PA Medical News about Chronic pelvic pain syndromes

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Chronic pelvic pain syndromes: clinical, urodynamic, and urothelial observations
International Urogynecology Journal, 05/28/09

Butrick CW et al. - Based on the chief complaints, patients were divided into four subgroups: BPS/IC, CPP, vulvodynia/dyspareunia, and "other". Similar findings were found in all four subgroups: complaints of voiding dysfunction (70%), dyspareunia (54%), mean PUF score of 15.9 ± 6.4, and a positive potassium sensitivity test in 83%. Urodynamics revealed a maximal urethral pressure of 131 cm of water and an abnormal uroflow in 80%. Urothelial therapy in the form of intravesical therapeutic anesthetic cocktails provided benefit in all groups. All subgroups had similar findings and response to therapy. Five to 10% of patients with chief complaints of stress or urge incontinence or prolapse were also found to have BPS/IC.

Exclusive Author Commentary
Charles W. Butrick, 05/29/09

Highlight of this data included that the prevalance of IC/PBS is approx 5-10% in Pts with prolapse, urge incontinence and stress incontinence. It is very important to be aware that patients can have more than one problem and each must be dealt with. Also, it does not matter what the chief complaint is, if the patient has any pelvic pain issues there is at least a 70% chance that their urothelium is upregulated, their pelvic floor will be tight and dysfunctional and they may have voiding dysfunction related to the pelvic floor's inability to relax. It is this pelvic floor dysfunction that with perpetuate the symptoms and therefore pelvic therapy must be a component of the managemnet plan.

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