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A Multidisciplinary, Multimodal Bundled Care Approach to Chronic Pelvic Pain

A Multidisciplinary, Multimodal Bundled Care Approach to Chronic Pelvic Pain

Status
Terminated
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT05658874
Enrollment
26
Registered
2022-12-21
Start date
2022-12-06
Completion date
2025-12-30
Last updated
2026-04-01

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Interstitial Cystitis, Levator Spasm, Bladder Pain Syndrome

Brief summary

The goal of this clinical trial is to compare two different treatment patterns in patients with chronic bladder pain. The main questions the investigators are seeking to answer is if bladder pain improves before and after treatment using a painful bladder scale. The participant will have 5 visits to evaluate your symptoms with questionnaires, at least one procedural visit, and must participate in physical therapy and some kind of behavioral health therapy. This study will assess participant response to a bundled-care approach to chronic bladder pain both pre-and post intervention as well as compared to a group of participants receiving typical care.

Detailed description

Objectives: The goals of this research program are to evaluate the patient-reported outcomes of a multimodal care bundle for patients presenting to a multidisciplinary chronic pelvic pain clinic compared to "usual care" in an Urogynecology clinic. Primary Aim: To compare pre and post intervention self-evaluation of pain and function scores in women with chronic pain syndromes with a primary finding of urinary/bladder pain symptoms with or without levator spasm who undergo multi-disciplinary, bundled care compared with usual care in a Urogynecology clinic setting. Secondary Aims: a) To identify and phenotype "non-responders" to a bundled approach to Interstitial Cystitis/Painful Bladder Syndrome/Chronic Pelvic Pain (IC/PBS/CPP). Hypothesis: We hypothesize that a bundled, multidisciplinary care approach will significantly improve patient scores on validated outcomes questionnaires compared to usual care. Methods: All treatment plans, medications, and procedures recommended for patients involved in this study are within the current standards of care for IC/PBS/CPP, regardless of treatment arm and are known to be safe interventions. Study Design: Single center, randomized pre-post intervention/prospective cohort study32 of usual FPMRS care vs. multimodal, multidisciplinary care bundle (MMCB). Setting: Patients will be recruited from an outpatient Urogynecology clinic. They will subsequently be randomized to a Multidisciplinary chronic pelvic pain clinic at an alternate site vs. continuing usual outpatient care in Urogynecology as above.

Interventions

DRUGMultimodal Bundle Drugs

multimodal pain therapy

PROCEDUREOperative Cystoscopy

Evaluate bladder and treat Hunner lesions with kenalog or fulguration as appropriate

BEHAVIORALBehavioral health consultation/therapy

Patient to see behavioral health/psychiatric care

Patient to have evaluation and treatment by a trained pelvic floor physical therapist

OTHERUsual Urogynecologic care

Usual care from practicing academic Urogynecologist

DRUGBladder Instillation

Intravesical lidocaine, heparin, sodium bicarb, Kenalog, gentamicin

Topical vaginal estradiol application

DRUGMethenamine

UTI prevention/bladder therapeutic

DRUGAmitriptyline/Gabapentin

Part of multimodal pain therapy

Sponsors

Jocelyn Fitzgerald
Lead SponsorOTHER

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE

Intervention model description

Single center, randomized pre-post intervention/prospective cohort study of usual Urogynecology care vs. multimodal, multidisciplinary care bundle (MMCB).

Eligibility

Sex/Gender
FEMALE
Age
18 Years to 99 Years
Healthy volunteers
No

Inclusion criteria

* Inclusion Criteria: * Female patient 18 years of age or older * diagnosis of Interstitial Cystitis/Painful Bladder Syndrome, scoring 6 points or higher on O'Leary Sant Questionnaire *

Exclusion criteria

Active pelvic or bladder infection within past 2 weeks * contraindications to medications or intervention therapeutics * inability to speak or read English * pelvic floor interventional procedure including bladder instillations 4 weeks prior to study recruitment * meets criteria for diagnostic laparoscopy * internal referral (to reduce severity bias) Note: patients are not excluded for currently taking any medication on the treatment list. Patients can be treated for UTI during the study period.

Design outcomes

Primary

MeasureTime frameDescription
--O'Leary Sant Questionnaire (OLS), Comprised of Interstitial Cystitis Symptom Index (ICSI) and Problem Index (ICPI), Change at 12 Weeks From BaselineBaseline, 12 weeksThis survey assesses IC/BPS symptoms and a change in \> or equal to 4 points is considered clinically significant. A higher score change indicates less pain and urinary symptoms. The minimum possible score is 0. The maximum possible score is 37.

Secondary

MeasureTime frameDescription
Healthcare Encounters Motivated on PainBaseline to 12-monthNumber of encounters with the UPMC healthcare system that include emergency room visits, provider calls, provider visits, procedures, and other treatments based on documentation within their medical record.

Countries

United States

Contacts

PRINCIPAL_INVESTIGATORJocelyn J Fitzgerald, MD

University of Pittsburgh

Participant flow

Recruitment details

Chronic Pelvic Pain Study, UPMC Magee's Women's Hospital, Recruited from 12/6/2022 to 9/25/2024

Baseline characteristics

Characteristic
Age, Customized
Age Demographics
Ages 18-29 years
11 Participants
Age, Customized
Age Demographics
Ages 30-42 years
8 Participants
Age, Customized
Age Demographics
Ages 43-55 years
5 Participants
Age, Customized
Age Demographics
Ages 56-68 years
2 Participants
Age, Customized
Age Demographics
Ages 69+ years
0 Participants
Body Mass Index (BMI)
Healthy weight: BMI 18.5-24.9
10 Participants
Body Mass Index (BMI)
Obese: BMI >30
8 Participants
Body Mass Index (BMI)
Overweight: BMI 25-29.9
6 Participants
Body Mass Index (BMI)
Underweight: BMI < 18.5
0 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
26 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
Menopausal Status
Postmenopausal, HRT
2 Participants
Menopausal Status
Postmenopausal, no HRT
2 Participants
Menopausal Status
Premenopausal
8 Participants
Menopausal Status
Uncertain
0 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
Race (NIH/OMB)
Asian
0 Participants
Race (NIH/OMB)
Black or African American
0 Participants
Race (NIH/OMB)
More than one race
0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
Race (NIH/OMB)
White
25 Participants
Sex: Female, Male
Female
26 Participants
Sex: Female, Male
Male
0 Participants
Smoking Status
Current Smoker
0 Participants
Smoking Status
Former Smoker
2 Participants
Smoking Status
Never Smoked
24 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
0 / 160 / 10
other
Total, other adverse events
0 / 160 / 10
serious
Total, serious adverse events
0 / 160 / 10

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Apr 2, 2026