Identification and Characterization of Subgroups in Patients with Comorbid Bladder Pain Syndrome/Interstitial Cystitis and Vulvodynia (Unicorn-study 4)

Background: The coexistence of Bladder Pain Syndrome/Interstitial Cystitis (BPS/IC) and vulvodynia complicates both diagnosis and treatment. This study aimed to identify distinct subgroups within this patient population and evaluate their symptom profiles, psychological characteristics, and sexual function metrics. Methods: A cross-sectional study was conducted involving 150 women diagnosed with both BPS/IC and vulvodynia. Participants completed validated questionnaires to assess bladder symptoms, psychological distress (PHQ-9, GAD-7), and sexual function (FSFI, FSDS-R). Cluster analysis techniques were used to identify distinct patient subgroups. Results: The analysis revealed three distinct clusters. Cluster 1 had moderate bladder-specific symptoms and psychological distress. Cluster 2 experienced severe bladder symptoms along with the highest levels of psychological distress. Cluster 3 was characterized by severe vulvodynia, notable psychological distress, and the most severe sexual dysfunction. Sexual function was significantly compromised across all clusters, with Cluster 3 exhibiting the greatest impairment. Conclusions: This study highlights the heterogeneity among patients with BPS/IC and vulvodynia. The identified subgroups exhibit varied symptom profiles, emphasizing the need for individualized treatment strategies. The profound impact on sexual function and quality of life underscores the importance of comprehensive management approaches that address both physical and psychological dimensions. Future longitudinal studies are necessary to assess the stability of these clusters and their response to different treatments.