Journal article
Urologic chronic pelvic pain syndrome 3-year symptom trajectories: the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Symptom Patterns Study
BJU international, Vol.137(2), pp.312-322
02/2026
DOI: 10.1111/bju.70087
PMCID: PMC12789841
PMID: 41328479
Appears in UI Libraries Support Open Access
Abstract
To characterise 3-year pelvic pain and urinary symptom trajectories and to identify baseline factors associated with urologic chronic pelvic pain syndrome (UCPPS) improvement.
The Trans-Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Symptom Patterns Study was a multicentre, prospective cohort study of UCPPS, including interstitial cystitis/bladder pain syndrome and chronic prostatitis/chronic pelvic pain syndrome. Patients completed four weekly run-in assessments, baseline visit, and quarterly visits up to 3 years, providing clinical and patient-reported data. A functional clustering approach, applied separately to Pelvic Pain Severity (PPS) and Urinary Symptom Severity (USS) longitudinal change scores, was used to generate symptom trajectory clusters dichotomised as Group 0 'improvers' vs Groups 1-3 'non-improvers'. Logistic regression models explored baseline factors associated with improvement and included run-in period average and baseline scores to adjust for regression to the mean effects.
A total of 545 patients (66% female) were followed for a median (interquartile range) of 34 (23-35) months. Four trajectory clusters were identified for each of PPS and USS, consistent with moderate improvement (Group 0), slight improvement (Group 1), no change (Group 2), and slight worsening (Group 3). In all, 18% and 19% of patients were in the moderately improved PPS and USS groups, respectively, representing 30% of patients overall. Female sex, better sleep, and less opioid use were associated with PPS improvement (Group 0); younger age and baseline cystoscopic treatment were associated with USS improvement (Group 0).
In all, 30% of patients with UCPPS demonstrated improvement in pain and/or urinary symptoms over 3 years. Baseline factors associated with improvement may represent markers of a milder or localised phenotype and/or treatment effects.
Details
- Title: Subtitle
- Urologic chronic pelvic pain syndrome 3-year symptom trajectories: the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Symptom Patterns Study
- Creators
- Catherine S Bradley - Department of Obstetrics and Gynecology, Carver College of Medicine, University of Iowa, Iowa City, IA, USAMengying You - Shanghai University of International Business and EconomicsWensheng Guo - University of PennsylvaniaNiloofar Afari - University of California - San Diego School of MedicinePriyanka Gupta - University of MichiganKarl J Kreder - University of IowaJohn N Krieger - University of Washington School of MedicineH Henry Lai - Washington University in St. Louis School of MedicineSusan K Lutgendorf - University of IowaBruce D Naliboff - David Geffen School of Medicine at UCLASiobhan Sutcliffe - Washington University in St. Louis School of MedicineFrank Tu - University of ChicagoDavid A Williams - University of MichiganTara McWilliams - University of PennsylvaniaLarissa Rodriguez - Weill Cornell MedicineJ Richard Landis - University of PennsylvaniaMultidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network
- Resource Type
- Journal article
- Publication Details
- BJU international, Vol.137(2), pp.312-322
- DOI
- 10.1111/bju.70087
- PMID
- 41328479
- PMCID
- PMC12789841
- NLM abbreviation
- BJU Int
- ISSN
- 1464-4096
- eISSN
- 1464-410X
- Publisher
- Wiley
- Grant note
- NIH HHS
- Language
- English
- Electronic publication date
- 12/02/2025
- Date published
- 02/2026
- Academic Unit
- Epidemiology; Psychological and Brain Sciences; Iowa Neuroscience Institute; Obstetrics and Gynecology; Urology
- Record Identifier
- 9985090626402771
Metrics
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