Genital Pain and the Spectrum of Bladder-Related Symptoms: Findings from the Prevention of Lower Urinary Tract Symptoms Research Consortium RISE FOR HEALTH Study, USA

• Published in: International Urogynecology Journal 2024-09, Vol.35 (9), p.1777-1787
• Main Authors: Harlow, Bernard L., McGwin, Gerald, Sutcliffe, Siobhan, Fitzgerald, Colleen M., Lowder, Jerry L., Newman, Diane K., Meister, Melanie, Camenga, Deepa R., Stapleton, Ann, Chary, Vanika, Lukacz, Emily S.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Bladder; Consortia; Cystitis, Interstitial - epidemiology; Cystitis, Interstitial - prevention & control; Female; Gynecology; Humans; Lower Urinary Tract Symptoms - etiology; Lower Urinary Tract Symptoms - prevention & control; Medicine; Medicine & Public Health; Middle Aged; Original Article; Pain; Pelvic Pain - epidemiology; Pelvic Pain - etiology; Surveys and Questionnaires; United States - epidemiology; Urinary Bladder - physiopathology; Urinary tract diseases; Urinary tract infections; Urogenital system; Urology
• ISSN: 0937-3462; 1433-3023; 1433-3023
• DOI: 10.1007/s00192-024-05868-3

Introduction and Hypothesis Women with vulvovaginal or genital pain more commonly experience interstitial cystitis/bladder pain syndrome (IC/BPS) and urinary tract infections. However, the relationship between genital pain and bladder health is lacking. Methods Women in the Prevention of Lower Urinary Tract Symptoms Consortium’s RISE FOR HEALTH population-based study answered questions about bladder health globally, and across nine bladder health domains of holding, efficacy, social–occupation, physical activity, intimacy, travel, emotion, perception, and freedom. Bladder function was assessed across six indices including urinary frequency, sensation, continence, comfort, emptying, and dysbiosis (e.g., urinary tract infections). Participants were grouped by no pain beyond transitory events (i.e., minor headaches, toothaches, or sprains), nongenital-related pain only, and any genital pain using a validated pain diagram. Mean adjusted scores and indices were compared using general linear modelling. Results Of 1,973 eligible women, 250 (12.7%) reported genital pain, 609 (30.9%) reported nongenital pain only, and 1,114 (56.5%) reported no pain. Women with any genital pain had lower (worse) adjusted mean scores across all bladder health scales (BHS; BHS global adjusted mean 47.5; 95% CI 40.8–54.1), compared with those with nongenital pain only (53.7; 95% CI 47.6–59.8), and no pain (59.3; 95% CI 53.3–65.4). Similarly, adjusted mean total Bladder Functional Index scores were lower for those with genital pain (63.1; 95% CI 58.4–67.9) compared with nongenital pain (72.1; 95% CI 67.7–76.5) and no pain (77.4; 95% CI 73.0–81.8). Conclusions Heightened awareness of the relationship between genital pain and bladder health should prompt clinicians caring for women with genital pain to assess bladder health and function.