Translational Research in Pelvic Pain
Condition: Endometriosis; Bladder Pain Syndrome; Chronic Pain
MeSH terms: Endometriosis; Cystitis, Interstitial; Syndrome; Chronic Pain; Pelvic Pain
Study type: Observational

Summary: 
      This study aims to better understand the pathways leading to pain in women with two types of
      pelvic pain condition (endometriosis-associated pain and bladder pain syndrome) and determine
      whether these pathways can be used to subgroup patients.
    

Detailed description: 
      Chronic pelvic pain is as common as asthma, migraine and back pain and has a very significant
      impact on quality of life. However, it is still poorly understood and the available
      treatments are limited and often not successful. This project focuses on two causes of
      chronic pelvic pain: endometriosis and interstitial cystitis/bladder pain syndrome.
      Endometriosis (the presence of tissue resembling the lining of the womb outside of the womb)
      is very common, affecting ~1 in 10 women, and is associated with often disabling pelvic pain
      symptoms including painful periods, pain throughout the month, and pain associated with sex,
      passing urine and opening bowels. Interstitial cystitis/bladder pain syndrome is much less
      common but dramatically reduces quality of life with many women planning their day around
      trips to the toilet.

      This multi-centre study will be carried out at 3 sites in Europe and 1 in the U.S.. Rather
      than focusing on the pelvis, the investigators will approach these conditions in the context
      of other chronic pain conditions with which they share many features and thus consider the
      many different systems that might contribute to generating and maintaining pain. The
      investigators will combine detailed clinical and questionnaire data with tests of the
      function of a variety of systems (including nerve function, stress response and psychology)
      and the results of analyses of different body fluids and tissues (including blood, urine,
      endometriosis lesions). No study treatment or intervention will be given during TRiPP. The
      aim is to identify pathways responsible for pain in these women and determine whether they
      can be divided into subgroups on the basis of different pain pathways that might therefore
      respond to different treatments. Ultimately the investigators hope to identify new targets
      for treatment and contribute to the design of more personalised treatment plans.
    

Observational model: Cohort
Time perspective: Cross-Sectional
Sampling method: Non-Probability Sample
Study population: 
        Controls, EAP and EABP will be selected from already recruited cohorts, with permission to
        be recontacted, in the ENDOX (University of Oxford) and BCE (Boston Childrens Hospital)
        studies. BPS will be recruited from secondary/tertiary care clinics and from adverts on
        patient support group sites and in local media.
      
Biospecimen description: 
      Saliva Blood Urine Bladder biopsies (for BPS patients) Eutopic and ectopic endometrium (for
      endometriosis patients and Oxford controls)

      N.B. Biospecimens have already been collected for all Endometriosis (with and without bladder
      symptoms) and Control subjects, therefore new bio specimens are only being collected for the
      BPS cohort or if necessary for additional analyses (e.g. salivary cortisol), in which case
      samples will not be retained.