Small-Fiber Polyneuropathy Is Prevalent in Patients With Interstitial Cystitis/Bladder Pain Syndrome

Wolff, Dylan T.; Xu, Raymond; Overholt, Tyler; Bassett, E Hadley; Ahn, Christine S.; Simon, Trang; Lee, Peyton; Badlani, Gopal H.; Matthews, Catherine A.; Evans, Robert J.; Walker, Stephen J.

doi:10.1097/spv.0000000000001240

Cited by 1 publication

(2 citation statements)

References 30 publications

(79 reference statements)

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“…Often, FM is a comorbid diagnosis in patients with similar chronic pain syndromes like IC/BPS and UCPPS (14). More specifically, patients in the non-bladder centric phenotype in IC/BPS are thought to have more systemic non-urologic symptoms and have been shown in preliminary studies to contain more SFPN+ individuals (5,6). Given the prevalence of SFPN in these co-occurring conditions, it is possible that SFPN may also contribute to the pain aspects of IC/BPS.…”

Section: Sfpn In Fibromyalgiamentioning

confidence: 99%

“…One emerging theme within this 'systemic pain disorder' concept in IC/BPS is the presence of small fiber polyneuropathy (SFPN). SFPN has been reported as a common finding in FM and UCPPS, and we have recently reported that approximately one-third of patients with IC/BPS have a confirmed finding of SFPN independent of diabetes mellitus (DM) (6). In this narrative review we describe SFPN and its presumed role in several chronic pain disorders that are directly related to IC/BPS.…”

Section: Introductionmentioning

confidence: 96%

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Small fiber polyneuropathy: A new therapeutic target in patients with interstitial cystitis/bladder pain syndrome?

Whitman

Sandberg²,

Lee³

et al. 2023

Front. Urol.

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Interstitial cystitis/bladder pain syndrome (IC/BPS) is a debilitating chronic disease that, based on the variable efficacy observed with most therapeutic options, is difficult to treat effectively. A more targeted patient selection process for current and emerging therapeutic options would likely help to improve outcomes. This narrative review explores small fiber polyneuropathy (SFPN) in IC/BPS as part of a larger widespread pain phenotype and as a potential therapeutic target. Because SFPN is becoming increasingly implicated in polysyndromic pain disorders (e.g., IC/BPS, chronic pelvic pain, and fibromyalgia) in which immune dysregulation is a suspected pathophysiologic etiology, continued consideration should be given to immunomodulatory therapies such as intravenous immunoglobulin (IVIg). Moreover, since the small fibers affected in SFPN continue to grow even as people age, targeted treatment may prevent further destruction and provide long-term benefits as the fibers are given time to repair. In addition to therapeutic potential, having a definitive SFPN diagnosis may provide psychological benefit in a patient population for which symptoms have historically been attributed to negative psychological factors. Finally, based on emerging data in this area, we propose consideration be given to include SFPN testing in the work-up of patients with IC/BPS that are refractory to treatments or have multiple comorbid pain syndromes since it may be an indicator of the need for alternative therapies. We believe that SFPN will play an increasingly larger role in the clinical evaluation and management of polysyndromic pain disorders, including IC/BPS.

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Section: Sfpn In Fibromyalgiamentioning

confidence: 99%

Section: Introductionmentioning

confidence: 96%