876 “VOIDING DYSFUNCTION PHENOTYPING OF WOMEN WITH CHRONIC PELVIC PAIN SYNDROMES: RESULTS FROM THE ICEPAC TRIAL” (2013)

You have accessJournal of UrologyInfections/Inflammation of the Genitourinary Tract: Interstitial Cystitis1 Apr 2013876 "VOIDING DYSFUNCTION PHENOTYPING OF WOMEN WITH CHRONIC PELVIC PAIN SYNDROMES: RESULTS FROM THE ICEPAC TRIAL" Elias Veizi, Adonis Hijaz, Firouz Daneshgari, and Thomas Chelimsky Elias VeiziElias Veizi Cleveland, OH , Adonis HijazAdonis Hijaz Cleveland, OH , Firouz DaneshgariFirouz Daneshgari Cleveland, OH , and Thomas ChelimskyThomas Chelimsky Milwaukee, WI View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.445AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Interstitial cystitis/Bladder pain syndrome (IC/BPS) and myofascial pelvic pain (MPP) are two of the most common forms of chronic pelvic pain (CPP). Cross organ sensitization in pelvis complicates the clinical diagnosis and treatment of IC/PBS as part of general CPP. ICEPAC trial aims to study the autonomic nervous dysfunction in patients with interstitial cystitis and myofascial pain and aims to assess the signature phenotypes of pain and voiding dynamic changes. METHODS ICEPAC supported by NIH-NIDDK was designed by an interdisciplinary team. Enrollment will include 76 women with IC, 76 women with myofascial pelvic pain disorder (MPP), 38 1st degree female relatives of IC subjects without pelvic pain, and 38 healthy age-matched women. Besides a detailed screening visit with comprehensive assessment of dysautonomias, pain intensity and disability scores, voiding dysfunction phenotype is assessed by Uroflow and a voiding diary. VAS scores, frequency, voiding volumes, flow parameters and timed flow assessment data are collected and analyzed. RESULTS This preliminary analysis includes the first 60 patients [29 healthy control (con) subjects; 23 IC/BPS patient and 8 chronic MPP]. Subjects enrolled in the study are age matched [con 40±15, IC 39.6±15, MPP 40.5±14 yo]. BMI in MPP patients is significantly higher than Hcon and IC subjects [42±5 vs 26±9 in con and 27±8 in IC]. Voiding volumes were lower in the IC group vs H con and MPP whether frequency was higher in the IC group with similar fluid intake. The peak flow [Qmax] was significantly lower in the IC cluster 16±2 ml/sec vs. 28±11 con, 23±4 MPP; while the average flow rate was lower in both IC and MPP vs. con. Similarly duration of flow was higher in IC and MPP vs. con. CONCLUSIONS This preliminary quantitative evaluation of voiding diary and uroflow metrics reveals distinct voiding phenotypes in IC and MPP. The decrease in Qmax in IC cluster in comparison to con and MPP could be an indication of the internal sphincter autonomic dysfunction while the prolonged voiding duration and avg flow in MPP patients could indicate external sphincter hypertonicity [incomplete relaxation]. Further details on voiding dysfunction could lead toward a better understanding of the pathogenesis in IC vs other pelvic floor dysfunction syndromes. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e361-e362 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.Metrics Author Information Elias Veizi Cleveland, OH More articles by this author Adonis Hijaz Cleveland, OH More articles by this author Firouz Daneshgari Cleveland, OH More articles by this author Thomas Chelimsky Milwaukee, WI More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...