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Transitions from Regional to Widespread Pain in Urologic Chronic Pelvic Pain Syndrome (UCPPS): A MAPP II Research Network Study
Journal article   Peer reviewed

Transitions from Regional to Widespread Pain in Urologic Chronic Pelvic Pain Syndrome (UCPPS): A MAPP II Research Network Study

J Quentin Clemens, Bruce D Naliboff, Catherine S Bradley, Claire C Yang, Daniel J Clauw, David Williams, H Henry Lai, Siobhan Sutcliffe, Steven E Harte, Theresa Spitznagle, …
The Journal of urology
01/21/2026
DOI: 10.1097/JU.0000000000004943
PMID: 41564284

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Abstract

We utilized prospective data from a well-characterized urologic chronic pelvic pain (UCPPS) cohort (including interstitial cystitis/bladder pain syndrome and chronic prostatitis/chronic pelvic pain syndrome) to identify transitions between localized pelvic pain (LP) and widespread pain (WP), and characteristics associated with these transitions.PURPOSEWe utilized prospective data from a well-characterized urologic chronic pelvic pain (UCPPS) cohort (including interstitial cystitis/bladder pain syndrome and chronic prostatitis/chronic pelvic pain syndrome) to identify transitions between localized pelvic pain (LP) and widespread pain (WP), and characteristics associated with these transitions.A total of 311 individuals (195 women; 116 men) with UCPPS were recruited from 6 sites and followed for 3 years. Participants completed five weekly "run-in" assessments at baseline, followed by quarterly symptom assessments. Responses on a self-reported body pain map were used to define LP vs WP (>2 non-pelvic body map regions with pain). Multivariable modeling was used to evaluate 74 baseline characteristics related to transitions between LP and WP.MATERIAL AND METHODSA total of 311 individuals (195 women; 116 men) with UCPPS were recruited from 6 sites and followed for 3 years. Participants completed five weekly "run-in" assessments at baseline, followed by quarterly symptom assessments. Responses on a self-reported body pain map were used to define LP vs WP (>2 non-pelvic body map regions with pain). Multivariable modeling was used to evaluate 74 baseline characteristics related to transitions between LP and WP.At baseline, 126 participants (41%) reported LP, 13 (10.3%) of whom transitioned to WP. Conversely, 17 of the 66 participants (26%) with WP transitioned to LP at follow-up. Progression from LP to WP was associated with: 1) not living with a partner/spouse, and 2) a higher Somatic Awareness Score on the Complex Multi-System Inventory (CMSI). Conversely, transition from WP to LP was associated with: 3) lower urinary urgency symptoms on the CMSI, and 4) higher frequency of sensation of not emptying bladder completely.RESULTSAt baseline, 126 participants (41%) reported LP, 13 (10.3%) of whom transitioned to WP. Conversely, 17 of the 66 participants (26%) with WP transitioned to LP at follow-up. Progression from LP to WP was associated with: 1) not living with a partner/spouse, and 2) a higher Somatic Awareness Score on the Complex Multi-System Inventory (CMSI). Conversely, transition from WP to LP was associated with: 3) lower urinary urgency symptoms on the CMSI, and 4) higher frequency of sensation of not emptying bladder completely.Greater levels of baseline non-painful somatic symptoms were associated with progression to widespread pain, suggesting that high baseline somatic symptoms may predict the development of future pain. Not living with a spouse/partner was also associated with progression to widespread pain, highlighting the importance of social support in UCPPS.CONCLUSIONSGreater levels of baseline non-painful somatic symptoms were associated with progression to widespread pain, suggesting that high baseline somatic symptoms may predict the development of future pain. Not living with a spouse/partner was also associated with progression to widespread pain, highlighting the importance of social support in UCPPS.

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