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Mindfulness-based stress reduction as a novel treatment for interstitial cystitis/bladder pain syndrome: a randomized controlled trial

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Abstract

Introduction and hypothesis

Mindfulness-based stress reduction (MBSR) is a standardized meditation program that may be an effective therapy for interstitial cystitis/bladder pain syndrome (IC/BPS), a condition exacerbated by stress. The aims of this study were to explore whether MBSR improved IC/BPS symptoms and the feasibility/acceptability of MSBR among women with IC/BPS.

Methods

This randomized controlled trial included women with IC/BPS undergoing first- or second-line therapies. Women were randomized to continuation of usual care (UC) or an 8-week MBSR class + usual care (MBSR). Participants completed baseline and 8-week post-treatment questionnaires, including the O’Leary–Sant Symptom Problem Index (OSPI), the visual analog pain scale (VAS), the Short Form Health Survey (SF-12), the Female Sexual Function Index (FSFI), and the Pain Self-Efficacy Questionnaire (PSEQ). The Global Response Assessment (GRA) was completed post-treatment. Analyses were performed using Student’s t test, Chi-squared, and MANOVA where appropriate.

Results

Eleven women were randomized to UC and 9 to MBSR, without differences in group characteristics. More MBSR participants’ symptoms were improved on the GRA (7 out of 8 [87.5 %] vs 4 out of 11 [36.4 %], p = 0.03). The MBSR group showed greater improvement in the OSPI total (p = 0.0498) and problem scores (p = 0.036); the OSPI symptom score change did not differ. PSEQ scores improved in MBSR compared with UC (p = 0.035). VAS, SF-12, and FSFI change did not differ between groups. Eighty-six percent of MBSR participants felt more empowered to control symptoms, and all participants planned to continue MBSR.

Conclusions

This trial provides initial evidence that MBSR is a promising adjunctive therapy for IC/BPS. Its benefit may arise from patients’ empowerment and ability to cope with symptoms.

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References

  1. Hanno PM, Burks DA, Clemens JQ, Dmochowski RR, Erickson D, Fitzgerald MP, Forrest JB, Gordon B, Gray M, Mayer RD, Newman D, Nyberg L Jr, Payne CK, Wesselmann U, Faraday MM (2011) AUA guideline for the diagnosis and treatment of interstitial cystitis/bladder pain syndrome. J Urol 185(6):2162–2170. doi:10.1016/j.juro.2011.03.064

    Article  PubMed  Google Scholar 

  2. Rosenberg MT, Hazzard M (2005) Prevalence of interstitial cystitis symptoms in women: a population based study in the primary care office. J Urol 174(6):2231–2234. doi:10.1097/01.ju.0000181203.82693.95

    Article  PubMed  Google Scholar 

  3. Clemens JQ, Meenan RT, O'Keeffe Rosetti MC, Brown SO, Gao SY, Calhoun EA (2005) Prevalence of interstitial cystitis symptoms in a managed care population. J Urol 174(2):576–580

    Article  PubMed  Google Scholar 

  4. Stanford EJ, Chen A, Wan GJ, Lunacsek OE, Sand PK (2008) Treatment modalities, health care resource utilization, and costs in patients diagnosed with interstitial cystitis. Am J Obstet Gynecol 199(1):71.e1–71.e10. doi:10.1016/j.ajog.2008.02.048

    Article  Google Scholar 

  5. Clemens JQ, Markossian T, Calhoun EA (2009) Comparison of economic impact of chronic prostatitis/chronic pelvic pain syndrome and interstitial cystitis/painful bladder syndrome. Urology 73(4):743–746. doi:10.1016/j.urology.2008.11.007

    Article  PubMed  PubMed Central  Google Scholar 

  6. Dyer AJ, Twiss CO (2014) Painful bladder syndrome: an update and review of current management strategies. Curr Urol Rep 15(2):384. doi:10.1007/s11934-013-0384-z

    Article  PubMed  Google Scholar 

  7. Logadottir Y, Delbro D, Lindholm C, Fall M, Peeker R (2014) Inflammation characteristics in bladder pain syndrome ESSIC type 3C/classic interstitial cystitis. Int J Urol 21 [Suppl 1]:75–78. doi:10.1111/iju.12370

    Article  CAS  PubMed  Google Scholar 

  8. Cervigni M, Natale F, Nasta L, Padoa A, Voi RL, Porru D (2008) A combined intravesical therapy with hyaluronic acid and chondroitin for refractory painful bladder syndrome/interstitial cystitis. Int Urogynecol J Pelvic Floor Dysfunct 19(7):943–947. doi:10.1007/s00192-008-0572-4

    Article  CAS  PubMed  Google Scholar 

  9. O'Hare PG 3rd, Hoffmann AR, Allen P, Gordon B, Salin L, Whitmore K (2013) Interstitial cystitis patients' use and rating of complementary and alternative medicine therapies. Int Urogynecol J 24(6):977–982. doi:10.1007/s00192-012-1966-x

    Article  PubMed  Google Scholar 

  10. Barnes PM, Bloom B, Nahin RL (2008) Complementary and alternative medicine use among adults and children: United States, 2007. Nat Health Stat Rep 12:1–23

    Google Scholar 

  11. Sampalli T, Berlasso E, Fox R, Petter M (2009) A controlled study of the effect of a mindfulness-based stress reduction technique in women with multiple chemical sensitivity, chronic fatigue syndrome, and fibromyalgia. J Multidiscip Healthc 2:53–59

    Article  PubMed  PubMed Central  Google Scholar 

  12. Slavin SL, Rogers RG, Komesu Y, Omotosho T, Hammil S, Lewis C, Sapien R (2010) Complementary and alternative medicine (CAM) use in women with pelvic floor disorders: a cohort study. Int Urogynecol J 21(4):431–437. doi:10.1007/s00192-009-1058-8

    Article  PubMed  Google Scholar 

  13. Zernicke KA, Campbell TS, Blustein PK, Fung TS, Johnson JA, Bacon SL, Carlson LE (2013) Mindfulness-based stress reduction for the treatment of irritable bowel syndrome symptoms: a randomized wait-list controlled trial. Int J Behav Med 20(3):385–396. doi:10.1007/s12529-012-9241-6

    Article  PubMed  Google Scholar 

  14. Rothrock NE, Lutgendorf SK, Kreder KJ, Ratliff T, Zimmerman B (2001) Stress and symptoms in patients with interstitial cystitis: a life stress model. Urology 57(3):422–427

    Article  CAS  PubMed  Google Scholar 

  15. Baker JNI, Costa D (2014) Comparison of mindfulness-based stress reduction (MBSR) versus yoga on urgency incontinence: a randomized pilot study. With 6-month and 1-year follow-up visits. Female Pelvic Med Reconstr Surg 20(3):141–146

    Article  PubMed  Google Scholar 

  16. Kabat-Zinn J (1982) An outpatient program in behavioral medicine for chronic pain patients based on the practice of mindfulness meditation: theoretical considerations and preliminary results. Gen Hosp Psychiatry 4(1):33–47

    Article  CAS  PubMed  Google Scholar 

  17. Kabat-Zinn J, Hanh TN (2009) Full catastrophe living: using the wisdom of your body and mind to face stress, pain, and illness. Random House, New York

    Google Scholar 

  18. Whitmore KE (2002) Complementary and alternative therapies as treatment approaches for interstitial cystitis. Rev Urol 4 [Suppl 1]:S28–35

    PubMed  PubMed Central  Google Scholar 

  19. Ballantyne JC, Sullivan MD (2015) Intensity of chronic pain—the wrong metric? N Engl J Med 373(22):2098–2099. doi:10.1056/NEJMp1507136

    Article  CAS  PubMed  Google Scholar 

  20. Cassel EJ (1982) The nature of suffering and the goals of medicine. N Engl J Med 306(11):639–645. doi:10.1056/nejm198203183061104

    Article  CAS  PubMed  Google Scholar 

  21. Hashmi JA, Baliki MN, Huang L, Baria AT, Torbey S, Hermann KM, Schnitzer TJ, Apkarian AV (2013) Shape shifting pain: chronification of back pain shifts brain representation from nociceptive to emotional circuits. Brain 136(Pt 9):2751–2768. doi:10.1093/brain/awt211

    Article  PubMed  PubMed Central  Google Scholar 

  22. Lutgendorf SK, Kreder KJ, Rothrock NE, Ratliff TL, Zimmerman B (2001) A laboratory stress model for examining stress and symptomatology in interstitial cystitis patients. Urology 57 [6 Suppl 1]:122

    Article  CAS  Google Scholar 

  23. Lauche R, Cramer H, Dobos G, Langhorst J, Schmidt S (2013) A systematic review and meta-analysis of mindfulness-based stress reduction for the fibromyalgia syndrome. J Psychosom Res 75(6):500–510. doi:10.1016/j.jpsychores.2013.10.010

    Article  PubMed  Google Scholar 

  24. Merkes M (2010) Mindfulness-based stress reduction for people with chronic diseases. Aust J Prim Health 16(3):200–210. doi:10.1071/py09063

    Article  PubMed  Google Scholar 

  25. Pickert K (2014) The mindful revolution. Time Magazine, 3 February, pp 34–48

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Acknowledgements

Thanks to Michelle DuVal for her support in this project and for providing MBSR teaching.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, MSC 10–5580, 1 University of New Mexico, Albuquerque, NM, 87131-0001, USA

    Gregory Kanter, Yuko M. Komesu, Fares Qaedan, Peter C. Jeppson, Gena C. Dunivan, Sara B. Cichowski & Rebecca G. Rogers

Authors
  1. Gregory Kanter
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  2. Yuko M. Komesu
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  3. Fares Qaedan
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  4. Peter C. Jeppson
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  5. Gena C. Dunivan
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  6. Sara B. Cichowski
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  7. Rebecca G. Rogers
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Corresponding author

Correspondence to Yuko M. Komesu.

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Conflicts of interest

G. Kanter, Y. Komesu, F. Qaedan, G.C. Dunivan, P.C. Jeppson, S.B. Cichowski-None state that they have no conflicts of interest. R.G. Rogers is the DSMB Chair for the TRANSFORM trial sponsored by American Medical Systems, and receives UptoDate royalties and Royalties from McGraw Hill for a textbook.

Funding

This project was supported (in part or in full) by the National Center for Research Resources and the National Center for Advancing Translational Sciences of the National Institutes of Health through grant number UL1 TR001449. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

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Kanter, G., Komesu, Y.M., Qaedan, F. et al. Mindfulness-based stress reduction as a novel treatment for interstitial cystitis/bladder pain syndrome: a randomized controlled trial. Int Urogynecol J 27, 1705–1711 (2016). https://doi.org/10.1007/s00192-016-3022-8

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  • DOI: https://doi.org/10.1007/s00192-016-3022-8

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