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Symptomatic Autonomic Dysfunction in Interstitial Cystitis/Bladder Pain Syndrome.

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Area of Science:

  • Urology
  • Autonomic Neuroscience
  • Pain Medicine

Background:

  • Interstitial cystitis/bladder pain syndrome (IC/BPS) is a prevalent condition with unclear pathophysiology, particularly regarding systemic symptoms.
  • The role of autonomic nervous system (ANS) dysfunction in IC/BPS is not well understood.

Purpose of the Study:

  • To investigate the association between autonomic symptom severity and the clinical characteristics of patients diagnosed with IC/BPS.

Main Methods:

  • A retrospective cohort study involving 122 IC/BPS patients who completed the Composite Autonomic Symptoms Score (COMPASS-31).
  • Data collected included bladder capacity, Hunner lesion status, IC/BPS symptom scores (ICSI/ICPI, PUF), and comorbid nonurologic syndromes.
  • Patients were divided into low (first quartile COMPASS-31) and high symptom load groups for comparison.

Main Results:

  • Patients with higher autonomic symptom scores (≥20.36) were less likely to have Hunner lesions (10.9% vs 26.7%).
  • Higher symptom load correlated with increased bladder capacity (823.10 vs 635.00 mL) and higher Pelvic Pain and Urgency/Frequency (PUF) scores (23.80 vs 19.61).
  • A significantly greater number of nonurologic associated syndromes were observed in patients with higher autonomic symptom severity (5.65 vs 2.60).

Conclusions:

  • Patients with IC/BPS exhibit widespread symptoms linked to autonomic nervous system dysfunction.
  • Increased autonomic symptom severity is strongly associated with a nonbladder-centric clinical presentation in IC/BPS.
  • These findings support the presence of systemic nervous system dysfunction in nonbladder-centric IC/BPS cases.