Neuropathic pain, urinary symptoms seen tied in primary Sjögren’s
Study finds neuropathic pain may affect bladder voiding
People with primary Sjögren’s disease and neuropathic pain — pain caused by damage or dysfunction of the nervous system — are more likely to experience lower urinary tract problems than those without neuropathic pain.
That’s according to a study in Turkey, which also found that neuropathic pain appeared to have more pronounced effects on bladder voiding functions than on the bladder’s ability to store urine.
“This study represents an initial attempt to provide evidence that neuropathic pain could negatively influence bladder voiding functions in [primary Sjögren’s disease] patients,” the researchers wrote. The study, “The relationship between neuropathic pain and lower urinary tract symptom scores in patients with primary Sjögren’s syndrome,” was published in BMC Urology.
Sjögren’s disease occurs when the immune system launches an inflammatory attack against healthy cells, primarily those in the glands that produce tears and saliva, leading to symptoms of eye and mouth dryness. Patients may also experience other symptoms, including lower urinary tract symptoms (LUTS) and neuropathic pain. LUTS may include changes in urinary frequency, urgency, or urinary incontinence.
Neuropathic pain can be continuous pain (burning, squeezing, or a pressure sensation), pain resembling electric shocks, stabbing pain, pain caused by a stimulus that normally does not elicit pain, or tingling and prickling sensations.
Associating neuropathic pain with urinary symptoms
Since “no previous study has evaluated the association of neuropathic pain with symptoms of LUTS in patients with [primary Sjögren’s disease],” the researchers wrote, they set out to analyze the data.
The researchers looked at data from 72 women with primary Sjögren’s disease who had a mean age of 52.4. Patients’ median score in the Leeds Assessment of Neuropathic Symptoms and Signs, which is used to identify patients with neuropathic pain, was 8, with almost 30% being classified as having neuropathic pain (defined a score of 12 points or more).
Urinary issues were evaluated using the International Prostate Symptom Score (IPSS), which grades urinary symptoms in a scale ranging from zero (no symptoms) to 35 (severe symptoms). Most patients had mild urinary symptoms (56.9%) or an IPSS of 1 to 7 points, while in 34.7% symptoms were moderate (IPSS of 8-19 points), and in 8.3% they were severe (IPSS of 20-35 points).
The median values of both IPSS and the IPSS voiding subscore were significantly higher in patients with neuropathic pain, than in those without neuropathic pain (11 vs. 5 for IPSS and 3 vs. 0 for the voiding subscore).
Although scores in other measures assessing urinary symptoms, including the International Incontinence Consultation Questionnaire Short Form, the Overactive Bladder Questionnaire, and the IPSS storage subscore were numerically higher in patients with neuropathic pain, the differences were not considered to be statistically significant.
Overall, study’s findings “suggest a potential association between LUTS in [primary Sjögren’s disease] and neuropathic pain,” the researchers wrote, noting that neuropathic pain may “negatively affect bladder voiding functions.” However, they said, further research is needed to understand the underlying mechanisms linking neuropathic pain to LUTS in this patient population.
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