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.
Similar content being viewed by others
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
References
Clauw DJ. Fibromyalgia. JAMA. 2014;311(15):1547.
Queiroz LP. Worldwide epidemiology of fibromyalgia. Curr Pain Headache Rep. 2013;17:356.
Lichtenstein A, Tiosano S, Amital H. The complexities of fibromyalgia and its comorbidities. Curr Opin Rheumatol. 2018;30(1):94–100.
Thornton KG, Robert M. Prevalence of pelvic floor disorders in the fibromyalgia population: a systematic review. J Obstet Gynaecol Can. 2020;42:72–9.
Meijlink JM. Interstitial cystitis and the painful bladder: a brief history of nomenclature, definitions and criteria. Int J Urol. 2014;21:4–12.
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.
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.
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.
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.
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.
Brand K, Littlejohn G, Kristjanson L, et al. The fibromyalgia bladder index. Clin Rheumatol. 2007;26:2097.
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.
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.
Kushner L, Moldwin RM. Efficiency of questionnaires used to screen for interstitial cystitis. J Urol. 2006;176(2):587–92.
Wallace DJ. Genitourinary manifestations of fibrositis: an increased association with the female urethral syndrome. J Rheumatol. 1990;17:238–9.
Paira SO. Fibromyalgia associated with female urethral syndrome. Clin Rheumatol. 1994;13(1):88–9.
Keller JJ, Chen YK, Lin HC. Comorbidities of bladder pain syndrome/interstitial cystitis: a population-based study. BJU Int. 2012;110:903–9.
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.
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.
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.
Adams K, Osmundsen B, Gregory WT. Does fibromyalgia influence symptom bother from pelvic organ prolapse? Int Urogynecol J. 2014;25:677–82.
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.
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.
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.
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.
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.
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.
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.
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.
Macfarlane GJ, Kronisch C, Dean LE, et al. EULAR revised recommendations for the management of fibromyalgia. Ann Rheum Dis. 2017;76:318–28.
Furtado D, Hachul H, Andersen ML, Castro RA, Girão MB, Tufik S. Nocturia × disturbed sleep: a review. Int Urogynecol J. 2012;23:255–67.
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.
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.
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.
Author information
Authors and Affiliations
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.
Corresponding author
Ethics declarations
Conflicts of interest
None.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
The study was conducted after securing the local IRB approval
Appendix
Appendix
lnterstitial Cystitis Symptom Index | Interstitial Cystitis Problem Index |
---|---|
Q 1. During the past month, how often have you felt the strong need to urinate with little or no warning? | During the past month, how much has each of the following been a problem for you? |
0 : not at all | Ql. Frequent urination during the day? |
l: less than 1 time in 5 | 0: no problem |
2: less than half the time | 1: very small problem |
3: about half the time | 2: small problem |
4: more than half the time | 3: medium problem |
5: almost always | 4: big problem |
Q2. During the past month, have you had to urinate less than 2 h after you finished urinating? | Q2. Getting up at night to urinate? |
0: not at all | : no problem |
l: less than 1 time in 5 | 1: very small problem |
2: less than half the time | 2: small problem |
3: about half the time | 3: medium problem |
4: more than half the time | 4: big problem |
5: almost always | Q3. Need to urinate with little warning? |
Q3. During the past month, how often did you most typically get up at night to urinate? | 0: no problem |
0: none | 1: very small problem |
1: once | 2: small problem |
2: 2 times | 3: medium problem |
3: 3 times | 4: big problem |
4: 4 times | Q4. Burning, pain, discomfort, or pressure in your bladder? |
5: 5 or more times | 0: no problem |
Q4. During the past month, have you experienced pain or burning in your bladder? | l: very small problem |
0: not at all | 2: small problem |
2: a few times | 3: medium problem |
3: almost always | 4: big problem |
4: fairly often | Add the numerical values of the checked entries for the total score |
5: usually | |
Add the numerical values of the checked entries for the total score |
Rights and permissions
About this article
Cite this article
Hamed, N., Rida, M.A., Uthman, I. et al. The Fibromyalgia Bladder Index in 100 consecutive women with fibromyalgia. Int Urogynecol J 31, 1883–1889 (2020). https://doi.org/10.1007/s00192-019-04199-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00192-019-04199-y