Examination of pelvic floor muscle elasticity in patients with interstitial cystitis/bladder pain syndrome using real-time tissue elastography

Abstract

Introduction and hypothesisThe aim was to compare pelvic floor muscle (PFM) elasticity between interstitial cystitis/bladder pain syndrome (IC/BPS) patients and healthy women using real-time tissue elastography. MethodsThe subjects were 17 IC/BPS female patients (IC/BPS group; age 34-84 years), 10 healthy middle-aged women (Middle-aged group; 50-80), and 17 healthy young adult women (Young group; 23-37). The target sites of elastography were the striated urethral sphincter (SUS) and adipose tissue as the reference site; muscle elasticity was calculated as the strain ratio (SR) of the SUS to the reference site. Evaluations were performed at rest and during PFM contraction. The IC/BPS group completed lower urinary tract symptom and pain questionnaires. SUS SR was compared among the three groups. SUS SR at rest and during PFM contraction was compared among the three groups with the t-test and the Wilcoxon test. Associations between questionnaire results and SUS SR were evaluated by correlation analysis. ResultsThere was no significant difference in age between the IC/BPS and Middle-aged 6 groups, but the Young group was significantly younger than the other groups (p<0.001). SUS SR at rest was significantly higher in the IC/BPS group than in the Middle-aged (p=0.014) and Young groups (p=0.002). Furthermore, in the IC/BPS group, there was no significant difference in SUS SR between at rest and during PFM contraction. SUS SR was not significantly correlated with questionnaire results for lower urinary tract symptoms. ConclusionSUS SR at rest was significantly higher in the IC/BPS group than in the Young and Middle-aged groups.

Pathophysiology, assessment, and treatment of overactive bladder symptoms in patients with interstitial cystitis/bladder pain syndrome

“…In a recent study of tissue elastography, the authors found the strain ratio at rest was significantly elevated in women with IC/BPS, and there was no difference in the strain ratio at rest versus during contraction. 15 These findings are consistent with a maximally contracted pelvic floor in patients with IC/BPS. As such, IC/BPS patients should be treated with PFPT strategies, which decrease pelvic floor tone.…”

“…Pelvic floor physical therapy (PFPT) has beneficial effects on both IC/BPS pain, and OAB storage LUTS. In a recent study of tissue elastography, the authors found the strain ratio at rest was significantly elevated in women with IC/BPS, and there was no difference in the strain ratio at rest versus during contraction 15 . These findings are consistent with a maximally contracted pelvic floor in patients with IC/BPS.…”