on mechanical allodynia in cyclophosphamide- (CYP-) induced cystitis is unclear. This study is aimed at determining whether and how Notch1 signaling modulates mechanical allodynia of CYP-induced cystitis. Methods. CYP was peritoneally injected to establish a bladder pain syndrome/interstitial cystitis (BPS/IC) rat model. A γ-secretase inhibitor, DAPT, was intrathecally injected to modulate Notch1 signaling indirectly. Mechanical withdrawal threshold in the lower abdomen was measured with von Frey filaments using the up-down method. The expression of Notch1 signaling, Iba-1, OX-42, TNF-α, and IL-1β in the L6-S1 spinal dorsal horn (SDH) was measured with Western blotting analysis and immunofluorescence staining. Results. Notch1 and Notch intracellular domain (NICD) were both upregulated in the SDH of the cystitis group. Moreover, the expression of Notch1 and NICD was negatively correlated with the mechanical withdrawal threshold of the cystitis rats. Furthermore, treatment with DAPT attenuated mechanical allodynia in CYP-induced cystitis and inhibited microglia activation, leading to decreased production of TNF-α and IL-1β. Conclusion. Notch1 signaling contributes to mechanical allodynia associated with CYP-induced cystitis by promoting microglia activation and neuroinflammation. Our study showed that inhibition of Notch1 signaling might have therapeutic value for treating pain symptoms in BPS/IC.

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Mirabegron to manage symptoms of interstitial cystitis / bladder pain syndrome: A stone for two birds?

Archive of Urological Research ◽

10.17352/aur.000032 ◽

2021 ◽

pp. 020-023

Author(s):

Pereira-Correia João Antonio ◽

Nahoum Luiza Amaral ◽

Aldred Pinto João Ernesto ◽

Fernandes Muller Valter José

Keyword(s):

Quality Of Life ◽

Chronic Pain ◽

Interstitial Cystitis ◽

Pain Syndrome ◽

Bladder Pain Syndrome ◽

Urinary Urgency ◽

Urinary Frequency ◽

Bladder Pain ◽

Pain Symptoms

Background: Interstitial Cystitis / Bladder Pain Syndrome (IC/BPS) patients often experience lowered quality of life due to pain, urinary urgency, and increases in urinary frequency. Like many chronic pain disorders, IC/BPS is poorly understood and treatment unsatisfactory. Materials and methods: We prospectively monitored the effects on pain and urinary complaints, of mirabegron associated with amitriptyline, for randomly selected women with IC/BPS. Results: Twenty-five women were randomly selected to treat pain symptoms of IC/BPS and 12 followed up until the end of the study. All patients showed improvement on all questionnaires referring to pain IC/BPS symptoms and urinary storage symptoms. There was no statistically significant improvement in urinary frequency. Conclusions: We suggest that mirabegron can work controlling urinary urgency and pain of IC/BPS patients.

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