Chronic Pelvic Pain in Women: From Threat to Stress to THRIVE.

This Master Class focuses on autonomic nervous system factors, potential molecular targets, and translational approaches to care for women with Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS), a relatively common chronic primary pelvic pain condition. A functional abnormality of the autonomic nervous system associated chronically increased activity of the central stress (threat) response system has been found in both women and pet cats (a naturally occurring animal model of IC).

In rodents, mitochondrial damage and increased oxidative stress associated with genitourinary dysfunctions including IC have been found. This suggests the possibility of resolving these dysfunctions with a purine nucleoside phosphorylase inhibitor (PNPase). Preclinical studies have revealed that inhibiting PNPase exerts beneficial effects in the lower urinary tract, suggesting a potential therapeutic role in the treatment of IC and related disorders.

Current bladder-centric treatments for IC remain disappointing, whereas those based on psychosocial models show more promise. We tested the feasibility of a behavioral intervention in women living with IC, the Learning to THRIVE Program, which uses principles of adult learning and instructional design. This pilot study used a one-group pre-post design to assess the feasibility of program implementation, and of pain intensity, distress, and interference outcomes. 

Please see below the recommended pre-reading list for the course. 

• Dr. Levesque - Clinical Criteria of Central Sensitization in Chronic Pelvic and Perineal Pain (Convergences PP Criteria): Elaboration of a Clinical Evaluation Tool Based on Formal Expert Consensus.
• Dr. Chelimsky - Autonomic neurophysiologic implications of disorders comorbid with bladder pain syndrome vs myofascial pelvic pain
• Dr. Birder - Purine nucleoside phosphorylase inhibition is an effective approach for the treatment of chemical hemorrhagic cystitis.
• Dr. Buffington - Interstitial Cystitis - an Imbalance of Risk and Protective Factors?
• Dr. Santurri - Learning the neurobiology of pain: A scoping review of pain education from an instructional design perspective

Faculty:

• Thomas Chelimsky
• Lori Birder
• Laura Santurri