Urinary pH Levels and Symptom Severity in Patients with Interstitial Cystitis

Objectives: Mainstays of treatment for interstitial cystitis/bladder pain syndrome include restricting acidic foods and beverages as well as modalities to alkalinize the urine. The association between interstitial cystitis/bladder pain syndrome and urinary pH, however, remains inconclusive. The objective of this study was to determine a relationship between urinary pH and severity of symptoms in those with interstitial cystitis/bladder pain syndrome.

Methods: In this cross-sectional study, eligible subjects completed the O’Leary-Sant questionnaire and a Visual Analog Scale regarding overall pain. Subjects’ urinary pH was also documented. The primary outcome was a difference in urinary pH in those with an O’Leary-Sant score >12 (severe symptoms) compared to < 12 (non-severe symptoms). Secondary outcomes included a correlation between the O’Leary-Sant score and urinary pH, overall Visual Analog Scale pain scores for each group, and a correlation between urinary pH and overall Visual Analog Scale pain scores.

Results: A total of 46 subjects met eligibility. Multiple office visits occurred for 28 subjects resulting in 114 total visits for analysis. There was no difference between median urinary pH between those with an O’Leary-Sant score of >12 and those with scores < 12 (6 vs 6, p=0.86). A linear relationship between urinary pH and O’Leary-Sant scores was also evaluated and no correlation was found. As expected, those with a more severe O’Leary-Sant score also reported significantly higher overall VAS pain score (p < 0.001). A correlation between overall VAS pain scores and urinary pH, however, was not found (p=0.33).

Conclusions: In patients with interstitial cystitis/bladder pain syndrome, there was no association between urinary pH and symptom severity nor a correlation with O’Leary-Sant scores.