Investigation of the hematological parameters in women with Interstitial Cystitis/Bladder Pain Syndrome and their relationship with disease severity

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Diagnosis of IC/BPS is difficult as there is no disease-specific diagnostic test. Our study analyzed the hematological parameters in female patients with IC/BPS to determine whether these parameters could assist in diagnosing IC/BPS and investigate the relationship between these parameters and disease severity. Methods: Fifty female patients with IC/BPS (i.e., patient group) and 50 healthy volunteers (i.e., control group) with no systemic diseases or complaints were included. The patients' O'Leary Sant Interstitial Cystitis Symptom Index (ICSI) scores were recorded at diagnosis. Blood neutrophil, lymphocyte, platelet counts, mean platelet volumes (MPV), neutrophil/lymphocyte (NLR), and platelet/lymphocyte ratios (PLR) were recorded and calculated based on the complete blood count results obtained during the initial outpatient clinic encounters. Patients and healthy volunteers were compared regarding age, neutrophil, lymphocyte, platelet counts, and MPV, NLR, and PLR values. The correlation between laboratory parameters and ICSI levels of the cases in the patient group was also analyzed. Results: The demographic data of the groups were similar. There was no significant difference between the groups regarding neutrophil, lymphocyte, platelet counts, and MPV levels. On the other hand, the median NLR values were significantly higher in the patient group compared to the control group (2.34 vs. 1.85, p<0.001). In the patient group, the lymphocyte count was significantly higher in the group with an ICSI score≥14 compared to the group with an ICSI score<14 (median, 1.90 vs. 1.62, p=0.009). Conclusion: Our study found that NLR was higher in IC/BPS patients than in healthy individuals and that lymphocyte counts might be associated with disease severity. Thus, hematological parameters can provide clinicians with valuable insights regarding IC/BPS disease severity and aid treatment planning. Interstitial cystitis Bladder pain syndrome Neutrophil/lymphocyte ratio Platelet/lymphocyte ratio Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Introduction Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS) is a clinical diagnosis characterized by chronic pain, pressure, or discomfort felt primarily in the bladder and/or pelvic region, accompanied by a sudden urge to urinate and/or frequent urination (pollakiuria) persisting for more than six months, after excluding other etiological causes that could explain the symptoms [ 1 , 2 ]. Diagnosis of IC/BPS is challenging since there is no specific diagnostic test, and its etiopathogenesis has not been fully understood [ 3 , 4 ]. Many hypotheses have been proposed regarding the pathogenesis of IC/BPS [ 5 ]. These hypotheses primarily focus on bladder dysfunction, functional disorders in organs adjacent to the bladder, and neural dysfunction in the pelvic area and refer to epithelial dysfunction, mast cell activation, infection, autoimmunity, cross-sensitivity of pelvic organs, neural upregulation, and genetic and environmental factors while explaining its etiopathogenesis. There are no definitive diagnostic criteria for the disease, making the diagnosis challenging. However, it is essential to rule out other conditions with similar symptoms. Additionally, questionnaires are crucial in diagnosing IC/BPS, assessing symptom severity, and evaluating treatment response [ 6 ]. The O’Leary-Sant Interstitial Cystitis Symptom Index (ICSI) is one of the most important questionnaires. Due to the uncertainties in the etiopathogenesis of the disease and the absence of a specific diagnostic test, diagnosing IC/BPS is challenging, and many patients experience delays in receiving a diagnosis. Therefore, researchers actively seek a disease-specific or adjunct laboratory test to assist in the diagnostic process. IC/BPS is classified among central sensitization syndromes, such as fibromyalgia syndrome (FMS) and restless leg syndrome (RLS). Studies on these conditions, which share a common pathogenesis, have shown that parameters derived from simple, inexpensive, and easily accessible tests such as complete blood count—such as mean platelet volume (MPV), neutrophil/lymphocyte ratio (NLR), and platelet/lymphocyte ratio (PLR)—could be valuable in disease diagnosis [ 7 ]. The lack of prior evaluation of these parameters in IC/BPS diagnosis highlights the need for research in this area. Our study evaluated blood neutrophil, lymphocyte, platelet counts, and MPV, NLR, and PLR values in female patients with IC/BPS. The primary aim was to determine the extent to which these parameters could assist in diagnosing IC/BPS. Our secondary aim was to investigate the relationship between these parameters and disease severity. Materials and methods This study was conducted at the Urology Clinic of Ankara Etlik City Hospital between October 2022 and August 2023. Before initiating the study, approval was obtained from the Institutional Ethical Review Committee of Ankara Etlik City Hospital (03.05 2023– AEŞH-EK1-2023-091). Female patients aged between 18 and 65 who were diagnosed with IC/BPS according to AUA IC/BPS diagnostic criteria and healthy female individuals in the same age range who visited our hospital's family medicine department for a check-up during the same period constituted the target population of this study [ 8 ]. Patients with other internal or surgical diseases or a history of surgery were excluded. Written and verbal consent was obtained from patients and healthy volunteers who agreed to participate. Individuals under 18 or over 65, pregnant women, and male patients were excluded from the study. Additionally, smokers were excluded from the study due to evidence suggesting that smoking increases IC/BPS symptoms [ 9 ]. For each participant, we recorded their age, smoking history, and O’Leary-Sant ICSI scores at the time of diagnosis. We then retrieved the neutrophil, lymphocyte, and platelet counts, as well as the MPV, NLR, and PLR values, from the routine complete blood count analyses performed during the initial admission of the patients and healthy volunteers. These data were recorded in an electronic database for further analysis. The patients and healthy volunteers were compared regarding age, neutrophil, lymphocyte, platelet counts, and MPV, NLR, and PLR values. The correlation between the ages and measured laboratory parameters of the cases within the patient group and their ICSI levels was also analyzed. Statistical analysis The data analysis was performed using the SPSS (Statistical Package for Social Sciences, v25, IBM SPSS Statistics, IBM Corp., Armonk, NY, US) software. The distribution of continuous numerical variables was evaluated for normality using the Kolmogorov-Smirnov test, and the homogeneity of variances was assessed using the Levene test. Descriptive statistics were expressed as means ± standard deviations or medians. Differences in mean values between groups were analyzed using Student’s t-test, while non-parametric continuous numerical variables were evaluated with the Mann-Whitney U test. The strength and significance of correlations between continuous numerical variables were assessed by calculating Spearman’s rank correlation coefficients. The effect of lymphocyte parameters on predicting changes in ICSI scores within the patient group was examined using univariate linear regression analysis by calculating regression coefficients and 95% confidence intervals. After determining the median ICSI score for the patient group, the data were dichotomized as ICSI < median and ICSI ≥ median for comparative analyses. The effect of NLR on ICSI ≥ median was assessed using univariate logistic regression analysis by calculating odds ratios and 95% confidence intervals. Results with a p value lower than 0.05 were considered statistically significant. Results Overall, 50 female patients with IC/BPS (i.e., patient group) and 50 healthy volunteers (i.e., control group) with no systemic diseases or complaints were included (Fig. 1 ). The mean age of the patient group was 46.5 ± 11.6 years, while the mean age of the control group was 47.4 ± 11.1. In the patient group, the neutrophil count, lymphocyte count, platelet count, MPV value, NLR value, and PLR value were 4.38 ± 1.35, 1.78 (1.52–2.20), 267.2 ± 70.6, 10.0 ± 1.3, 2.34 (2.04–2.74), and 138.3 (118.6–181.9), respectively. In the control group, these values were 3.93 ± 1.12, 2.03 (1.68–2.24), 265.2 ± 54.8, 9.8 ± 0.9, 1.85 (1.53–2.18), and 127.4 (109.0–161.6), respectively. The median ICSI score in the patient group was 13.5 (10.0–17.0). Table 1 presents the results of the comparative analysis between the patient and control groups regarding demographic data and clinical characteristics. No statistically significant differences were observed between the groups regarding mean age, neutrophil, lymphocyte, platelet counts, and MPV values (p > 0.05). However, NLR levels were significantly higher in the patient group compared to the control group (p < 0.001) (Fig. 2 ). While PLR levels were also higher in the patient group than in the control group, the difference was insignificant (p = 0.066) (Fig. 3 ). Table 1 Demographic and clinical characteristics of the study groups Control group (n = 50) Patient group (n = 50) p value Age (years) * 47,4 ± 11,1 46,5 ± 11,6 0,718† Neutrophil * 3,93 ± 1,12 4,38 ± 1,35 0,074† Lymphocyte ** 2,03 (1,68 − 2,24) 1,78 (1,52 − 2,20) 0,101‡ Platelet * 265,2 ± 54,8 267,2 ± 70,6 0,878† MPV * 9,8 ± 0,9 10,0 ± 1,3 0,305† NLR ** 1,85 (1,53 − 2,18) 2,34 (2,04 − 2,74) < 0,001 ‡ PLR ** 127,4 (109,0-161,6) 138,3 (118,6-181,9) 0,066‡ ICSI ** N/A 13,5 (10,0–17,0) N/A Descriptive statistics; * mean ± standard deviation or ** shown in the format median (25th percentile-75th percentile). † Student’s t test, ‡ Mann Whitney U test. N/A, not applicable; MPV, mean platelet volume; NLR, neutrophil/lymphocyte ratio; PLR, platelet/lymphocyte ratio; ICSI, Interstitial Cystitis Symptom Index Table 2 shows the results of the correlation analysis between the laboratory parameters and ICSI scores of the participants in the patient group. This analysis found no statistically significant correlation between the ages, neutrophil counts, platelet counts, MPV, NLR, and PLR values, and the ICSI scores in the patient group (p > 0.05). However, a significant positive correlation was detected between lymphocyte levels and ICSI scores (r = 0.415, p = 0.003) (Fig. 4 ). This analysis revealed that each one-unit increase in lymphocyte level was associated with a 2.198-unit increase in the ICSI score (95% Confidence Interval: 0.384–4.013, p = 0.019). Table 2 Results of correlation analysis in the patient group Correlation coefficient p value † Age 0,100 0,488 Neutrophil -0,058 0,691 Lymphocyte 0,415 0,003 Platelet 0,130 0,368 MPV -0,184 0,202 NLR -0,237 0,097 PLR -0,099 0,492 † Spearman's ordinal correlation test. MPV, mean platelet volume; NLR, neutrophil/ lymphocyte ratio; PLR, platelet/lymphocyte ratio Table 3 shows the results of the comparative analysis between the patients with ICSI scores below or above the median concerning age and laboratory parameters. The median ICSI score in the patient group was calculated as 13.5. Subsequently, cases were dichotomized into two groups: ICSI score < 14 and ICSI score ≥ 14. No statistically significant differences were determined between the groups with ICSI score 0.05). However, the lymphocyte level was statistically significantly higher in the group with an ICSI score ≥ 14 compared to the group with an ICSI score < 14 (p = 0.009). Additionally, the NLR value was significantly lower in the former group than in the latter (p = 0.036) (Fig. 5 ). Although each one-unit decrease in NLR was associated with a 2.061-fold increase in having an ICSI score of 14 or higher, this statistic was insignificant (95% Confidence Interval: 0.997–4.258) (p = 0.051). Table 3 Comparative analysis of the patient subgroups with low (i.e, < 14) and high (i.e., ≥ 14) Interstitial Cystitis Symptom Index scores ICSI < 14 (n = 25) ICSI ≥ 14 (n = 25) p value Age (year) * 47,5 ± 10,6 45,6 ± 12,6 0,555† Neutrophil * 4,58 ± 1,33 4,18 ± 1,38 0,300† Lymphocyte ** 1,62 (1,50 − 1,80) 1,90 (1,65 − 2,32) 0,009 ‡ Platelet * 259,7 ± 60,1 274,6 ± 80,3 0,459† MPV * 10,1 ± 1,3 9,9 ± 1,3 0,565† NLR ** 2,44 (2,24 − 3,43) 2,16 (1,62 − 2,56) 0,036 ‡ PLR ** 150,5 (128,3-179,0) 133,6 (103,6-191,5) 0,290‡ Descriptive statistics; * shown as mean ± standard deviation or ** median (25th percentile-75th percentile). † Student’s t test, ‡ Mann Whitney U test. N/A, Not applicable; MPV, mean platelet volume; NLR, neutrophil/lymphocyte ratio; PLR, platelet/lymphocyte ratio; ICSI, Interstitial Cystitis Symptom Index Discussion Interstitial Cystitis/Bladder Pain Syndrome is a chronic condition originating from the bladder, characterized by discomfort and pain in the suprapubic region [ 1 ]. Although there are no studies on the epidemiology of IC/BPS in our country, some studies have examined its epidemiology worldwide. In an extensive population-based survey conducted in the United States, 2.7% of women and 1.9% of men met the specified criteria for IC/BPS. It is more commonly observed in women aged 50–59 and men aged 56–74. Epidemiological studies report a female-to-male ratio ranging from 5:1 to 10:1 [ 4 , 5 ]. The IC/BPS symptoms restrict patients' daily activities and lead to a decline in quality of life. The International Association for the Study of Pain defines central sensitization as the state of nociceptive neurons in the central nervous system responding excessively to standard or subthreshold afferent inputs [ 10 ]. Hypersensitized spinal neurons have lower firing thresholds compared to healthy neurons. Increased sensitivity leads to the perception of pain from non-painful stimuli (allodynia) and a heightened pain response to painful stimuli (hyperalgesia). Significant visceral hypersensitivity can affect every organ system, causing unbearable discomfort. This condition may result from causes such as trauma, repeated pain stimuli, or inflammation. Examples of central sensitization syndromes include FMS, migraines, IC/BPS, RLS, irritable bowel syndrome (IBS), and chronic fatigue syndrome. Fibromyalgia syndrome is the most extensively studied disease among central sensitization syndromes [ 11 ]. It has been suggested that inflammatory and immunological processes significantly affect its pathogenesis. Therefore, researchers analyzed the NLR and PLR values in patients with FMS and compared them with healthy controls [ 12 ]. These studies concluded that NLR and PLR were beneficial tools in the diagnostic management of FMS. Also, it is known that these analyses are easy, inexpensive, and widely available. 7 Based on the shared pathogenesis of central sensitization, we aimed to evaluate neutrophil-to-lymphocyte counts and MPV, NLR, and PLR values in patients with IC/BPS and investigate their relationship with disease severity. In another study on FMS, neutrophil counts were found to be higher in the control group compared to the patient group, and it was demonstrated that this parameter could serve as an adjunct diagnostic tool for FMS [ 13 ]. In the same study, lymphocyte counts were comparable between the two groups, as observed in our study.In our study, although neutrophil counts were higher in the patient group than in the control group, the difference was not statistically significant (p = 0.074). On the other hand, in our study, no statistically significant difference in PLR was detected between the groups. Our analysis also included comparisons in terms of NLR. While Ilgun et al. and Karabas et al. did not find significant results regarding NLR in their studies involving FMS patients, our study identified a statistically significant increase in NLR in the patient group compared to the control group (p < 0.001) [ 7 , 13 ]. Ilgun et al. found no statistically significant differences between patient and control groups regarding platelet counts and MPV values [ 7 ]. Similarly, in our study, no significant differences were observed between the two groups regarding platelet and MPV values (p = 0.305). In the etiopathogenesis of RLS, as with other central sensitization syndromes, the role of inflammatory processes has not been fully elucidated [ 14 ]. In a study evaluating the NLR in these patients, similar to ours, NLR was found to be significantly higher in the patient group compared to the control group [ 15 ]. In another study, both NLR and the PLR were assessed in RLS patients, and no significant differences were found between the patient and control groups [ 16 ]. A meta-analysis reported higher NLR values in patient groups than in control groups, but this difference was not statistically significant [ 17 ]. The authors concluded that further studies are needed to confirm the potential role of inflammatory factors in the pathogenesis of RLS. Several studies evaluated the relationship between inflammatory markers and IBS, as it is one of the central sensitization syndromes [ 18 , 19 ]. In a study by Aktas et al., similar to our findings, the NLR was significantly higher in the IBS patient group than the control group [ 18 ]. However, unlike our study, the PLR was also significantly higher in the former group than the latter. 18 On the other hand, Guven et al. reported that both NLR and PLR levels were significantly elevated in the IBS patient group and demonstrated that NLR and PLR could serve as independent predictors of IBS [ 19 ]. It is widely accepted that systemic inflammatory response also plays a significant role in the development and progression of cancer [ 20 ]. In a study by Kulaksızoğlu et al., NLR and PLR values were elevated in colorectal cancer patients, and these parameters were considered important biomarkers for detecting the disease [ 21 ]. Similarly, another study comparing patients with renal cell carcinoma to those with benign renal masses reported higher NLR levels in patients with renal cell carcinoma [ 22 ]. This study also suggested that NLR could be one of the parameters used to predict the malignancy potential of renal masses. Although the diagnostic role of inflammatory parameters such as neutrophil, lymphocyte, platelet, MPV, NLR, and PLR has been investigated in several diseases associated with central sensitization, to the best of our knowledge, no study has evaluated the value of these parameters in the diagnostic management of IC/BPS or their relationship with disease severity in these patients. Our study found no statistically significant correlation between the neutrophil, platelet, MPV, NLR, and PLR values and ICSI scores of the IC/BPS patients. However, we determined that as lymphocyte levels increased, ICSI scores increased significantly. Additionally, lymphocyte counts were significantly higher, and NLR values were significantly lower in the group with ICSI scores ≥ 14 than those with an ICSI score < 14. These findings suggest lymphocyte counts may reflect disease severity in IC/BPS patients. However, further research is needed to delineate this relationship better. Limitations Our study has some limitations that must be considered when evaluating its findings. First, since it is the first study investigating this topic, its findings need validation in randomized controlled multicenter studies, including more extensive patient series. Second, no male patients were included in our series. Therefore, the results of this study cannot be generalized to the general population. Third, although the absence of comorbidities was an inclusion criterion in our study, no objective assessments were performed to exclude potential comorbidities in the patient and healthy control groups. We solely relied on patient declarations instead. Conclusion Complete blood counts are routinely performed during the diagnostic management of IC/BPS patients to rule out urinary tract infections. This cheap and readily available test reveals the neutrophil, lymphocyte, platelet counts, and MPV, NLR, and PLR values can be easily calculated. Our study found that NLR was higher in IC/BPS patients than in healthy individuals and that lymphocyte counts might be associated with disease severity. Therefore, despite the aforementioned weaknesses, our findings can be highly beneficial in the diagnostic management of IC/BPS since it is a condition without a specific pathognomonic laboratory test. Also, they could provide clinicians with valuable insights regarding disease severity and aid in treatment planning. However, our findings need further validation before incorporating the relevant tests into clinical practice. Declarations Disclosure of interest: There is no competing interest. Funding Statement: This study has received no financial support. Author Contribution M.A. and S.C.:wrote the main manuscript text; M.A., A.E.D. and F.S.: Data collection and data analysis; M.A. and A.E.D.: prepared tables and figures and 5. All authors reviewed the manuscript. Acknowledgments: None. References Hanno PM. Bladder pain Syndrome (ınterstitial Cystitis) and Related Disorders., in A. j. Wein LRK, A. W. partin, editor: Campbell-Walsh Urology, Elsevier, 2016, pp pp. 334–370. https://citeseerx.ist.psu.edu/document?repid=rep1&type=pdf&doi=9bc278a6e6cbb52f799a19b1557e40efbe57fe2e Malde S, Palmisani S, Al-Kaisy A, Sahai A. Guideline of guidelines: bladder pain syndrome. Br J Urol Int. 2018;122(5):729–43. https://doi.org/10.1111/bju.14399 . Berry SH, Elliott MN, Suttorp M, Bogart LM, Stoto MA, Eggers P, et al. Prevalence of symptoms of bladder pain syndrome/interstitial cystitis among adult females in the United States. J Urol. 2011;186(2):540–4. https://doi.org/10.1016/j.juro.2011.03.132 . 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Cite Share Download PDF Status: Published Journal Publication published 19 Feb, 2026 Read the published version in BMC Urology → Version 1 posted Editorial decision: Revision requested 13 Nov, 2025 Reviewers agreed at journal 12 Nov, 2025 Reviews received at journal 07 Nov, 2025 Reviewers agreed at journal 07 Nov, 2025 Reviewers agreed at journal 03 Nov, 2025 Reviews received at journal 03 Nov, 2025 Reviewers agreed at journal 03 Nov, 2025 Reviewers agreed at journal 03 Nov, 2025 Reviewers invited by journal 03 Nov, 2025 Editor invited by journal 20 Oct, 2025 Editor assigned by journal 16 Oct, 2025 Submission checks completed at journal 16 Oct, 2025 First submitted to journal 05 Oct, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7785569","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":544094903,"identity":"f8f21ae1-1318-4b42-872c-f0b0f6687081","order_by":0,"name":"Mehmet Altan","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA5UlEQVRIiWNgGAWjYPACCxDB+ABI8PARpeEAg4QEkGI2AGlhI0ULG4hgIKhFt7078fGHGok6/tm9xyq/5tjJsDEwP3x0A48WszNnNxscOCYhIXHnXNpt2W3JQIexGRvn4NNyI3ebxAE2oMNu5JjdltzGDNTCwyaNV8v9t9t/HPgnISEP1FIsua2eCC03eLcxHGyTkDAAamH8uO0wEVrO5G6WONsnIbnxRo6xNOO24zxszIT8cvzsxg8V32z45W7kGH78ua3anp+9+eFjfFpQADMPmCRWOQgw/iBF9SgYBaNgFIwYAAD+2kd49p9MCgAAAABJRU5ErkJggg==","orcid":"","institution":"Sorgun State Hospital","correspondingAuthor":true,"prefix":"","firstName":"Mehmet","middleName":"","lastName":"Altan","suffix":""},{"id":544094904,"identity":"2341b59e-3d1d-42f6-a72d-b48bf8097e8a","order_by":1,"name":"Ahmet Emin Dogan","email":"","orcid":"","institution":"Etlik City Hospital","correspondingAuthor":false,"prefix":"","firstName":"Ahmet","middleName":"Emin","lastName":"Dogan","suffix":""},{"id":544094905,"identity":"9c90b7d2-a4e2-45ca-b82c-e830f4cf9958","order_by":2,"name":"Fatih Sandikci","email":"","orcid":"","institution":"Etlik City Hospital","correspondingAuthor":false,"prefix":"","firstName":"Fatih","middleName":"","lastName":"Sandikci","suffix":""},{"id":544094906,"identity":"2a5b9e86-6cb9-4b63-9169-9b40f397f75a","order_by":3,"name":"Sertac Cimen","email":"","orcid":"","institution":"Etlik City Hospital","correspondingAuthor":false,"prefix":"","firstName":"Sertac","middleName":"","lastName":"Cimen","suffix":""}],"badges":[],"createdAt":"2025-10-05 15:38:07","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7785569/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7785569/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12894-026-02091-8","type":"published","date":"2026-02-19T15:58:14+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":95877111,"identity":"5cb4f006-a6d8-4ca8-9e2a-8fcb1294088c","added_by":"auto","created_at":"2025-11-14 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01:41:12","extension":"xml","order_by":19,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":78721,"visible":true,"origin":"","legend":"","description":"","filename":"775523b4ffe548a3b759289a2907ee7c1structuring.xml","url":"https://assets-eu.researchsquare.com/files/rs-7785569/v1/f9acd5f4630a2a94ec9445ea.xml"},{"id":95877123,"identity":"97688da7-9e6c-42a6-a9ed-235f497db774","added_by":"auto","created_at":"2025-11-14 01:41:12","extension":"html","order_by":20,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":85702,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-7785569/v1/e26459f28e39fb9aa9935e62.html"},{"id":95877105,"identity":"2c1dbe43-47be-4acf-9f35-0d40a2ebc2df","added_by":"auto","created_at":"2025-11-14 01:41:12","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":14505,"visible":true,"origin":"","legend":"\u003cp\u003eStudy flow diagram\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-7785569/v1/1c6700d672d8abf7b033e2e0.png"},{"id":95877107,"identity":"138505f9-9cca-405a-8dde-bad8571ea392","added_by":"auto","created_at":"2025-11-14 01:41:12","extension":"jpeg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":42250,"visible":true,"origin":"","legend":"\u003cp\u003eBox-plot graph of neutrophil/lymphocyte ratio levels: The lines in the center of each box represent the median neutrophil/lymphocyte ratio levels. The lower and upper edges of the boxes correspond to the 25\u003csup\u003eth\u003c/sup\u003e and 75\u003csup\u003eth\u003c/sup\u003e percentile values of the neutrophil/lymphocyte ratio levels. The vertical sections extending downward and upward from the lower and upper edges of the boxes represent the minimum and maximum values, respectively. NLR, neutrophil/lymphocyte ratio\u003c/p\u003e","description":"","filename":"floatimage2.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7785569/v1/845d41f43733fefd9d228392.jpeg"},{"id":95877108,"identity":"afb305eb-4453-4c06-b3a5-cd0b76ccf9d3","added_by":"auto","created_at":"2025-11-14 01:41:12","extension":"jpeg","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":37141,"visible":true,"origin":"","legend":"\u003cp\u003eBox-plot graph of platelet/lymphocyte ratio levels: The lines in the center of each box represent the median PLR levels. The lower and upper edges of the boxes correspond to the 25\u003csup\u003eth\u003c/sup\u003e and 75\u003csup\u003eth\u003c/sup\u003e percentile values of the PLR levels. The vertical sections extending downward and upward from the lower and upper edges of the boxes represent the minimum and maximum values, respectively. PLR, platelet/lymphocyte ratio\u003c/p\u003e","description":"","filename":"floatimage3.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7785569/v1/d45330c771ac443b406d921d.jpeg"},{"id":96241598,"identity":"43e774f1-e7d7-4920-816b-22c6cfd30eb7","added_by":"auto","created_at":"2025-11-19 07:11:07","extension":"jpeg","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":53211,"visible":true,"origin":"","legend":"\u003cp\u003eDistribution of lymphocyte counts and Interstitial Cystitis Symptom Indexscores in the patient group: Each one-unit increase in lymphocyte level increased the ICSI score by 2.198 units (95% Confidence Interval: 0.384–4.013, p=0.019). ICSI, Interstitial Cystitis Symptom Index\u003c/p\u003e","description":"","filename":"floatimage4.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7785569/v1/7fa60f4aa686759b9a359010.jpeg"},{"id":96241127,"identity":"574f47ff-2a5e-49c5-aa76-d94892e4fb39","added_by":"auto","created_at":"2025-11-19 07:10:16","extension":"jpeg","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":41824,"visible":true,"origin":"","legend":"\u003cp\u003eBox-plot graph of NLR measurements of cases according to ICSI levels in the patient group: The lines in the middle of each box represent the median NLR levels, while the lower and upper edges of the boxes correspond to the 25\u003csup\u003eth\u003c/sup\u003e and 75\u003csup\u003eth\u003c/sup\u003e percentile of the NLR measurements, respectively. The vertical lines extending downward and upward from the lower and upper edges of the boxes represent the minimum and maximum values, respectively. NLR, neutrophil/lymphocyte ratio; ICSI, Interstitial Cystitis Symptom Index\u003c/p\u003e","description":"","filename":"floatimage5.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7785569/v1/cd3022a1c1b5232e67e03335.jpeg"},{"id":103252852,"identity":"fc8e65c3-e4e4-46be-b2dc-14bda8a383b7","added_by":"auto","created_at":"2026-02-23 16:16:21","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":728857,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7785569/v1/282fd382-7fec-4f57-a11e-c912670d57ee.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Investigation of the hematological parameters in women with Interstitial Cystitis/Bladder Pain Syndrome and their relationship with disease severity","fulltext":[{"header":"Introduction","content":"\u003cp\u003eInterstitial Cystitis/Bladder Pain Syndrome (IC/BPS) is a clinical diagnosis characterized by chronic pain, pressure, or discomfort felt primarily in the bladder and/or pelvic region, accompanied by a sudden urge to urinate and/or frequent urination (pollakiuria) persisting for more than six months, after excluding other etiological causes that could explain the symptoms [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eDiagnosis of IC/BPS is challenging since there is no specific diagnostic test, and its etiopathogenesis has not been fully understood [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Many hypotheses have been proposed regarding the pathogenesis of IC/BPS [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. These hypotheses primarily focus on bladder dysfunction, functional disorders in organs adjacent to the bladder, and neural dysfunction in the pelvic area and refer to epithelial dysfunction, mast cell activation, infection, autoimmunity, cross-sensitivity of pelvic organs, neural upregulation, and genetic and environmental factors while explaining its etiopathogenesis.\u003c/p\u003e\u003cp\u003eThere are no definitive diagnostic criteria for the disease, making the diagnosis challenging. However, it is essential to rule out other conditions with similar symptoms. Additionally, questionnaires are crucial in diagnosing IC/BPS, assessing symptom severity, and evaluating treatment response [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. The O\u0026rsquo;Leary-Sant Interstitial Cystitis Symptom Index (ICSI) is one of the most important questionnaires.\u003c/p\u003e\u003cp\u003eDue to the uncertainties in the etiopathogenesis of the disease and the absence of a specific diagnostic test, diagnosing IC/BPS is challenging, and many patients experience delays in receiving a diagnosis. Therefore, researchers actively seek a disease-specific or adjunct laboratory test to assist in the diagnostic process. IC/BPS is classified among central sensitization syndromes, such as fibromyalgia syndrome (FMS) and restless leg syndrome (RLS). Studies on these conditions, which share a common pathogenesis, have shown that parameters derived from simple, inexpensive, and easily accessible tests such as complete blood count\u0026mdash;such as mean platelet volume (MPV), neutrophil/lymphocyte ratio (NLR), and platelet/lymphocyte ratio (PLR)\u0026mdash;could be valuable in disease diagnosis [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. The lack of prior evaluation of these parameters in IC/BPS diagnosis highlights the need for research in this area. Our study evaluated blood neutrophil, lymphocyte, platelet counts, and MPV, NLR, and PLR values in female patients with IC/BPS. The primary aim was to determine the extent to which these parameters could assist in diagnosing IC/BPS. Our secondary aim was to investigate the relationship between these parameters and disease severity.\u003c/p\u003e"},{"header":"Materials and methods","content":"\u003cp\u003eThis study was conducted at the Urology Clinic of Ankara Etlik City Hospital between October 2022 and August 2023. Before initiating the study, approval was obtained from the Institutional Ethical Review Committee of Ankara Etlik City Hospital (03.05 2023\u0026ndash; AEŞH-EK1-2023-091).\u003c/p\u003e\u003cp\u003eFemale patients aged between 18 and 65 who were diagnosed with IC/BPS according to AUA IC/BPS diagnostic criteria and healthy female individuals in the same age range who visited our hospital's family medicine department for a check-up during the same period constituted the target population of this study [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Patients with other internal or surgical diseases or a history of surgery were excluded. Written and verbal consent was obtained from patients and healthy volunteers who agreed to participate. Individuals under 18 or over 65, pregnant women, and male patients were excluded from the study. Additionally, smokers were excluded from the study due to evidence suggesting that smoking increases IC/BPS symptoms [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eFor each participant, we recorded their age, smoking history, and O\u0026rsquo;Leary-Sant ICSI scores at the time of diagnosis. We then retrieved the neutrophil, lymphocyte, and platelet counts, as well as the MPV, NLR, and PLR values, from the routine complete blood count analyses performed during the initial admission of the patients and healthy volunteers. These data were recorded in an electronic database for further analysis.\u003c/p\u003e\u003cp\u003eThe patients and healthy volunteers were compared regarding age, neutrophil, lymphocyte, platelet counts, and MPV, NLR, and PLR values. The correlation between the ages and measured laboratory parameters of the cases within the patient group and their ICSI levels was also analyzed.\u003c/p\u003e\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003eStatistical analysis\u003c/h2\u003e\u003cp\u003eThe data analysis was performed using the SPSS (Statistical Package for Social Sciences, v25, IBM SPSS Statistics, IBM Corp., Armonk, NY, US) software. The distribution of continuous numerical variables was evaluated for normality using the Kolmogorov-Smirnov test, and the homogeneity of variances was assessed using the Levene test. Descriptive statistics were expressed as means\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviations or medians. Differences in mean values between groups were analyzed using Student\u0026rsquo;s t-test, while non-parametric continuous numerical variables were evaluated with the Mann-Whitney U test. The strength and significance of correlations between continuous numerical variables were assessed by calculating Spearman\u0026rsquo;s rank correlation coefficients. The effect of lymphocyte parameters on predicting changes in ICSI scores within the patient group was examined using univariate linear regression analysis by calculating regression coefficients and 95% confidence intervals. After determining the median ICSI score for the patient group, the data were dichotomized as ICSI\u0026thinsp;\u0026lt;\u0026thinsp;median and ICSI\u0026thinsp;\u0026ge;\u0026thinsp;median for comparative analyses. The effect of NLR on ICSI\u0026thinsp;\u0026ge;\u0026thinsp;median was assessed using univariate logistic regression analysis by calculating odds ratios and 95% confidence intervals. Results with a p value lower than 0.05 were considered statistically significant.\u003c/p\u003e\u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eOverall, 50 female patients with IC/BPS (i.e., patient group) and 50 healthy volunteers (i.e., control group) with no systemic diseases or complaints were included (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eThe mean age of the patient group was 46.5\u0026thinsp;\u0026plusmn;\u0026thinsp;11.6 years, while the mean age of the control group was 47.4\u0026thinsp;\u0026plusmn;\u0026thinsp;11.1. In the patient group, the neutrophil count, lymphocyte count, platelet count, MPV value, NLR value, and PLR value were 4.38\u0026thinsp;\u0026plusmn;\u0026thinsp;1.35, 1.78 (1.52\u0026ndash;2.20), 267.2\u0026thinsp;\u0026plusmn;\u0026thinsp;70.6, 10.0\u0026thinsp;\u0026plusmn;\u0026thinsp;1.3, 2.34 (2.04\u0026ndash;2.74), and 138.3 (118.6\u0026ndash;181.9), respectively. In the control group, these values were 3.93\u0026thinsp;\u0026plusmn;\u0026thinsp;1.12, 2.03 (1.68\u0026ndash;2.24), 265.2\u0026thinsp;\u0026plusmn;\u0026thinsp;54.8, 9.8\u0026thinsp;\u0026plusmn;\u0026thinsp;0.9, 1.85 (1.53\u0026ndash;2.18), and 127.4 (109.0\u0026ndash;161.6), respectively. The median ICSI score in the patient group was 13.5 (10.0\u0026ndash;17.0).\u003c/p\u003e\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e presents the results of the comparative analysis between the patient and control groups regarding demographic data and clinical characteristics. No statistically significant differences were observed between the groups regarding mean age, neutrophil, lymphocyte, platelet counts, and MPV values (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05). However, NLR levels were significantly higher in the patient group compared to the control group (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). While PLR levels were also higher in the patient group than in the control group, the difference was insignificant (p\u0026thinsp;=\u0026thinsp;0.066) (Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eDemographic and clinical characteristics of the study groups\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eControl group (n\u0026thinsp;=\u0026thinsp;50)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003ePatient group (n\u0026thinsp;=\u0026thinsp;50)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003ep value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAge (years) *\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e47,4\u0026thinsp;\u0026plusmn;\u0026thinsp;11,1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e46,5\u0026thinsp;\u0026plusmn;\u0026thinsp;11,6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0,718\u0026dagger;\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNeutrophil *\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e3,93\u0026thinsp;\u0026plusmn;\u0026thinsp;1,12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4,38\u0026thinsp;\u0026plusmn;\u0026thinsp;1,35\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0,074\u0026dagger;\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLymphocyte **\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2,03 (1,68\u0026thinsp;\u0026minus;\u0026thinsp;2,24)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1,78 (1,52\u0026thinsp;\u0026minus;\u0026thinsp;2,20)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0,101\u0026Dagger;\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePlatelet *\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e265,2\u0026thinsp;\u0026plusmn;\u0026thinsp;54,8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e267,2\u0026thinsp;\u0026plusmn;\u0026thinsp;70,6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0,878\u0026dagger;\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMPV *\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e9,8\u0026thinsp;\u0026plusmn;\u0026thinsp;0,9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e10,0\u0026thinsp;\u0026plusmn;\u0026thinsp;1,3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0,305\u0026dagger;\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNLR **\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1,85 (1,53\u0026thinsp;\u0026minus;\u0026thinsp;2,18)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2,34 (2,04\u0026thinsp;\u0026minus;\u0026thinsp;2,74)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0,001\u003c/b\u003e\u0026Dagger;\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePLR **\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e127,4 (109,0-161,6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e138,3 (118,6-181,9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0,066\u0026Dagger;\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eICSI **\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eN/A\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e13,5 (10,0\u0026ndash;17,0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eN/A\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eDescriptive statistics; * mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation or ** shown in the format median (25th percentile-75th percentile). \u0026dagger; Student\u0026rsquo;s t test, \u0026Dagger; Mann Whitney U test. N/A, not applicable; MPV, mean platelet volume; NLR, neutrophil/lymphocyte ratio; PLR, platelet/lymphocyte ratio; ICSI, Interstitial Cystitis Symptom Index\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e shows the results of the correlation analysis between the laboratory parameters and ICSI scores of the participants in the patient group. This analysis found no statistically significant correlation between the ages, neutrophil counts, platelet counts, MPV, NLR, and PLR values, and the ICSI scores in the patient group (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05). However, a significant positive correlation was detected between lymphocyte levels and ICSI scores (r\u0026thinsp;=\u0026thinsp;0.415, p\u0026thinsp;=\u0026thinsp;0.003) (Fig.\u0026nbsp;\u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e4\u003c/span\u003e). This analysis revealed that each one-unit increase in lymphocyte level was associated with a 2.198-unit increase in the ICSI score (95% Confidence Interval: 0.384\u0026ndash;4.013, p\u0026thinsp;=\u0026thinsp;0.019).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eResults of correlation analysis in the patient group\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCorrelation coefficient\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003ep value \u0026dagger;\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAge\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0,100\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0,488\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNeutrophil\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-0,058\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0,691\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLymphocyte\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0,415\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003e0,003\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePlatelet\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0,130\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0,368\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMPV\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-0,184\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0,202\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNLR\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-0,237\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0,097\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePLR\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-0,099\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0,492\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u0026dagger; Spearman's ordinal correlation test. MPV, mean platelet volume; NLR, neutrophil/ lymphocyte ratio; PLR, platelet/lymphocyte ratio\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e shows the results of the comparative analysis between the patients with ICSI scores below or above the median concerning age and laboratory parameters. The median ICSI score in the patient group was calculated as 13.5. Subsequently, cases were dichotomized into two groups: ICSI score\u0026thinsp;\u0026lt;\u0026thinsp;14 and ICSI score\u0026thinsp;\u0026ge;\u0026thinsp;14. No statistically significant differences were determined between the groups with ICSI score\u0026thinsp;\u0026lt;\u0026thinsp;14 and ICSI score\u0026thinsp;\u0026ge;\u0026thinsp;14 in terms of mean age, neutrophil count, platelet count, MPV, and PLR values (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05). However, the lymphocyte level was statistically significantly higher in the group with an ICSI score\u0026thinsp;\u0026ge;\u0026thinsp;14 compared to the group with an ICSI score\u0026thinsp;\u0026lt;\u0026thinsp;14 (p\u0026thinsp;=\u0026thinsp;0.009). Additionally, the NLR value was significantly lower in the former group than in the latter (p\u0026thinsp;=\u0026thinsp;0.036) (Fig.\u0026nbsp;\u003cspan refid=\"Fig5\" class=\"InternalRef\"\u003e5\u003c/span\u003e). Although each one-unit decrease in NLR was associated with a 2.061-fold increase in having an ICSI score of 14 or higher, this statistic was insignificant (95% Confidence Interval: 0.997\u0026ndash;4.258) (p\u0026thinsp;=\u0026thinsp;0.051).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eComparative analysis of the patient subgroups with low (i.e, \u0026lt;\u0026thinsp;14) and high (i.e., \u0026ge;\u0026thinsp;14) Interstitial Cystitis Symptom Index scores\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eICSI\u0026thinsp;\u0026lt;\u0026thinsp;14 (n\u0026thinsp;=\u0026thinsp;25)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eICSI\u0026thinsp;\u0026ge;\u0026thinsp;14 (n\u0026thinsp;=\u0026thinsp;25)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003ep value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAge (year) *\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e47,5\u0026thinsp;\u0026plusmn;\u0026thinsp;10,6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e45,6\u0026thinsp;\u0026plusmn;\u0026thinsp;12,6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0,555\u0026dagger;\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNeutrophil *\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e4,58\u0026thinsp;\u0026plusmn;\u0026thinsp;1,33\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4,18\u0026thinsp;\u0026plusmn;\u0026thinsp;1,38\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0,300\u0026dagger;\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLymphocyte **\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1,62 (1,50\u0026thinsp;\u0026minus;\u0026thinsp;1,80)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1,90 (1,65\u0026thinsp;\u0026minus;\u0026thinsp;2,32)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e0,009\u003c/b\u003e\u0026Dagger;\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePlatelet *\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e259,7\u0026thinsp;\u0026plusmn;\u0026thinsp;60,1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e274,6\u0026thinsp;\u0026plusmn;\u0026thinsp;80,3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0,459\u0026dagger;\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMPV *\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e10,1\u0026thinsp;\u0026plusmn;\u0026thinsp;1,3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e9,9\u0026thinsp;\u0026plusmn;\u0026thinsp;1,3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0,565\u0026dagger;\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNLR **\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2,44 (2,24\u0026thinsp;\u0026minus;\u0026thinsp;3,43)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2,16 (1,62\u0026thinsp;\u0026minus;\u0026thinsp;2,56)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e0,036\u003c/b\u003e\u0026Dagger;\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePLR **\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e150,5 (128,3-179,0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e133,6 (103,6-191,5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0,290\u0026Dagger;\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eDescriptive statistics; * shown as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation or ** median (25th percentile-75th percentile). \u0026dagger; Student\u0026rsquo;s t test, \u0026Dagger; Mann Whitney U test. N/A, Not applicable; MPV, mean platelet volume; NLR, neutrophil/lymphocyte ratio; PLR, platelet/lymphocyte ratio; ICSI, Interstitial Cystitis Symptom Index\u003c/p\u003e\u003cp\u003e\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eInterstitial Cystitis/Bladder Pain Syndrome is a chronic condition originating from the bladder, characterized by discomfort and pain in the suprapubic region [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Although there are no studies on the epidemiology of IC/BPS in our country, some studies have examined its epidemiology worldwide. In an extensive population-based survey conducted in the United States, 2.7% of women and 1.9% of men met the specified criteria for IC/BPS. It is more commonly observed in women aged 50\u0026ndash;59 and men aged 56\u0026ndash;74. Epidemiological studies report a female-to-male ratio ranging from 5:1 to 10:1 [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. The IC/BPS symptoms restrict patients' daily activities and lead to a decline in quality of life.\u003c/p\u003e\u003cp\u003eThe International Association for the Study of Pain defines central sensitization as the state of nociceptive neurons in the central nervous system responding excessively to standard or subthreshold afferent inputs [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Hypersensitized spinal neurons have lower firing thresholds compared to healthy neurons. Increased sensitivity leads to the perception of pain from non-painful stimuli (allodynia) and a heightened pain response to painful stimuli (hyperalgesia). Significant visceral hypersensitivity can affect every organ system, causing unbearable discomfort. This condition may result from causes such as trauma, repeated pain stimuli, or inflammation. Examples of central sensitization syndromes include FMS, migraines, IC/BPS, RLS, irritable bowel syndrome (IBS), and chronic fatigue syndrome.\u003c/p\u003e\u003cp\u003eFibromyalgia syndrome is the most extensively studied disease among central sensitization syndromes [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. It has been suggested that inflammatory and immunological processes significantly affect its pathogenesis. Therefore, researchers analyzed the NLR and PLR values in patients with FMS and compared them with healthy controls [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. These studies concluded that NLR and PLR were beneficial tools in the diagnostic management of FMS. Also, it is known that these analyses are easy, inexpensive, and widely available.\u003csup\u003e7\u003c/sup\u003e Based on the shared pathogenesis of central sensitization, we aimed to evaluate neutrophil-to-lymphocyte counts and MPV, NLR, and PLR values in patients with IC/BPS and investigate their relationship with disease severity.\u003c/p\u003e\u003cp\u003eIn another study on FMS, neutrophil counts were found to be higher in the control group compared to the patient group, and it was demonstrated that this parameter could serve as an adjunct diagnostic tool for FMS [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. In the same study, lymphocyte counts were comparable between the two groups, as observed in our study.In our study, although neutrophil counts were higher in the patient group than in the control group, the difference was not statistically significant (p\u0026thinsp;=\u0026thinsp;0.074). On the other hand, in our study, no statistically significant difference in PLR was detected between the groups.\u003c/p\u003e\u003cp\u003eOur analysis also included comparisons in terms of NLR. While Ilgun et al. and Karabas et al. did not find significant results regarding NLR in their studies involving FMS patients, our study identified a statistically significant increase in NLR in the patient group compared to the control group (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. Ilgun et al. found no statistically significant differences between patient and control groups regarding platelet counts and MPV values [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Similarly, in our study, no significant differences were observed between the two groups regarding platelet and MPV values (p\u0026thinsp;=\u0026thinsp;0.305).\u003c/p\u003e\u003cp\u003eIn the etiopathogenesis of RLS, as with other central sensitization syndromes, the role of inflammatory processes has not been fully elucidated [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. In a study evaluating the NLR in these patients, similar to ours, NLR was found to be significantly higher in the patient group compared to the control group [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. In another study, both NLR and the PLR were assessed in RLS patients, and no significant differences were found between the patient and control groups [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. A meta-analysis reported higher NLR values in patient groups than in control groups, but this difference was not statistically significant [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. The authors concluded that further studies are needed to confirm the potential role of inflammatory factors in the pathogenesis of RLS.\u003c/p\u003e\u003cp\u003eSeveral studies evaluated the relationship between inflammatory markers and IBS, as it is one of the central sensitization syndromes [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. In a study by Aktas et al., similar to our findings, the NLR was significantly higher in the IBS patient group than the control group [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. However, unlike our study, the PLR was also significantly higher in the former group than the latter.\u003csup\u003e18\u003c/sup\u003e On the other hand, Guven et al. reported that both NLR and PLR levels were significantly elevated in the IBS patient group and demonstrated that NLR and PLR could serve as independent predictors of IBS [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eIt is widely accepted that systemic inflammatory response also plays a significant role in the development and progression of cancer [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. In a study by Kulaksızoğlu et al., NLR and PLR values were elevated in colorectal cancer patients, and these parameters were considered important biomarkers for detecting the disease [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. Similarly, another study comparing patients with renal cell carcinoma to those with benign renal masses reported higher NLR levels in patients with renal cell carcinoma [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. This study also suggested that NLR could be one of the parameters used to predict the malignancy potential of renal masses.\u003c/p\u003e\u003cp\u003eAlthough the diagnostic role of inflammatory parameters such as neutrophil, lymphocyte, platelet, MPV, NLR, and PLR has been investigated in several diseases associated with central sensitization, to the best of our knowledge, no study has evaluated the value of these parameters in the diagnostic management of IC/BPS or their relationship with disease severity in these patients. Our study found no statistically significant correlation between the neutrophil, platelet, MPV, NLR, and PLR values and ICSI scores of the IC/BPS patients. However, we determined that as lymphocyte levels increased, ICSI scores increased significantly. Additionally, lymphocyte counts were significantly higher, and NLR values were significantly lower in the group with ICSI scores\u0026thinsp;\u0026ge;\u0026thinsp;14 than those with an ICSI score\u0026thinsp;\u0026lt;\u0026thinsp;14. These findings suggest lymphocyte counts may reflect disease severity in IC/BPS patients. However, further research is needed to delineate this relationship better.\u003c/p\u003e"},{"header":"Limitations","content":"\u003cp\u003eOur study has some limitations that must be considered when evaluating its findings. First, since it is the first study investigating this topic, its findings need validation in randomized controlled multicenter studies, including more extensive patient series. Second, no male patients were included in our series. Therefore, the results of this study cannot be generalized to the general population. Third, although the absence of comorbidities was an inclusion criterion in our study, no objective assessments were performed to exclude potential comorbidities in the patient and healthy control groups. We solely relied on patient declarations instead.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eComplete blood counts are routinely performed during the diagnostic management of IC/BPS patients to rule out urinary tract infections. This cheap and readily available test reveals the neutrophil, lymphocyte, platelet counts, and MPV, NLR, and PLR values can be easily calculated. Our study found that NLR was higher in IC/BPS patients than in healthy individuals and that lymphocyte counts might be associated with disease severity. Therefore, despite the aforementioned weaknesses, our findings can be highly beneficial in the diagnostic management of IC/BPS since it is a condition without a specific pathognomonic laboratory test. Also, they could provide clinicians with valuable insights regarding disease severity and aid in treatment planning. However, our findings need further validation before incorporating the relevant tests into clinical practice.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003ch2\u003eDisclosure of interest:\u003c/h2\u003e\u003cp\u003eThere is no competing interest.\u003c/p\u003e\u003c/p\u003e\u003ch2\u003eFunding Statement:\u003c/h2\u003e\u003cp\u003eThis study has received no financial support.\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eM.A. and S.C.:wrote the main manuscript text; M.A., A.E.D. and F.S.: Data collection and data analysis; M.A. and A.E.D.: prepared tables and figures and 5. All authors reviewed the manuscript.\u003c/p\u003e\u003ch2\u003eAcknowledgments:\u003c/h2\u003e\u003cp\u003eNone.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eHanno PM. 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Folia Med (Plovdiv). 2018;60(4):553\u0026ndash;7. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.academia.edu/download/112359274/folmed-2018-0037.pdf\u003c/span\u003e\u003cspan address=\"https://www.academia.edu/download/112359274/folmed-2018-0037.pdf\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-urology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"buro","sideBox":"Learn more about [BMC Urology](http://bmcurol.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/buro/default.aspx","title":"BMC Urology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Interstitial cystitis, Bladder pain syndrome, Neutrophil/lymphocyte ratio, Platelet/lymphocyte ratio","lastPublishedDoi":"10.21203/rs.3.rs-7785569/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7785569/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eObjective:\u003c/strong\u003eInterstitial Cystitis/Bladder Pain Syndrome (IC/BPS) is an important public health problem that mainly affects middle-aged female patients. Diagnosis of IC/BPS is difficult as there is no disease-specific diagnostic test. Our study analyzed the hematological parameters in female patients with IC/BPS to determine whether these parameters could assist in diagnosing IC/BPS and investigate the relationship between these parameters and disease severity.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003eFifty female patients with IC/BPS (i.e., patient group) and 50 healthy volunteers (i.e., control group) with no systemic diseases or complaints were included. The patients' O'Leary Sant Interstitial Cystitis Symptom Index (ICSI) scores were recorded at diagnosis. Blood neutrophil, lymphocyte, platelet counts, mean platelet volumes (MPV), neutrophil/lymphocyte (NLR), and platelet/lymphocyte ratios (PLR) were recorded and calculated based on the complete blood count results obtained during the initial outpatient clinic encounters. Patients and healthy volunteers were compared regarding age, neutrophil, lymphocyte, platelet counts, and MPV, NLR, and PLR values. The correlation between laboratory parameters and ICSI levels of the cases in the patient group was also analyzed.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e The demographic data of the groups were similar. There was no significant difference between the groups regarding neutrophil, lymphocyte, platelet counts, and MPV levels. On the other hand, the median NLR values were significantly higher in the patient group compared to the control group (2.34 vs. 1.85, p\u0026lt;0.001). In the patient group, the lymphocyte count was significantly higher in the group with an ICSI score≥14 compared to the group with an ICSI score\u0026lt;14 (median, 1.90 vs. 1.62, p=0.009).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion:\u003c/strong\u003e Our study found that NLR was higher in IC/BPS patients than in healthy individuals and that lymphocyte counts might be associated with disease severity. Thus, hematological parameters can provide clinicians with valuable insights regarding IC/BPS disease severity and aid treatment planning.\u003c/p\u003e","manuscriptTitle":"Investigation of the hematological parameters in women with Interstitial Cystitis/Bladder Pain Syndrome and their relationship with disease severity","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-11-14 01:41:07","doi":"10.21203/rs.3.rs-7785569/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-11-13T07:54:28+00:00","index":"","fulltext":""},{"type":"reviewerAgreed","content":"248477128911533835135647783084041364732","date":"2025-11-12T17:30:43+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-11-08T02:36:58+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"134649302798835205558533346830283888204","date":"2025-11-08T02:21:28+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"135417659424721161118268271221938969196","date":"2025-11-03T23:11:44+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-11-03T19:20:34+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"36119674893215330219467493697341562979","date":"2025-11-03T09:45:21+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"126735227843172772273101963410629909492","date":"2025-11-03T09:00:00+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-11-03T08:38:08+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-10-20T19:50:50+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-10-16T13:45:16+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-10-16T13:42:39+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Urology","date":"2025-10-05T15:22:44+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-urology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"buro","sideBox":"Learn more about [BMC Urology](http://bmcurol.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/buro/default.aspx","title":"BMC Urology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"fe25e260-ad5e-424c-b449-9dd245c937a4","owner":[],"postedDate":"November 14th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2026-02-23T16:16:15+00:00","versionOfRecord":{"articleIdentity":"rs-7785569","link":"https://doi.org/10.1186/s12894-026-02091-8","journal":{"identity":"bmc-urology","isVorOnly":false,"title":"BMC Urology"},"publishedOn":"2026-02-19 15:58:14","publishedOnDateReadable":"February 19th, 2026"},"versionCreatedAt":"2025-11-14 01:41:07","video":"","vorDoi":"10.1186/s12894-026-02091-8","vorDoiUrl":"https://doi.org/10.1186/s12894-026-02091-8","workflowStages":[]},"version":"v1","identity":"rs-7785569","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7785569","identity":"rs-7785569","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}