Perceived Stress and Accompanying Low Urine pH Are in Relation to Bladder Pain Syndrome

Abstract

Objective:The clinical relevance of low urine pH and perceived stress levels in patients with bladder pain syndrome (BPS) has not yet been clarified. In this study, we hypothesised that urine pH and perceived stress levels may differ in patients with BPS and that they may be related to each other.Materials and Methods:A prospective case-control study was conducted to test the hypothesis. Patients aged >18 years who were newly diagnosed with BPS were included in the patient group. The control group consisted of healthy volunteers aged >18 years. The 10-item Perceived Stress scale (PSS-10), spot urine pH measurements, Interstitial Cystitis Symptom index (ICSI), Interstitial Cystitis Problem index (ICPI), visual analogue scale for pain (VAS-Pain) and quality-of-life (QOL) scores were evaluated. Independent samples t-test and multivariate regression with path analysis were performed.Results:The study evaluated 84 patients with BPS and 86 healthy participants. The mean spot urine pH, PSS-10, ICSI, ICPI, VAS-Pain and QOL scores were different between the patient group and control group. Spot urine pH level [p=0.01, odds ratio (OR)=0.31] and PSS-10 scores (p=0.01, OR=1.1) remained significant predictors of BPS in the multivariate analysis. Lower urine pH and higher perceived stress levels were associated with worse ICSI, ICPI, VAS-Pain and QOL scores.Conclusion:Acidic urine pH and high perceived stress levels are associated with the presence of BPS. Perceived stress is independent from low urine pH, as they each relate to BPS symptoms in a bidirectional manner.

Keywords

• acidic urine
• bladder pain
• interstitial cystitis
• perceived stress