Catherine S Bradley
The University of Iowa, Carver College of Medicine, Faculty Member
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Women with overactive bladder (OAB) report psychological distress, anxiety and depression, but short-term associations between these symptoms are poorly studied. Our objectives were to study daily associations between OAB symptoms and... more
Women with overactive bladder (OAB) report psychological distress, anxiety and depression, but short-term associations between these symptoms are poorly studied. Our objectives were to study daily associations between OAB symptoms and psychological symptoms and test whether these associations were stable when reassessed after 3 months. We hypothesized that OAB symptoms are positively associated with anxiety and depression symptoms over a short-term (daily) basis. Female patients with OAB [bothersome urgency and/or urgency urinary incontinence (UUI)] assessed OAB and mood symptoms at baseline and 3 months using a 3-day bladder diary and visual analog scale (VAS) ratings (0–100 mm) for anxiety, depression and stress. Daily OAB and mood symptom associations were tested using Spearman correlations. Generalized estimating equation (GEE) models tested associations between daily urgency scores and each psychological rating adjusting for covariates, time and a time-symptom interaction term. Participants (n = 69) had mean (SD) age 63.3 (13.4) years. Baseline diary outcomes [median (IQR)/day] included day voids 8 (7–11), nocturia 0 (0–1), UUI episodes 1 (0–3) and urgency score 1.75 (1–2.25). Anxiety and depression diagnoses (dx) and treatment (tx) were common (anxiety dx 30.4%, tx 21.7%; depression dx 47.8%, tx 37.7%), but daily anxiety, depression and stress ratings were low [median (IQR) mm 10 (3–35), 5 (1–16), and 16 (4–39), respectively]. Daily urgency scores correlated with anxiety (r = 0.30–0.40, days 1–3, p ≤ 0.01 for all), depression (r = 0.24–0.35, p ≤ 0.05 all) and stress (r = 0.27–0.34, p ≤ 0.03 all). GEE models indicated no significant change in these associations between baseline and 3 months, and OAB treatment did not impact the associations. Urgency scores were positively associated with same-day ratings of anxiety, depression and stress in OAB patients.
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To describe the association between childhood traumas (death of a family member, severe illness, sexual trauma, parental separation) reported by women and men and lower urinary tract symptoms (LUTS).
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Altered Toll-like receptor (TLR)4 activation has been identified in several chronic pain conditions but has not been well studied in interstitial cystitis/bladder pain syndrome (IC/BPS). Our previously published human studies indicated... more
Altered Toll-like receptor (TLR)4 activation has been identified in several chronic pain conditions but has not been well studied in interstitial cystitis/bladder pain syndrome (IC/BPS). Our previously published human studies indicated that patients with IC/BPS present altered systemic TLR4-mediated inflammatory responses, which were significantly correlated with reported pain severity. In the present study, we sought to determine whether altered TLR4 activation plays a role in pelvic/bladder pain seen in patients with IC/BPS using our validated IC/BPS-like transgenic autoimmune cystitis model (URO-OVA). URO-OVA mice developed responses consistent with pelvic and bladder pain after cystitis induction, which was associated with increased splenocyte production of TLR4-mediated proinflammatory cytokines IL-1β, IL-6, and TNF-α. Increased spinal expression of mRNAs for proinflammatory cytokines IL-6 and TNF-α, glial activation markers CD11b and glial fibrillary acidic protein, and endoge...
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The current literature on pelvic organ prolapse (POP) employs wildly varying definitions of surgical success. Understanding which definitions of success have been used and how these may impact reported outcomes is critical. Therefore, we... more
The current literature on pelvic organ prolapse (POP) employs wildly varying definitions of surgical success. Understanding which definitions of success have been used and how these may impact reported outcomes is critical. Therefore, we performed a systematic review to identify and summarize these definitions and how they have changed over time. A PubMed search was performed for studies reporting POP surgical outcomes (1996 and later). Inclusion criteria were: original research, English, adult women with POP, nonobliterative surgical treatment, comparison group, reported prolapse-specific outcomes, and clear definition of treatment success. This definition was categorized according to presence of anatomic, subjective, retreatment, or other components and whether these components were evaluated individually or in a composite definition (in which all components must be present for success). One-hundred forty articles were included. The number of included studies increased over time (...
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The 2016 American Urogynecologic Society Prolapse Consensus Conference brought together thought leaders in the field of pelvic organ prolapse (POP). The goal was to identify critical areas of need for future research. This article... more
The 2016 American Urogynecologic Society Prolapse Consensus Conference brought together thought leaders in the field of pelvic organ prolapse (POP). The goal was to identify critical areas of need for future research. This article summarizes the findings. Prior to the conference, 5 major focus areas were identified. Focus areas were explored over the 2-day conference. Clinicians, clinical and basic science researchers, and representatives from government agencies, industry, patient advocacy groups, and the public convened to identify the major gaps in knowledge in each of these focus areas. The 5 major topics were as follows: (1) mechanistic research on pelvic supportive structures and how these are altered with pregnancy, delivery, and aging; (2) novel prostheses or implants that address pathophysiology and provide mechanical support; (3) large-scale community-based research; (4) clinical trials to optimize outcomes after POP surgery; and (5) evidence-based quality measures for POP...
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Although many factors have been proposed to trigger symptom exacerbations ("flares") in patients with interstitial cystitis/bladder pain syndrome and chronic prostatitis/chronic pelvic pain syndrome, few studies have... more
Although many factors have been proposed to trigger symptom exacerbations ("flares") in patients with interstitial cystitis/bladder pain syndrome and chronic prostatitis/chronic pelvic pain syndrome, few studies have investigated these factors empirically. Therefore, we embedded a case-crossover study in the Multidisciplinary Approach to the Study of Chronic Pelvic Pain longitudinal study to evaluate a range of patient-reported triggers. Exposure to proposed triggers (diet, physical activities, sedentary behaviors, stress, sexual activities, infection-like symptoms, and allergies) was assessed by questionnaire a maximum of three times when participants reported flares and at three randomly-selected times. Participants' pre-flare to -non-flare exposures were compared by conditional logistic regression. In our full analytic sample (n=292 participants), only two factors, recent sexual activity (odds ratio (OR)=1.44, 95% confidence interval (CI): 1.06-1.96) and symptoms of...
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Bladder inflammation frequently causes cystitis pain and lower urinary tract dysfunction (LUTD) such as urinary frequency and urgency. Although mast cells have been identified to play a critical role in bladder inflammation and pain, the... more
Bladder inflammation frequently causes cystitis pain and lower urinary tract dysfunction (LUTD) such as urinary frequency and urgency. Although mast cells have been identified to play a critical role in bladder inflammation and pain, the role of mast cells in cystitis-associated LUTD has not been demonstrated. Interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic and debilitating inflammatory condition of the urinary bladder characterized by the hallmark symptoms of pelvic pain and LUTD. In this study we investigated the role of mast cells in LUTD using a transgenic autoimmune cystitis model (URO-OVA) that reproduces many clinical correlates of IC/BPS. URO-OVA mice express the membrane form of the model antigen ovalbumin (OVA) as a self-antigen on the urothelium and develop bladder inflammation upon introduction of OVA-specific T cells. To investigate the role of mast cells, we crossed URO-OVA mice with mast cell-deficient KitW-sh mice to generate URO-OVA/KitW-sh mice th...
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We examined how mental health measures, sleep and physical function are associated with the presence and type of urinary incontinence and severity in women seeking treatment for lower urinary tract symptoms. This baseline cross-sectional... more
We examined how mental health measures, sleep and physical function are associated with the presence and type of urinary incontinence and severity in women seeking treatment for lower urinary tract symptoms. This baseline cross-sectional analysis was performed in treatment seeking women with lower urinary tract symptoms. All participants completed the LUTS (Lower Urinary Tract Symptoms) Tool (Pfizer, New York, New York), which was used to classify women based on urinary incontinence symptoms and measure severity. The PROMIS (Patient-Reported Outcomes Measurement Information System) questionnaire for depression, anxiety, sleep disturbance and physical function, the PSS (Perceived Stress Scale) and the IPAQ-SF (International Physical Activity Questionnaire Short Form) were administered. Multivariable regression modeling was done to assess associations with urinary symptom presence, type and severity. We studied 510 women with a mean ± SD age of 56 ± 14 years. Of the women 82% were Cau...
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Adverse Childhood Experiences (ACEs) such as sexual and physical violence, serious illness, and bereavement have been linked to number of chronic pain conditions in adulthood, and specifically to urologic chronic pelvic pain syndrome... more
Adverse Childhood Experiences (ACEs) such as sexual and physical violence, serious illness, and bereavement have been linked to number of chronic pain conditions in adulthood, and specifically to urologic chronic pelvic pain syndrome (UCPPS). We sought to characterize the prevalence of ACEs in UCPPS using a large well-characterized cohort in comparison with a group of healthy controls. We also sought to determine the association of ACE severity with psychological factors known to impact pain and to determine whether ACEs are associated with patterns of improvement or worsening of symptom over a year of naturalistic observation. For longitudinal analyses we used functional clusters identifying broad classes of (a) improved, (b) worsened, and (c) stable groups for genitourinary pain and urinary symptoms. We employed a mediation/path analysis framework to determine whether ACEs influenced 1 year outcomes directly, or indirectly through worse perceptions of physical well-being. ACE seve...
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Bowel symptoms, pelvic organ prolapse, and sexual dysfunction are common, but their frequency among women with lower urinary tract symptoms (LUTS) has not been well described. Our aims were to describe pelvic floor symptoms among women... more
Bowel symptoms, pelvic organ prolapse, and sexual dysfunction are common, but their frequency among women with lower urinary tract symptoms (LUTS) has not been well described. Our aims were to describe pelvic floor symptoms among women with and without urinary incontinence (UI) and among subtypes of UI. Women with LUTS seeking care at six U.S. tertiary care centers enrolled in prospective cohort study were studied. At baseline, participants completed the Pelvic Floor Distress Inventory (PFDI-20), Pelvic Organ Prolapse/Incontinence Sexual Questionnaire (PISQ-IR), and PROMIS GI Diarrhea, Constipation, and Fecal Incontinence Scales. Mean age among the 510 women was 56.4 ± 14.4 years. Women who reported UI (n = 420) had more diarrhea and constipation symptoms (mean scores 49.5 vs 46.2 [P = 0.01] and 51.9 vs 48.4 [P < 0.01], respectively) at baseline. Among sexually active women, mean PISQ-IR subscale scores were lower among those with UI (condition specific: 89.8 vs 96.7, P < 0.01...
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Patients with interstitial cystitis/bladder pain syndrome (IC/BPS) can potentially develop symptom flares after exposure to minor bladder irritants such as subclinical bacterial infection. To reproduce this symptom onset, we... more
Patients with interstitial cystitis/bladder pain syndrome (IC/BPS) can potentially develop symptom flares after exposure to minor bladder irritants such as subclinical bacterial infection. To reproduce this symptom onset, we intravesically instilled a sub-noxious dose of uropathogenic E. coli component lipopolysaccharide (LPS) in young URO-OVA/OT-I mice, a transgenic autoimmune cystitis model that spontaneously develops bladder inflammation at ≥10 weeks of age. Female URO-OVA/OT-I mice (6-weeks old) were treated intravesically with phosphate-buffered saline (PBS) or PBS containing a sub-noxious dose (1 μg) of LPS. Mice were evaluated for bladder inflammation, pelvic pain, and voiding dysfunction at days 1, 7, and 14 post-treatment. Mice treated with LPS but not PBS developed early bladder inflammation with increased macrophage infiltration. Accordingly, the inflamed bladders expressed increased levels of mRNA for proinflammatory cytokines (IL-1β and IL-6) and pain mediator (substanc...
Research Interests: Inflammation and Medicine
Despite intensive work in the field, urinary incontinence (UI) treatment is characterized by unintended side effects, uncertain durability, high risk of complications, and inconsistent outcomes. Therapy is generally directed toward... more
Despite intensive work in the field, urinary incontinence (UI) treatment is characterized by unintended side effects, uncertain durability, high risk of complications, and inconsistent outcomes. Therapy is generally directed toward underlying anatomic and physiologic causes, with little attention to important cognitive, psychosocial and behavioral aspects of UI. Recognition that the variability in UI treatment success is likely driven at least in part by individual variability-combined with a demonstrated need for better outcomes for patients with UI; a torrent of technical advances involving -omic, mobile health, and data science technologies; and growth of intra- and transdisciplinary research-has made the development of a science base to enable better targeting of UI treatments based on individual patient characteristics both interesting and feasible. The National Institute of Diabetes and Digestive and Kidney Diseases convened expert stakeholders to conceptualize research needed...
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To evaluate the association between pharmacologic therapy for urgency urinary incontinence (UUI) and sleep quality. We conducted a planned secondary data analysis of sleep outcomes in a previously conducted multicenter, double-blind,... more
To evaluate the association between pharmacologic therapy for urgency urinary incontinence (UUI) and sleep quality. We conducted a planned secondary data analysis of sleep outcomes in a previously conducted multicenter, double-blind, 12-week randomized trial of pharmacologic therapy for urgency-predominant incontinence among community-dwelling women self-diagnosed using the 3-Incontinence Questions questionnaire. Participants (N=645) were assigned randomly to 4-8 mg antimuscarinic therapy daily or placebo. At baseline and 12 weeks, participants completed a validated voiding diary to evaluate incontinence and voiding symptoms, the Pittsburgh Sleep Quality Index to evaluate sleep quality, and the Epworth Sleepiness Scale to evaluate daytime sleepiness. Mean (SD) age was 56 (±14) years, 68% were white, and 57% had poor sleep quality (Pittsburgh Sleep Quality Index score greater than 5). Mean frequency of any urinary incontinence and UUI was 4.6 and 3.9 episodes/d, respectively. After 1...
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To describe and compare the frequency and type of lower urinary tract symptoms (LUTS) reported by men and women at the time they were recruited from urology and urogynecology clinics into the Symptoms of Lower Urinary Tract Dysfunction... more
To describe and compare the frequency and type of lower urinary tract symptoms (LUTS) reported by men and women at the time they were recruited from urology and urogynecology clinics into the Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN) multi-center, prospective, observational cohort study. Six research sites enrolled treatment-seeking men and women who reported any LUTS at a frequency more than "rarely" during the past month on the LUTS tool. At baseline, study participants underwent a standardized clinical evaluation and completed validated questionnaires; urological tests were performed, including pelvic/rectal examination, post-void residual, and urinalysis. A total of 545 women and 519 men were enrolled. The mean age was 58.8 ± 14.1 years. At baseline, nocturia, frequency, and a sensation of incomplete emptying were similar between men and women, whereas men experienced more voiding symptoms (90% vs. 85%, p=0.007), and women reported more urgenc...
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Foods, fluid intake, caffeine, alcohol, and tobacco may influence lower urinary tract symptoms (LUTS). Changes in these potentially modifiable non-urologic factors (NUF) are often suggested to improve LUTS. To better understand the... more
Foods, fluid intake, caffeine, alcohol, and tobacco may influence lower urinary tract symptoms (LUTS). Changes in these potentially modifiable non-urologic factors (NUF) are often suggested to improve LUTS. To better understand the relationship of NUFs with LUTS, we performed a systematic literature review to examine, grade, and summarize reported associations between LUTS and diet, fluid intake, caffeine, tobacco and alcohol use. We performed PubMed searches for eligible articles providing evidence on associations between one or more NUF and LUTS. A modified Oxford system was used to grade the evidence. We reviewed 110 articles covering diet (n=28), fluid intake (n=21), caffeine (n=20), alcohol (n=26) and tobacco use (n=44). The evidence grade was generally low (6% level 1, 24% level 2, 11% level 3; 59% level 4). Fluid intake was associated with urinary frequency and urgency in men and women. Modest alcohol use was associated with less likelihood of benign prostatic hyperplasia (BP...
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We characterized the location and spatial distribution of whole body pain among patients with urologic chronic pelvic pain syndrome (UCPPS) using a body map; and compared the severity of urinary symptoms, pelvic pain, non-pelvic pain, and... more
We characterized the location and spatial distribution of whole body pain among patients with urologic chronic pelvic pain syndrome (UCPPS) using a body map; and compared the severity of urinary symptoms, pelvic pain, non-pelvic pain, and psychosocial health among patients with different pain patterns. 233 women and 191 men with UCPPS enrolled in a multi-center, one-year observational study completed a battery of baseline measures, including a body map describing the location of pain during the past week. Participants were categorized as having "pelvic pain only" if they reported pain in the abdomen and pelvis only. Participants who reported pain beyond the pelvis were further divided into two sub-groups based on the number of broader body regions affected by pain: an "intermediate" group (1-2 additional regions outside the pelvis) and a "widespread pain" group (3-7 additional regions). Of the 424 enrolled patients 25% reported pelvic pain only, and 75%...
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Monocyte chemoattractant protein-1 (MCP-1) is one of the key chemokines that play important roles in diverse inflammatory and chronic pain conditions. Interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic and debilitating... more
Monocyte chemoattractant protein-1 (MCP-1) is one of the key chemokines that play important roles in diverse inflammatory and chronic pain conditions. Interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic and debilitating inflammatory condition of the urinary bladder characterized by the hallmark symptoms of pelvic pain and voiding dysfunction. To facilitate IC/BPS research, we used transgenic technology to develop a novel urothelial MCP-1 secretion mouse model (URO-MCP-1). A transgene consisting of the uroplakin II gene promoter and the mouse MCP-1 coding sequence with a secretory element was constructed and microinjected. URO-MCP-1 mice were found to express MCP-1 mRNA in the bladder epithelium and MCP-1 protein in the urine, and developed bladder inflammation 24 hours after intravesical administration of a single sub-noxious dose of lipopolysaccharide (LPS). The inflamed bladders of URO-MCP-1 mice exhibited elevated mRNAs for interleukin (IL)-1ß, IL-6, substance P pre...
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Research Interests: Research Design, Quality of life, Treatment Outcome, Medicine, Urinary incontinence, and 13 morePelvic Organ Prolapse, Humans, Behavior Therapy, Female, Middle Aged, Questionnaires, Adult, Analysis of Variance, Pessaries, Combined Modality Therapy, Severity of Illness Index, Pelvic Floor, and Outcome assessment (Health care)
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To determine the error rate for discharge coding of anal sphincter laceration at vaginal delivery in a cohort of primiparous women. As part of the Childbirth and Pelvic Symptoms study performed by the National Institutes of Health Pelvic... more
To determine the error rate for discharge coding of anal sphincter laceration at vaginal delivery in a cohort of primiparous women. As part of the Childbirth and Pelvic Symptoms study performed by the National Institutes of Health Pelvic Floor Disorders Network, we assessed the relationship between perineal lacerations and corresponding discharge codes in three groups of primiparous women: 393 women with anal sphincter laceration after vaginal delivery, 383 without anal sphincter laceration after vaginal delivery, and 107 after cesarean delivery before labor. Discharge codes for perineal lacerations were compared with data abstracted directly from the medical record shortly after delivery. Patterns of coding and coding error rates were described. The coding error rate varied by delivery group. Of 393 women with clinically recognized and repaired anal sphincter lacerations by medical record documentation, 92 (23.4%) were coded incorrectly (four as first- or second-degree perineal laceration and 88 with no code for perineal diagnosis or procedure). One (0.3%) of the 383 women who delivered vaginally without clinically reported anal sphincter laceration was coded with a sphincter tear. No women in the cesarean delivery group had a perineal laceration diagnostic code. Coding errors were not related to the number of deliveries at each clinical site. Discharge coding errors are common after delivery-associated anal sphincter laceration, with omitted codes representing the largest source of errors. Before diagnostic coding can be used as a quality measure of obstetric care, the clinical events of interest must be appropriately defined and accurately coded.
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Research Interests: Obstetrics, Medicine, Humans, Behavior Therapy, Female, and 12 moreObstetrics Gynecology, Follow-up studies, Patient Satisfaction, Ambulatory, Middle Aged, Adult, Randomized Controlled Trial, Combination drug therapy, Pessaries, Combination Therapy, Paediatrics and reproductive medicine, and Intention to treat analysis
Research Interests: Obstetrics, Epidemiology, Magnetic Resonance Imaging, Adolescent, Medicine, and 13 moreAnatomy, Humans, Female, Obstetrics Gynecology, African Americans, Pelvis, Gynecology, Adult, Ethnic Group, European Continental Ancestry Group, Nuclear Magnetic Resonance Imaging, Magnetic resonance image, and Paediatrics and reproductive medicine
Research Interests: Obstetrics, Quality of life, Linear models, Probability, Multivariate Analysis, and 12 moreUrinary incontinence, Humans, Female, Obstetrics Gynecology, Aged, Middle Aged, Cost of Illness, Cross Sectional Studies, Incontinence Pads, Severity of Illness Index, Costs and Cost Analysis, and Paediatrics and reproductive medicine
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One in 5 recently deployed US women veterans report overactive bladder symptoms. Mental health conditions such as depression and anxiety commonly co-occur in women with overactive bladder, but temporal relationships between these outcomes... more
One in 5 recently deployed US women veterans report overactive bladder symptoms. Mental health conditions such as depression and anxiety commonly co-occur in women with overactive bladder, but temporal relationships between these outcomes have not been well studied, and the mechanism behind this association is unknown. The Women Veterans Urinary Health Study, a nationwide longitudinal study in recently deployed women veterans, was designed to better understand relationships between overactive bladder and mental health conditions. We sought to estimate the 1-year incidence and remission of overactive bladder and to identify the impact of depression, anxiety, posttraumatic stress disorder, and prior sexual assault on 1-year overactive bladder incidence and remission rates. Participants of this 1-year prospective cohort study were female veterans separated from military service who had returned from Iraq or Afghanistan deployment within the previous 2 years. Eligible women were identif...
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Globally, Spanish is the primary language for 329 million people; however, most urogynecologic questionnaires are available in English. We set out to develop valid Spanish translations of the Questionnaire for Urinary Incontinence... more
Globally, Spanish is the primary language for 329 million people; however, most urogynecologic questionnaires are available in English. We set out to develop valid Spanish translations of the Questionnaire for Urinary Incontinence Diagnosis (QUID), the Three Incontinence Questions (3IQ), and the short Pelvic Floor Distress Inventory (PFDI-20) and Pelvic Floor Impact Questionnaire (PFIQ-7). The TRAPD method (translation, review, adjudication, pretesting, and documentation) was used for translation. Eight native Spanish-speaking translators developed Spanish versions collaboratively. These were pretested with cognitive interviews and revised until optimal. For validation, bilingual patients at seven clinics completed Spanish and English questionnaire versions in randomized order. Participants completed a second set of questionnaires later. The Spanish versions&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; internal consistency and reliability and Spanish-English agreement were measured using Cronbach&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s alpha, weighted kappa, and intraclass correlation coefficients. A total of 78 subjects were included; 94.9 % self-identified as Hispanic and 73.1 % spoke Spanish as their primary language. The proportion of per-item missing responses was similar in both languages (median 1.3 %). Internal consistency for Spanish PFDI-20 subscales was acceptable to good and for PFIQ-7 and QUID excellent. Test-retest reliability per item was moderate to near perfect for PFDI-20, substantial to near perfect for PFIQ-7 and 3IQ, and substantial for QUID. Spanish-English agreement for individual items was substantial to near perfect for all questionnaires (kappa range 0.64-0.95) and agreement for PFDI-20, PFIQ-7, and QUID subscales scores was high [intraclass correlation coefficient (ICC) range 0.92-0.99]. We obtained valid Spanish translations of the PFDI-20, PFIQ-7, QUID, and 3IQ. These results support their use as clinical and research assessment tools in Spanish-speaking populations.
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Pelvic floor disorders affect up to 24% of adult women in the United States, and many patients with pelvic organ prolapse (POP) choose to undergo surgical repair to improve their quality of life. While a variety of surgical repair... more
Pelvic floor disorders affect up to 24% of adult women in the United States, and many patients with pelvic organ prolapse (POP) choose to undergo surgical repair to improve their quality of life. While a variety of surgical repair approaches and techniques are utilized, including mesh augmentation, there is limited comparative effectiveness and safety outcome data guiding best practice. In conjunction with device manufacturers, federal regulatory organizations, and professional societies, the American Urogynecologic Society developed the Pelvic Floor Disorders Registry (PFDR) designed to improve the quality of POP surgery by facilitating quality improvement and research on POP treatments. The PFDR will serve as a resource for surgeons interested in benchmarking and outcomes data and as a data repository for Food and Drug Administration-mandated POP surgical device studies. Provider-reported clinical data and patient-reported outcomes will be collected prospectively at baseline and for up to 3 years after treatment. All data elements including measures of success, adverse events, and surgeon characteristics were identified and defined within the context of the anticipated multifunctionality of the registry, and with collaboration from multiple stakeholders. The PFDR will provide a platform to collect high-quality, standardized patient-level data from a variety of nonsurgical (pessary) and surgical treatments of POP and other pelvic floor disorders. Data from this registry may be used to evaluate short- and longer-term treatment outcomes, patient-reported outcomes, and complications, as well as to identify factors associated with treatment success and failure with the overall goal of improving the quality of care for women with these conditions.
To explore inflammatory factors that influence symptom changes in interstitial cystitis/bladder pain syndrome (IC/BPS). This longitudinal, prospective study examined the association of inflammation elicited by Toll-Like Receptor (TLR)... more
To explore inflammatory factors that influence symptom changes in interstitial cystitis/bladder pain syndrome (IC/BPS). This longitudinal, prospective study examined the association of inflammation elicited by Toll-Like Receptor (TLR) stimulation in peripheral blood mononuclear cells (PBMCs) and diurnal cortisol rhythms with changes in painful and urinary symptoms of IC/BPS and symptom flares over a 48 week period. Participants were 24 women meeting criteria for IC/BPS who supplied blood for isolation of PBMCs and three days of salivary cortisol samples prior to a baseline visit. Participants completed the Genitourinary Pain Index (pain and urinary subscales) and reported symptom flares every 2 weeks for 48 weeks. Mixed effects longitudinal and regression models were used to determine if inflammatory variables were associated with the changes in IC/BPS symptoms (Time X variable interactions), and the probability of a symptom flare. Elevated TLR-4 inflammation (p = .031) and elevated...