Journal article
A Case-Crossover Study of Urological Chronic Pelvic Pain Syndrome Flare Triggers in the MAPP Research Network
The Journal of Urology, Vol.199(5), pp.1245-1251
05/2018
DOI: 10.1016/j.juro.2017.12.050
PMID: 29288643
Abstract
Although many factors have been proposed to trigger symptom exacerbations (flares) in patients with interstitial cystitis/bladder pain syndrome and chronic prostatitis/chronic pelvic pain syndrome, few studies have investigated these factors empirically. Therefore, we embedded a case-crossover study in the Multidisciplinary Approach to the Study of Chronic Pelvic Pain longitudinal study to evaluate a range of patient reported triggers. We assessed exposure to proposed triggers, including diet, physical activities, sedentary behaviors, stress, sexual activities, infection-like symptoms and allergies, by questionnaire a maximum of 3 times when participants reported flares and at 3 randomly selected times. We compared participant preflare to nonflare exposures by conditional logistic regression. In our full analytical sample of 292 participants only 2 factors, including recent sexual activity (OR 1.44, 95% CI 1.06–1.96) and urinary tract infection symptoms (OR 3.39, 95% CI 2.02–5.68), which may overlap with those of flares, were associated with flare onset. On subanalyses restricted to flares with specific suspected triggers additional positive associations were observed for some factors such as certain dietary factors, abdominal muscle exercises, and vaginal infection-like symptoms and fever, but not for other factors (eg stress). Except for sexual activity our findings suggest that patient reported triggers may be individual or group specific, or they may not contribute to flares. These findings suggest caution in following rigid, global flare prevention strategies and support additional research to develop evidence-based strategies.
Details
- Title: Subtitle
- A Case-Crossover Study of Urological Chronic Pelvic Pain Syndrome Flare Triggers in the MAPP Research Network
- Creators
- Siobhan Sutcliffe - Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MissouriThomas Jemielita - Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PennsylvaniaH. Henry Lai - Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, MissouriGerald L Andriole - Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, MissouriCatherine S Bradley - Department of Obstetrics and Gynecology, University of Iowa, Iowa City, IowaJ. Quentin Clemens - Division of Neurology and Pelvic Reconstructive Surgery, Department of Urology, University of Michigan, Ann Arbor, MichiganRobert Gallop - Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PennsylvaniaThomas M Hooton - Division of Infectious Diseases, Department of Medicine, University of Miami School of Medicine, Miami, FloridaKarl J Kreder - Department of Urology, University of Iowa, Iowa City, IowaJohn N Krieger - Department of Urology, University of Washington, Seattle, WashingtonJohn W Kusek - National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MarylandJennifer Labus - Oppenheimer Center for Neurobiology of Stress and Resilience, Division of Digestive Diseases, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CaliforniaM. Scott Lucia - Department of Pathology, University of Colorado, Aurora, ColoradoSean Mackey - Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, CaliforniaBruce D Naliboff - Departments of Medicine and Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CaliforniaNancy A Robinson - Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PennsylvaniaLarissa V Rodriguez - Institute of Urology, University of Southern California, Beverly Hills, CaliforniaAlisa Stephens-Shields - Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PennsylvaniaAdrie van Bokhoven - Department of Pathology, University of Colorado, Aurora, ColoradoKathleen Y Wolin - ScaleDown, Chicago, IllinoisYan Yan - Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MissouriClaire C Yang - Department of Urology, University of Washington, Seattle, WashingtonJ. Richard Landis - Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PennsylvaniaGraham A Colditz - Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MissouriMAPP Research Network
- Resource Type
- Journal article
- Publication Details
- The Journal of Urology, Vol.199(5), pp.1245-1251
- DOI
- 10.1016/j.juro.2017.12.050
- PMID
- 29288643
- NLM abbreviation
- J Urol
- ISSN
- 0022-5347
- eISSN
- 1527-3792
- Publisher
- Elsevier Inc
- Language
- English
- Date published
- 05/2018
- Academic Unit
- Epidemiology; Obstetrics and Gynecology; Urology
- Record Identifier
- 9983930374702771
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