Sensory mapping of pelvic dermatomes in women with interstitial cystitis/bladder pain syndrome

Neurourol Urodyn. 2018 Jan;37(1):458-465. doi: 10.1002/nau.23330. Epub 2017 Jun 19.

Abstract

Aim: To describe a sensory map of pelvic dermatomes in women with Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS). We hypothesized that if IC/BPS involves changes in central processing, then women with IC/BPS will exhibit sensory abnormalities in neurologic pelvic dermatomes.

Methods: Women with IC/BPS and healthy controls underwent neurologic examination that included evaluation of sharp pain sensitivity and vibration in dermatomes T12, L1, L2, S1-5. Peripheral nervous system sensitivity to pressure, vibration, and pinprick were scored using numeric rating scales (NRS). Bilateral comparisons were made with Wilcoxon signed-rank test and comparisons between groups were made by the Mann-Whitney U-test.

Results: Total of 74 women with IC/BPS and 36 healthy counterparts were included. IC/BPS and control groups had similar age (43.0 ± 14.1 and 38.6 ± 15.3 years, P = 0.14) and BMI (28.9 ± 8.0 kg/m2 and 26.9 ± 8.4 kg/m2 , P = 0.24), respectively. Women with IC/BPS reported hyperalgesia (elevated bilateral NRS pain intensity) in all pelvic dermatomes compared to healthy controls. S4-S5 region had the highest pain intensity in all participants. All IC/BPS participants exhibited vibration sensation hypoesthesia, at least unilaterally, in all of the pelvic dermatomes except L1 compared to healthy controls.

Conclusion: This detailed map of neurologic pelvic dermatomes in women with IC/BPS found hyperalgesia in all pelvic dermatomes, and some evidence of vibration sensation hypoesthesia, compared to healthy controls. These findings support the hypothesis that IC/BPS may involve changes in central signal processing biased towards nociception.

Keywords: chronic pelvic pain; interstitial cystitis/bladder pain syndrome; myofascial pelvic pain syndrome; pelvic dermatomes; sensory mapping.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cystitis, Interstitial / diagnosis*
  • Female
  • Humans
  • Hyperalgesia / etiology
  • Middle Aged
  • Pain Measurement
  • Pelvic Pain / diagnosis*
  • Pelvic Pain / etiology
  • Pelvis*
  • Peripheral Nervous System Diseases / complications
  • Peripheral Nervous System Diseases / diagnosis
  • Physical Stimulation
  • Sensory Thresholds
  • Syndrome
  • Urinary Bladder Diseases / diagnosis*
  • Urinary Bladder Diseases / etiology
  • Vibration