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The Fibromyalgia Bladder Index in 100 consecutive women with fibromyalgia

  • Nouran Hamed
  • Mohamad Ali Rida
  • Imad Uthman
  • Lina El Taha
  • Mariam Assad
  • Elie Mikhael
  • Tony BaziEmail author
Original Article

Abstract

Introduction and hypothesis

The Fibromyalgia Bladder Index (FBI) is a validated instrument to quantify bothersome bladder symptoms specifically in women with fibromyalgia syndrome (FMS). The FBI includes two sub-scales: one addressing urinary urgency and bladder pain (UP), the other addressing urinary frequency and nocturia (FN). The objectives of this study are to evaluate the FBI in a cohort of patients with FMS, to correlate it with certain characteristics in this cohort, and to compare it with controls.

Methods

We performed a case–control study of 100 women with FMS and 155 controls. Demographic data, comorbidities, and other characteristics were registered. Comparison between FBI scores of participants with and without FMS, as well as correlation of FBI scores with the characteristics of FMS patients, were undertaken using independent two-sample t test for continuous outcomes and Pearson’s Chi-squared test for categorical outcomes.

Results

The mean UP subscale score of the FBI was significantly higher in the FMS group (10.29 ± 5.61) compared with the controls (1.65 ± 2.65; (p = 0.001). The mean FN subscale score was significantly higher in the FMS group (9.93 ± 5.37) compared with the controls (2.95 ± 3.27; p = 0.001). FMS patients diagnosed >3 years ago had a higher UP subscale score and a higher FN subscale score compared with FMS patients diagnosed <3 years ago (p = 0.020 and p = 0.024 respectively). Menopause and parity significantly increased the FBI scores. Smoking and a history of depression did not significantly affect any of the FBI subscale scores in the FMS group.

Conclusion

Women with FMS suffer from bothersome bladder symptoms that can be readily identified and quantified.

Keywords

Fibromyalgia Painful bladder syndrome Interstitial cystitis Fibromyalgia Bladder Index O’Leary–Sant questionnaire 

Abbreviations

BMI

Body mass index

FBI

Fibromyalgia Bladder Index

FMS

Fibromyalgia syndrome

OS

O’Leary–Sant

PBS/IC

Painful bladder syndrome/interstitial cystitis

PBS

Painful bladder syndrome

UP

Urinary urgency and bladder pain

FN

Frequency and nocturia

Notes

Authors contributions

NH: protocol development, literature search, data collection, and manuscript review; MAR: protocol development, literature search, data collection, and manuscript review; IU: protocol development, literature search, data collection, and manuscript review; LET: statistical analysis and manuscript review; MA: data collection, statistical analysis, and manuscript review; EM: protocol development, literature search, and manuscript review; TB: study design, literature search, and manuscript writing, editing, and submission.

Compliance with ethical standards

Conflicts of interest

None.

References

  1. 1.
    Clauw DJ. Fibromyalgia. JAMA. 2014;311(15):1547.CrossRefGoogle Scholar
  2. 2.
    Queiroz LP. Worldwide epidemiology of fibromyalgia. Curr Pain Headache Rep. 2013;17:356.CrossRefGoogle Scholar
  3. 3.
    Lichtenstein A, Tiosano S, Amital H. The complexities of fibromyalgia and its comorbidities. Curr Opin Rheumatol. 2018;30(1):94–100.CrossRefGoogle Scholar
  4. 4.
    Thornton KG, Robert M. Prevalence of pelvic floor disorders in the fibromyalgia population: a systematic review. J Obstet Gynaecol Can. 2020;42:72–9.CrossRefGoogle Scholar
  5. 5.
    Meijlink JM. Interstitial cystitis and the painful bladder: a brief history of nomenclature, definitions and criteria. Int J Urol. 2014;21:4–12.CrossRefGoogle Scholar
  6. 6.
    Patnaik SS, Laganà AS, Vitale SG, Butticè S, Noventa M, Gizzo S, et al. Etiology, pathophysiology and biomarkers of interstitial cystitis/painful bladder syndrome. Arch Gynecol Obstet. 2017;295:1341–59.CrossRefGoogle Scholar
  7. 7.
    Davis N, Brady C, Creagh T. Interstitial cystitis/painful bladder syndrome: epidemiology, pathophysiology and evidence based treatment options. Eur J Obstet Gynecol Reprod Biol. 2014;175:30–7.CrossRefGoogle Scholar
  8. 8.
    Nickel JC, Tripp DA, Pontari M, et al. Interstitial cystitis/painful bladder syndrome and associated medical conditions with an emphasis on irritable bowel syndrome, fibromyalgia and chronic fatigue syndrome. J Urol. 2010;184:1358–63.CrossRefGoogle Scholar
  9. 9.
    O’Leary MP, Sant GR, Fowler FJ, Whitmore KE, Spolarich-Kroll J. The interstitial cystitis symptom index and problem index. Urology. 1997;49:58–63.CrossRefGoogle Scholar
  10. 10.
    Pazin C, de Souza Mitidieri AM, Silva APM, et al. Treatment of bladder pain syndrome and interstitial cystitis: a systematic review. Int Urogynecol J. 2016;27:697.CrossRefGoogle Scholar
  11. 11.
    Brand K, Littlejohn G, Kristjanson L, et al. The fibromyalgia bladder index. Clin Rheumatol. 2007;26:2097.CrossRefGoogle Scholar
  12. 12.
    Bazi T, Kabakian-Khasholian T, Ezzeddine D, Ayoub H. Validation of an Arabic version of the global Pelvic Floor Bother Questionnaire. Int J Gynaecol Obstet. 2013;121(2):166–9.CrossRefGoogle Scholar
  13. 13.
    Jones GT, Atzeni F, Beasley M, et al. The prevalence of fibromyalgia in the general population: a comparison of the American College of Rheumatology 1990, 2010, and modified 2010 classification criteria. Arthritis Rheumatol. 2015;67(2):568–75.CrossRefGoogle Scholar
  14. 14.
    Kushner L, Moldwin RM. Efficiency of questionnaires used to screen for interstitial cystitis. J Urol. 2006;176(2):587–92.CrossRefGoogle Scholar
  15. 15.
    Wallace DJ. Genitourinary manifestations of fibrositis: an increased association with the female urethral syndrome. J Rheumatol. 1990;17:238–9.PubMedGoogle Scholar
  16. 16.
    Paira SO. Fibromyalgia associated with female urethral syndrome. Clin Rheumatol. 1994;13(1):88–9.CrossRefGoogle Scholar
  17. 17.
    Keller JJ, Chen YK, Lin HC. Comorbidities of bladder pain syndrome/interstitial cystitis: a population-based study. BJU Int. 2012;110:903–9.CrossRefGoogle Scholar
  18. 18.
    Clauw D, Schmidt M, Radulovic D, Singer A, Katz P, Bresette J. The relationship between fibromyalgia and interstitial cystitis. J Psychiatr Res. 1997;31(1):125–31.CrossRefGoogle Scholar
  19. 19.
    Van de Merwe JP, Nordling J, Bouchelouche P, et al. Diagnostic criteria, classification, and nomenclature for painful bladder syndrome/interstitial cystitis: an ESSIC proposal. Eur Urol. 2008;53:60–7.CrossRefGoogle Scholar
  20. 20.
    Ghandour L, Minassian V, Al-Badr A, Abou Ghaida R, Geagea S, Bazi T. Prevalence and degree of bother of pelvic floor disorder symptoms among women from primary care and specialty clinics in Lebanon: an exploratory study. Int Urogynecol J. 2017;28:105–18.CrossRefGoogle Scholar
  21. 21.
    Adams K, Osmundsen B, Gregory WT. Does fibromyalgia influence symptom bother from pelvic organ prolapse? Int Urogynecol J. 2014;25:677–82.CrossRefGoogle Scholar
  22. 22.
    Chung JH, Kim SA, Choi BY, Lee H, Lee SW, Kim YT, et al. The association between overactive bladder and fibromyalgia syndrome: a community survey. Neurourol Urodyn. 2013;32:66–9.CrossRefGoogle Scholar
  23. 23.
    Haylen BT, de Ridder D, Freeman RM, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J. 2010;21:5–26.CrossRefGoogle Scholar
  24. 24.
    Fusco HCS, Pontes Filho MAG, Haddad JM, et al. Lower urinary tract symptoms and perineal function in women with and without fibromyalgia: a cross-sectional study. Clin Rheumatol. 2019;38(10):2885–90.  https://doi.org/10.1007/s10067-019-04617-y.CrossRefPubMedGoogle Scholar
  25. 25.
    Choy E, Perrot S, Leon T, Kaplan J, Petersel D, Ginovker A, et al. A patient survey of the impact of fibromyalgia and the journey to diagnosis. BMC Health Serv Res. 2010;10(1):102.CrossRefGoogle Scholar
  26. 26.
    Warren JW, Wesselmann U, Morozov V, et al. Numbers and types of non-bladder syndromes as risk factors for interstitial cystitis/painful bladder syndrome. Urology. 2011;77:313–9.CrossRefGoogle Scholar
  27. 27.
    Furuta A, Suzuki Y, Honda M, Koike Y, Naruoka T, Asano K, et al. Time-dependent changes in bladder function and plantar sensitivity in a rat model of fibromyalgia syndrome induced by hydrochloric acid injection into the gluteus. BJU Int. 2012;109(2):306–10.CrossRefGoogle Scholar
  28. 28.
    Allen-Brady K, Norton PA, Cannon-Albright L. Risk of associated conditions in relatives of subjects with interstitial cystitis. Female Pelvic Med Reconstr Surg. 2015;21:93–8.CrossRefGoogle Scholar
  29. 29.
    Zhang Z, Feng J, Mao A, Le K, La Placa D, Wu X, et al. SNPs in inflammatory genes CCL11, CCL4 and MEFV in a fibromyalgia family study. PLoS One. 2018;13(6):e0198625.CrossRefGoogle Scholar
  30. 30.
    Macfarlane GJ, Kronisch C, Dean LE, et al. EULAR revised recommendations for the management of fibromyalgia. Ann Rheum Dis. 2017;76:318–28.CrossRefGoogle Scholar
  31. 31.
    Furtado D, Hachul H, Andersen ML, Castro RA, Girão MB, Tufik S. Nocturia × disturbed sleep: a review. Int Urogynecol J. 2012;23:255–67.CrossRefGoogle Scholar
  32. 32.
    Bennett R, Friend R, Jones KD, Ward R, Han BK, Ross RL. The revised Fibromyalgia Impact Questionnaire (FIQR): validation and psychometric properties. Arthritis Res Ther. 2009;11:120.CrossRefGoogle Scholar
  33. 33.
    Muraleetharan D, Fadich A, Stephenson C, Garney W (2018) Understanding the impact of fibromyalgia on men: findings from a nationwide survey. Am J Mens Health 12(4):952–960.CrossRefGoogle Scholar
  34. 34.
    Hosier GW, Doiron RC, Tolls V, Nickel JC. The X-Y factor: females and males with urological chronic pelvic pain syndrome present distinct clinical phenotypes. Can Urol Assoc J. 2018;12(6):E270–5.CrossRefGoogle Scholar

Copyright information

© The International Urogynecological Association 2020

Authors and Affiliations

  1. 1.Department of Obstetrics and GynecologyAmerican University of Beirut Medical CenterBeirutLebanon
  2. 2.Department of Internal Medicine, Division of RheumatologyAmerican University of Beirut Medical CenterBeirutLebanon
  3. 3.American University of Beirut Medical CenterBeirutLebanon
  4. 4.Department of Obstetrics and GynecologyHôpital Simone VeilEaubonneFrance

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