{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T14:17:21Z","timestamp":1784557041087,"version":"3.55.0"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T00:00:00Z","timestamp":1784505600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T00:00:00Z","timestamp":1784505600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int Urogynecol J"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction and Hypothesis<\/jats:title>\n                    <jats:p>Female bladder pain syndrome (FBPS) is a chronic condition characterized by bladder pain, urgency, and frequency that significantly impacts quality of life. Management includes nonsurgical and procedural therapies. Our objective was to evaluate the time from FBPS diagnosis to procedural intervention and identify predictors of intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort study identified women with FBPS from 2013 to 2023 using ICD-10 codes at a single tertiary care center in the United States. Interventions were categorized per the 2022 AUA guideline, including behavioral\/non-pharmacologic therapies, medications, intravesical instillations, procedures, and major surgeries. Kaplan\u2013Meier analysis estimated time to first procedural intervention, and Cox proportional hazards models identified factors associated with intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 149 patients, 111 (74.5%) underwent at least one bladder-directed procedural intervention, with a median time to first procedure of 1.08 years. The most common intervention was cystoscopy with hydrodistension (\n                      <jats:italic>N<\/jats:italic>\n                      = 83, 55.7%), followed by intravesical instillations (53, 35.6%). Image-guided nerve blocks (11, 7.4%) and onabotulinumtoxinA injections (5, 3.4%) were less frequent. Among those undergoing procedures, 84 (75.7%) required repeat interventions. On multivariable analysis, stress urinary incontinence (HR 2.02,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.05) and tobacco use (HR 1.86,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.03) were associated with increased hazard, while partnered relationship status was associated with reduced hazard (HR 0.62,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Most patients with FBPS underwent procedural intervention by 1.08 years from diagnosis, most commonly cystoscopy with hydrodistension. Stress urinary incontinence and tobacco use were significant predictors. These findings highlight the importance of individualized management and early identification of patients likely to require procedural therapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00192-026-06819-w","type":"journal-article","created":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T13:45:19Z","timestamp":1784555119000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Time Until Procedural Intervention in Female Bladder Pain Syndrome at a Tertiary Referral Center in the United States"],"prefix":"10.1007","author":[{"given":"Noor Banihashem","family":"Ahmad","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shreela","family":"Natarajan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allen","family":"Kunselman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Stetter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah S.","family":"Boyd","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,20]]},"reference":[{"issue":"4","key":"6819_CR1","doi-asserted-by":"publisher","first-page":"274","DOI":"10.1002\/nau.20687","volume":"28","author":"P Hanno","year":"2009","unstructured":"Hanno P, Dmochowski R. Status of international consensus on female bladder pain syndrome\/painful bladder syndrome: 2008 snapshot. Neurourol Urodyn. 2009;28(4):274\u201386. https:\/\/doi.org\/10.1002\/nau.20687","journal-title":"Neurourol Urodyn"},{"issue":"1","key":"6819_CR2","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1097\/JU.0000000000002756","volume":"208","author":"JQ Clemens","year":"2022","unstructured":"Clemens JQ, Erickson DR, Varela NP, Lai HH. Diagnosis and treatment of female bladder pain syndrome. J Urol. 2022;208(1):34\u201342. https:\/\/doi.org\/10.1097\/JU.0000000000002756","journal-title":"J Urol"},{"issue":"3","key":"6819_CR3","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1046\/j.1464-410X.2003.04060.x","volume":"91","author":"RO Roberts","year":"2003","unstructured":"Roberts RO, Bergstralh EJ, Bass SE, Lightner DJ, Lieber MM, Jacobsen SJ. Incidence of physician-diagnosed interstitial cystitis in Olmsted County: a community-based study. BJU Int. 2003;91(3):181\u20135. https:\/\/doi.org\/10.1046\/j.1464-410X.2003.04060.x","journal-title":"BJU Int"},{"issue":"3","key":"6819_CR4","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1207\/s15327655jchn2303_3","volume":"23","author":"JE Johnson","year":"2006","unstructured":"Johnson JE, Johnson KE. Ambiguous chronic illness in women: a community health nursing concern. J Community Health Nurs. 2006;23(3):159\u201367. https:\/\/doi.org\/10.1207\/s15327655jchn2303_3.","journal-title":"J Community Health Nurs"},{"key":"6819_CR5","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD013325.pub2","volume":"3","author":"M Imamura","year":"2020","unstructured":"Imamura M, Scott NW, Wallace SA, et al. Interventions for treating people with symptoms of bladder pain syndrome: a network meta-analysis. Cochrane Database Syst Rev. 2020;3:CD013325. https:\/\/doi.org\/10.1002\/14651858.CD013325.pub2","journal-title":"Cochrane Database Syst Rev"},{"issue":"1","key":"6819_CR6","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1097\/SPV.0b013e318198692e","volume":"15","author":"DF Shalom","year":"2009","unstructured":"Shalom DF, Klapper A, Lin S, Gurshumov E. Use of the pain urgency frequency (PUF) questionnaire to measure response of patients with interstitial cystitis\/painful bladder syndrome to intravesical DMSO and 1% lidocaine. J Pelvic Med Surg. 2009;15(1):5\u201310. https:\/\/doi.org\/10.1097\/SPV.0b013e318198692e","journal-title":"J Pelvic Med Surg."},{"key":"6819_CR7","doi-asserted-by":"publisher","first-page":"156","DOI":"10.1016\/j.ejogrb.2021.08.025","volume":"265","author":"Y Chen","year":"2021","unstructured":"Chen Y, Ying Z, Xiao Y, Liu Y, Wu S. Diagnostic and therapeutic efficacy of cystoscopy with hydrodistension and random biopsies in suspected female bladder pain syndrome. Eur J Obstet Gynecol Reprod Biol. 2021;265:156\u201361. https:\/\/doi.org\/10.1016\/j.ejogrb.2021.08.025","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"issue":"5","key":"6819_CR8","doi-asserted-by":"publisher","first-page":"1434","DOI":"10.1016\/S0022-5347(05)66955-8","volume":"163","author":"KJ Propert","year":"2000","unstructured":"Propert KJ, Schaeffer AJ, Brensinger CM, Kusek JW, Nyberg LM, Landis JR. A prospective study of interstitial cystitis: results of longitudinal follow-up of the interstitial cystitis database cohort. J Urol. 2000;163(5):1434\u20139. https:\/\/doi.org\/10.1016\/S0022-5347(05)66955-8","journal-title":"J Urol"},{"issue":"1","key":"6819_CR9","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1007\/s00192-010-1252-8","volume":"16","author":"JT Anger","year":"2010","unstructured":"Anger JT, Weinberg AE, Albo ME, Smith AL, Kim JH, Rodr\u00edguez LV. Treatment choice, duration, and cost in patients with interstitial cystitis and painful bladder syndrome. Female Pelvic Med Reconstr Surg. 2010;16(1):21\u20137. https:\/\/doi.org\/10.1007\/s00192-010-1252-8","journal-title":"Female Pelvic Med Reconstr Surg"},{"issue":"4 Pt 1","key":"6819_CR10","doi-asserted-by":"publisher","first-page":"1242","DOI":"10.1097\/01.ju.0000137953.49304.6c","volume":"172","author":"CAT Buffington","year":"2004","unstructured":"Buffington CAT. Comorbidity of interstitial cystitis with other unexplained clinical conditions. J Urol. 2004;172(4 Pt 1):1242\u20138. https:\/\/doi.org\/10.1097\/01.ju.0000137953.49304.6c","journal-title":"J Urol"},{"issue":"2","key":"6819_CR11","doi-asserted-by":"publisher","first-page":"599","DOI":"10.1016\/j.juro.2008.04.009","volume":"180","author":"CL Link","year":"2008","unstructured":"Link CL, Pulliam SJ, Hanno PM, et al. Prevalence and psychosocial correlates of symptoms suggestive of painful bladder syndrome: results from the Boston Area Community Health Survey. J Urol. 2008;180(2):599\u2013606. https:\/\/doi.org\/10.1016\/j.juro.2008.04.009","journal-title":"J Urol"},{"issue":"1","key":"6819_CR12","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1016\/j.urology.2008.06.031","volume":"73","author":"JW Warren","year":"2009","unstructured":"Warren JW, Howard FM, Cross RK, et al. Antecedent nonbladder syndromes in case-control study of interstitial cystitis\/painful bladder syndrome. Urology. 2009;73(1):52\u20137. https:\/\/doi.org\/10.1016\/j.urology.2008.06.031","journal-title":"Urology"},{"key":"6819_CR13","doi-asserted-by":"publisher","unstructured":"Kullmann FA. A new player in interstitial cystitis\/bladder pain syndrome: platelet-activating factor and its connection to smoking.\u00a0Physiol Rep. 2017;5(9):e13235. https:\/\/doi.org\/10.14814\/phy2.13235","DOI":"10.14814\/phy2.13235"},{"issue":"1","key":"6819_CR14","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1007\/s00192-005-1348-8","volume":"17","author":"CM Kennedy","year":"2006","unstructured":"Kennedy CM, Bradley CS, Galask RP, Nygaard IE. Risk factors for painful bladder syndrome in women seeking gynecologic care. Int Urogynecol J. 2006;17(1):73\u20138. https:\/\/doi.org\/10.1007\/s00192-005-1348-8","journal-title":"Int Urogynecol J"},{"issue":"1","key":"6819_CR15","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1002\/nau.20513","volume":"28","author":"Y Song","year":"2009","unstructured":"Song Y, Zhang W, Xu B, Hao L, Song J. Prevalence and correlates of painful bladder syndrome symptoms in Fuzhou Chinese women. Neurourol Urodyn. 2009;28(1):22\u20135. https:\/\/doi.org\/10.1002\/nau.20513","journal-title":"Neurourol Urodyn"},{"issue":"3","key":"6819_CR16","doi-asserted-by":"publisher","first-page":"585","DOI":"10.1016\/j.ogc.2021.05.010","volume":"48","author":"CC Moody","year":"2021","unstructured":"Moody CC, Fashokun TB. Painful bladder syndrome\/interstitial cystitis and high tone pelvic floor dysfunction. Obstet Gynecol Clin North Am. 2021;48(3):585\u201397. https:\/\/doi.org\/10.1016\/j.ogc.2021.05.010","journal-title":"Obstet Gynecol Clin North Am"},{"issue":"2","key":"6819_CR17","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1007\/s00192-017-3343-7","volume":"29","author":"LE Olson","year":"2018","unstructured":"Olson LE, Dyer JE, Haq A, Ockrim J, Greenwell TJ. A systematic review of cystodistension in bladder pain syndrome. Int Urogynecol J. 2018;29(2):251\u20137. https:\/\/doi.org\/10.1007\/s00192-017-3343-7","journal-title":"Int Urogynecol J"},{"issue":"1","key":"6819_CR18","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1002\/nau.7017","volume":"45","author":"DT Wolff","year":"2026","unstructured":"Wolff DT, Langefeld CD, Call JT, Badlani G, Evans RJ, Walker SJ. Correlates of positive response to therapeutic hydrodistension in interstitial cystitis\/bladder pain syndrome. Neurourol Urodyn. 2026;45(1):169\u201376. https:\/\/doi.org\/10.1002\/nau.7017","journal-title":"Neurourol Urodyn"},{"issue":"1","key":"6819_CR19","first-page":"25","volume":"9","author":"MK Chung","year":"2005","unstructured":"Chung MK, Chung RP, Gordon D. Interstitial cystitis and endometriosis in patients with chronic pelvic pain: the \u201cevil twins\u201d syndrome. JSLS. 2005;9(1):25\u20139.","journal-title":"JSLS."},{"issue":"4","key":"6819_CR20","doi-asserted-by":"publisher","first-page":"1413","DOI":"10.1002\/nau.23462","volume":"37","author":"CC Wu","year":"2018","unstructured":"Wu CC, Chung SD, Lin HC. Endometriosis increased the risk of bladder pain syndrome\/interstitial cystitis: a population-based study. Neurourol Urodyn. 2018;37(4):1413\u20139. https:\/\/doi.org\/10.1002\/nau.23462","journal-title":"Neurourol Urodyn"},{"issue":"3","key":"6819_CR21","doi-asserted-by":"publisher","first-page":"660","DOI":"10.1016\/j.neuroscience.2007.07.053","volume":"149","author":"AP Malykhina","year":"2007","unstructured":"Malykhina AP. Neural mechanisms of pelvic organ cross-sensitization. Neuroscience. 2007;149(3):660\u201372. https:\/\/doi.org\/10.1016\/j.neuroscience.2007.07.053","journal-title":"Neuroscience"}],"container-title":["International Urogynecology Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00192-026-06819-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00192-026-06819-w","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00192-026-06819-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T13:45:20Z","timestamp":1784555120000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00192-026-06819-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,20]]},"references-count":21,"alternative-id":["6819"],"URL":"https:\/\/doi.org\/10.1007\/s00192-026-06819-w","relation":{},"ISSN":["0937-3462","1433-3023"],"issn-type":[{"value":"0937-3462","type":"print"},{"value":"1433-3023","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,20]]},"assertion":[{"value":"1 April 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 July 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 July 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This study received IRB approval from the Pennsylvania State University IRB (STUDY00022514).","order":1,"name":"Ethics","label":"Ethical Approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"None.","order":2,"name":"Ethics","label":"Conflicts of Interest","group":{"name":"EthicsHeading","label":"Declarations"}}]}}