Guided imagery for women with interstitial cystitis: Results of a prospective, randomized controlled pilot study

Introduction: In the United States, more than 1 million women and men are affected with interstitial cystititis (IC), which is a clinical syndrome involving urinary urgency, frequency, and pelvic pain. A review of the literature revealed that there are no studies showing the effect of guided imagery in women with IC. The purpose of this clinical investigation was to explore the effect of guided imagery on pelvic pain and urinary symptoms in women with IC symptoms. Methodology: Thirty (30) women with diagnosed IC were randomized into 2 equal groups. One group (treatment) listened to a 25-minute guided imagery compact disc (CD), that was created specifically for women with pelvic pain and IC, twice a day for 8 weeks. The control group rested for 25 minutes twice daily for 8 weeks. Because no guided imagery CDs specifically for women with IC were found on the commercial market, the authors created a script and recorded the CD specifically for women with IC and pelvic pain. The focus of this guided imagery CD was on healing the bladder, relaxing the pelvic-floor muscles, and quieting the nerves specifically involved in IC. Baseline and end-of-study assessment questionnaires (Interstitial Cystitis Symptom Index & Problem Index [IC-SIPI], IC Self-Efficacy Scale, a visual analogue [VAS] scale for pain, and a global response assessment [GRA]), 2-day voiding diaries, and 24-hour pain diaries were completed by the subjects and were evaluated using SPSS (Chicago, IL). Results: More than 45% of the treatment group were responders to guided imagery therapy noting a moderate or marked improvement on the GRA. Pain scores and episodes of urgency significantly decreased in the treatment group. Responders had significant reductions in IC-SIPI scores (problem index, p = 0.006; symptom index, p = 0.004). In addition, responders on the GRA had significant (p = 0.039) improvements in mean pain scores from 5.50 to 2.57 at the end of the study in contrast to the nonresponders, whose pain levels remained the same (4.89 to 4.39). Conclusions: This is the first study providing preliminary data supporting the use of guided imagery as a potential therapy for IC. Guided imagery may be a useful tool to offer women with IC for pain and IC symptom management. It is an intervention without negative side-effects, is readily available, and shows a trend toward improvement of IC symptoms.