ABSTRACT
INTRODUCTION: Interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic pain condition creating a wide range of urologic and pain symptoms. There is currently limited evidence to understand the mechanisms of IC/BPS. There have been recent studies suggesting that altered function in brain motor areas, particularly the supplementary motor cortex (SMA), relates to altered bladder sensorimotor control and may play an important role in IC/BPS. This study aims to provide evidence that non-invasive stimulation targeting the motor cortex may help reduce IC/BPS pain, as well as better understand the neural mechanism by which this stimulation targets neuromuscular dysfunction. This study is a two-group quadruple-blinded randomized controlled trial (RCT) of active vs. sham repetitive transmagnetic stimulation (rTMS). In addition, our study will also include functional magnetic resonance imaging (fMRI), pelvic floor electromyography (EMG), pelvic exam, and outcome measures and questionnaires to further study outcomes. ETHICS AND DISSEMINATION: All aspects of the study were approved by the Institutional Review Board of the University of Southern California (protocol HS-20-01021). All participants provided informed consent by the research coordinator/assistants. The results will be submitted for publication in peer-reviewed journals and disseminated at scientific conferences. TRIAL REGISTRATION: ClinicalTrials.gov NCT04734847. Registered on February 1, 2021.
Subject(s)
Cystitis, Interstitial , Motor Cortex , Randomized Controlled Trials as Topic , Transcranial Magnetic Stimulation , Humans , Cystitis, Interstitial/therapy , Cystitis, Interstitial/physiopathology , Motor Cortex/physiopathology , Female , Transcranial Magnetic Stimulation/methods , Treatment Outcome , Urinary Bladder/physiopathology , Urinary Bladder/innervation , Electromyography , Magnetic Resonance Imaging , Adult , Middle Aged , Pain Measurement , Pain Management/methods , Pelvic Floor/physiopathologyABSTRACT
Training of the pelvic floor muscles (PFMs) as part of a multimodal prehabilitation program that includes cardiovascular and hip strengthening and patient education can yield patient benefits after urologic surgery. A personalized, multifaceted, holistic care plan that includes PFM training should be developed by an interdisciplinary team. Further research is needed to identify the impact of PFM prehabilitation on various urologic and surgical outcomes.