OUR RESEARCH PROGRAMS

PRINCIPAL INVESTIGATOR
Ursula Wesselmann, MD

Laboratory-based Research

Our main research focus has been laboratory-based. Little is known about the pathways in the nervous system for chronic urogenital and chronic pelvic pain. This field has lagged behind other areas of pain research, where tremendous progress has been made over the last 20 years. From a clinical perspective there is urgent need for a better understanding of the pathophysiological mechanisms of these pain syndromes so that pharmacological manipulations targeted at these mechanisms can be developed. We have developed novel animal models of pelvic and urogenital pain in our laboratory. These animal models can be studied to further characterize the pathophysiology of pelvic and urogenital pain syndromes at different levels of the neuraxis (peripheral, spinal and supraspinal). The greatest contribution of these animal models may lie in their use to study the effects of traditional therapies and to develop new pain management approaches.

Ultimately it is important to determine whether the mechanisms of chronic pelvic and urogenital pain and nociception and their pharmacological manipulations studied in animal models are of actual clinical relevance. An important feature of our basic science studies is the possibility of a rapid clinical outcome, based on a better understanding of the nervous system pathways processing nociceptive information from the pelvis and urogenital area, and the readily available opportunity to study pharmacological manipulations in these animal models.

Clinical Research

Complementary to our basic science research efforts our clinical research efforts are focused on understanding what the pathophysiological mechanisms are, that result in chronic urogenital and pelvic pain syndromes. Although these pain syndromes have been described in the medical literature for a long time, the etiology is not clear. Current treatment efforts are empirical only and are done on a trial and error basis. Therefore patients are presently not sought for new drug studies.

Instead our clinical research studies are aimed at understanding the pathophysiological mechanism of these chronic pain syndromes. If we are able to elucidate the mechanisms that result in chronic pelvic and urogenital pain, then we should be able to design specific treatment approaches, targeted at the underlying pathophysiological mechanism(s) in the future.

We are currently enrolling patients and control subjects for the following clinical studies:

(1) PAIN IN INTERSTITIAL CYSTITIS
(2) MECHANISMS OF VULVODYNIA

 If you are interested to enroll in these clinical studies, please contact Dr. Ursula Wesselmann at: 410-614-4517

To be eligible to enroll you must be female and between 18 and 45 years old. If you are a patient with a history of vulvodynia or interstitial cystitis you will need to provide a letter form your physician confirming the diagnosis. If you would like to enroll as a control subject, you should have no history of any urogenital or pelvic pain and you should not have had any abdominal, pelvic or urogenital surgery in the past. If you fulfill the inclusion criteria for the study, we will ask you to come to Johns Hopkins Hospital for an evaluation. This clinic visit will take about 3 hours of your time.

SELECTED PUBLICATIONS FROM OUR RESEARCH PROGRAM:

Wesselmann U: Gender differences - Implications for Pain Management. Behavioral & Brain Sciences, 20, 470-471, 1997.

Wesselmann U, Burnett AL and Heinberg LJ: The urogenital and rectal pain syndromes. Pain, 73, 269-294, 1997.

Wesselmann U and Lai J: Mechanisms of referred visceral pain: Uterine inflammation in the adult virgin rat results in neurogenic plasma extravasation in the skin. Pain, 73, 309-317, 1997.

Wesselmann U, Czakanski PP, Affaitati B. and Giamberardino MA: Uterine inflammation as a noxious visceral stimulus: behavioral characterization in the rat. Neurosci. Lett., 246, 73-76, 1998.

Wesselmann U: Management of Chronic Pelvic Pain. Pages 269-279 in G. M. ARONOFF, Ed., Evaluation and Treatment of Chronic Pain. 3rd edition, Williams and Wilkins, Baltimore, MD, 1998.

Burnett A L and Wesselmann U: Neurobiology of the pelvis and perineum: Principles for a practical approach. J. Pelvic Surgery, 5, 224-232, 1999.

Wesselmann U: A call for recognizing, legitimizing and treating chronic visceral pain syndromes. Pain Forum, 8, 146-150, 1999

Wesselmann U: Guest Editorial: Pain - the neglected aspect of visceral disease. Eur. J. Pain, 3, 189-191, 1999

Wesselmann U and Burnett AL: Genitourinary Pain. Pages 689-709 in P.D. WALL, and R. MELZACK, Eds., Textbook of Pain. 4th edition, Churchill Livingstone, New York, NY, 1999.

Wesselmann U: Pain of pelvic origin. In: Pain 1999 - An Updated Review: Refresher Course Syllabus - International Association for the Study of Pain, Editor: M. Max, IASP Press, Seattle, pages 47-58, 1999

Wesselmann U and Czakanski PP: Pain of urogenital origin. Curr. Rev. Pain, 3, 160-171, 1999

Wesselmann U, Czakanski PP, and Sanders C: Altered CNS processing of nociceptive messages from the vagina in rats, that have recovered from uterine inflammation. Progress in Pain Research and Management, 16, 581-588, 2000.

Wesselmann U: Urogenital pain syndromes in men and women. Progress in Pain Research and Management, 16, 551-566, 2000.