Pd25-01 Small Fiber Polyneuropathy in Interstitial Cystitis/Bladder Pain Syndrome: An Important Feature of the Non-Bladder-Centric Systemic Pain Phenotype

You have accessJournal of UrologyInfections/Inflammation/Cystic Disease of the Genitourinary Tract: Interstitial Cystitis (PD25)1 May 2024PD25-01 SMALL FIBER POLYNEUROPATHY IN INTERSTITIAL CYSTITIS/BLADDER PAIN SYNDROME: AN IMPORTANT FEATURE OF THE NON-BLADDER-CENTRIC SYSTEMIC PAIN PHENOTYPE Mary Namugosa, Rory Ritts, Robert Evans, Gopal Badlani, Catherine Ann Matthews, and Stephen J. Walker Mary NamugosaMary Namugosa , Rory RittsRory Ritts , Robert EvansRobert Evans , Gopal BadlaniGopal Badlani , Catherine Ann MatthewsCatherine Ann Matthews , and Stephen J. WalkerStephen J. Walker View All Author Informationhttps://doi.org/10.1097/01.JU.0001008584.88541.ff.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Small fiber polyneuropathy (SFPN) is a condition resulting from damage to A-delta and C sensory nerve fibers that plays a role in pain and temperature perception. While SFPN is known to be a common finding in fibromyalgia and irritable bowel syndrome (IBS), we have also shown that approximately 30% of interstitial cystitis/bladder pain syndrome (IC/BPS) patients exhibit SFPN, making it a potential therapeutic target. The goal of this study is to determine how SFPN fits into the overall IC/BPS clinical picture. METHODS: 172 IC/BPS patients (152 F; 20 M) undergoing therapeutic hydrodistension were enrolled in this study. A 3mm punch biopsy was obtained from the mid-calf, processed, stained, and read by a dermatopathologist to determine linear intraepidermal nerve fiber density (IENFD). Co-occurring diagnoses were charted from patient reports and medical records. Univariate analysis was conducted to compare demographics and clinical characteristics of participants with and without SFPN and logistic regression was performed to identify the variables that impacted the dependent variable SFPN. RESULTS: Of the 172 participants, 58 (34%) were identified to have an IENFD indicative of SFPN based on normative reference ranges that account for age and gender. Notably, 139 (80.8%) had an IENFD less than the median for their demographic. The average age for all participants was 50.74 (±15.0). Age, bladder capacity (BC), and the total number of non-urologic associated syndromes did not differ significantly based on SFPN status. Logistic regression identified race (OR 3.66, CI 1.223-10.921), HL status (OR 0.176, 0.038-0.820), chronic fatigue syndrome (CFS: OR 6.541, CI 2.188-19.55), migraines (OR 0.233, CI 0.089-0.606) and diabetes mellitus (DM: OR 3.680, CI1.25-10.87) to be correlated with SFPN. CONCLUSIONS: SFPN is an important clinical finding in a significant proportion of IC/BPS patients and is likely to co-occur with CFS, but not HL. This suggests that a finding of SFPN in IC/BPS is associated with a systemic pain disorder phenotype rather than a bladder-centric disease phenotype. Source of Funding: RO1 DK124599/DK/NIDDK NIH HHS/United States © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e536 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Mary Namugosa More articles by this author Rory Ritts More articles by this author Robert Evans More articles by this author Gopal Badlani More articles by this author Catherine Ann Matthews More articles by this author Stephen J. Walker More articles by this author Expand All Advertisement PDF downloadLoading ...