title: Pain in interstitial cystitis/bladder pain syndrome: do characteristics differ in ulcerative and non-ulcerative subtypes?
abstract: OBJECTIVE
  Key differences between interstitial cystitis/bladder pain syndrome (IC/BPS) subtypes (with and without Hunner's ulcer) have been noted. We hypothesized that pain characteristics in women grouped by IC/BPS subtype would differ.
  
  
  METHODS
  A survey was mailed to 749 women to assess IC/BPS pain and other characteristics. Cystoscopy/hydrodistention reports were reviewed for presence/absence of Hunner's ulcer. The McGill Pain Questionnaire Short Form© (MPQ-SF), Brief Pain Inventory (BPI), and Interstitial Cystitis Symptom and Problem Indices (ICSI-PI) assessed symptoms. Data were analyzed with Pearson's chi-square, Fisher's exact, t tests, and Wilcoxon rank tests.
  
  
  RESULTS
  Of the 214 women that returned a survey (36 ulcerative and 178 non-ulcerative IC/BPS), similar proportions in each group reported that certain foods, exercise, and/or stress triggered symptoms. Fewer ulcerative patients reported pain with vaginal penetration than non-ulcerative (5/33, 15.2 % vs 76/160, 47.5 %; p = 0.0006). On the BPI, the ulcerative and non-ulcerative groups reported similar numbers of painful areas (mean 4.1 ± 6.1 and 4.1 ± 3.8; p = 0.33), and lower abdominal/pelvic pain was reported most (13/35, 37 % vs 79/172, 46 %; p = 0.34) followed by lower back pain (12/35, 34 % vs 69/172, 40 %; p = 0.52). Even though ICSI-PI, MPQ-SF, and BPI scores/responses did not differ, on the MPQ-SF the three words most frequently used by ulcerative patients to describe their pain were sharp, stabbing, and hot burning, and in non-ulcerative were aching, cramping, and tender.
  
  
  CONCLUSIONS
  These measures did not reveal any significant differences in pain between subtypes. More research is needed in larger samples to determine whether differences exist.
authors.affiliation: William Beaumont Hospital, Royal Oak, MI 48073, USA. KKillinger@beaumont.edu
authors.forename: Kim A
authors.initials: KA
authors.lastname: Killinger
authors.forename: Judith A
authors.initials: JA
authors.lastname: Boura
authors.forename: Kenneth M
authors.initials: KM
authors.lastname: Peters
mesh_terms: D000328:Adult; D000368:Aged; D015897:Comorbidity; D018856:Cystitis, Interstitial / Q000150:complications* / Q000453:epidemiology; D003558:Cystoscopy; D005260:Female; D006306:Health Surveys; D006801:Humans; D008875:Middle Aged; D010146:Pain / Q000145:classification* / Q000175:diagnosis / Q000209:etiology*; D010147:Pain Measurement; D011795:Surveys and Questionnaires; D013577:Syndrome; D014456:Ulcer / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D001745:Urinary Bladder Diseases / Q000150:complications* / Q000453:epidemiology