Journal article
A longitudinal analysis of urological chronic pelvic pain syndrome flares in the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network
BJU international, Vol.124(3), pp.522-531
09/2019
DOI: 10.1111/bju.14783
PMCID: PMC6706296
PMID: 31012513
Abstract
To describe the frequency, intensity and duration of urological chronic pelvic pain syndrome symptom exacerbations ('flares'), as well as risk factors for these features, in the Multidisciplinary Approach to the Study of Chronic Pelvic Pain Epidemiology and Phenotyping longitudinal study. Current flare status ('urological or pelvic pain symptoms that are much worse than usual') was ascertained at each bi-weekly assessment. Flare characteristics, including start date, and current intensity of pelvic pain, urgency and frequency (scales of 0-10), were assessed for participants' first three flares and at three randomly selected times when they did not report a flare. Generalized linear and mixed effects models were used to investigate flare risk factors. Of the 385 eligible participants, 24.2% reported no flares, 22.9% reported one flare, 28.3% reported 2-3 flares, and 24.6% reported ≥4 flares, up to a maximum of 18 during the 11-month follow-up (median incidence rate = 0.13/bi-weekly assessment, range = 0.00-1.00). Pelvic pain (mean = 2.63-point increase) and urological symptoms (mean = 1.72) were both significantly worse during most flares (60.6%), with considerable within-participant variability (26.2-37.8%). Flare duration varied from 1 to 150 days (94.3% within-participant variability). In adjusted analyses, flares were more common, symptomatic, and/or longer-lasting in women and in those with worse non-flare symptoms, bladder hypersensitivity, and chronic overlapping pain conditions. In this foundational flare study, we found that pelvic pain and urological symptom flares were common, but variable in frequency and manifestation. We also identified subgroups of participants with more frequent, symptomatic, and/or longer-lasting flares for targeted flare management/prevention and further study.
Details
- Title: Subtitle
- A longitudinal analysis of urological chronic pelvic pain syndrome flares in the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network
- Creators
- Siobhan Sutcliffe - Division of Public Health Sciences, Department of Surgery and the Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USARobert Gallop - Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USAHing Hung Henry Lai - Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO, USAGerald L Andriole - Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USACatherine S Bradley - Department of Urology, Carver College of Medicine, University of Iowa, Iowa City, IA, USAGisela Chelimsky - Department of Pediatrics, Division of Pediatric Gastroenterology, Medical College of Wisconsin, Milwaukee, WI, USAThomas Chelimsky - Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USAJames Quentin Clemens - Division of Neurourology and Pelvic Reconstructive Surgery, Department of Urology, University of Michigan, Ann Arbor, MI, USAGraham A Colditz - Division of Public Health Sciences, Department of Surgery and the Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USABradley Erickson - Department of Urology, Carver College of Medicine, University of Iowa, Iowa City, IA, USAJames W Griffith - Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USAJayoung KimJohn N Krieger - Department of Urology, University of Washington, Seattle, WA, USAJennifer Labus - Oppenheimer Center for Neurobiology of Stress and Resilience and Division of Digestive Diseases, Department of Medicine, David Geffen School of Medicine, University of California - Los Angeles, Los Angeles, CA, USABruce D Naliboff - Oppenheimer Center for Neurobiology of Stress and Resilience and Division of Digestive Diseases, Department of Medicine, David Geffen School of Medicine, University of California - Los Angeles, Los Angeles, CA, USALarissa V Rodriguez - Institute of Urology, University of Southern California, Beverly Hills, CA, USASuzette E Sutherland - Department of Urology, University of Washington, Seattle, WA, USABayley J Taple - Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USAJohn Richard Landis - Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Resource Type
- Journal article
- Publication Details
- BJU international, Vol.124(3), pp.522-531
- DOI
- 10.1111/bju.14783
- PMID
- 31012513
- PMCID
- PMC6706296
- NLM abbreviation
- BJU Int
- ISSN
- 1464-4096
- eISSN
- 1464-410X
- Publisher
- England
- Grant note
- U01 DK082344 / NIDDK NIH HHS U01 DK082342 / NIDDK NIH HHS U01 DK082315 / NIDDK NIH HHS U01 DK082325 / NIDDK NIH HHS U01 DK082345 / NIDDK NIH HHS U01 DK082333 / NIDDK NIH HHS U24 DK082316 / NIDDK NIH HHS U01 DK082370 / NIDDK NIH HHS U01 DK082316 / NIDDK NIH HHS T32 DK062716 / NIDDK NIH HHS
- Language
- English
- Date published
- 09/2019
- Academic Unit
- Epidemiology; Obstetrics and Gynecology; Urology
- Record Identifier
- 9983931746002771
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