Associations Between Urological Chronic Pelvic Pain Syndrome Symptom Flares, Illness Impact, and Health Care Seeking Activity: Findings From the Multidisciplinary Approach to the Study of Chronic Pelvic Pain Symptom Patterns Study

No AccessJournal of UrologyAdult Urology1 Apr 2023Associations Between Urological Chronic Pelvic Pain Syndrome Symptom Flares, Illness Impact, and Health Care Seeking Activity: Findings From the Multidisciplinary Approach to the Study of Chronic Pelvic Pain Symptom Patterns Study Siobhan Sutcliffe, Craig Newcomb, Catherine S. Bradley, J. Quentin Clemens, Bradley Erickson, Priyanka Gupta, H. Henry Lai, Bruce Naliboff, Eric Strachan, and Alisa Stephens-Shields Siobhan SutcliffeSiobhan Sutcliffe *Correspondence: Division of Public Health Sciences, Department of Surgery, Alvin J. Siteman Cancer Center, Washington University School of Medicine, Taylor Avenue Building, 600 S Taylor Ave, 2nd Floor, Rm 208S, MSC 8100-04-02, St Louis, MO 63108 telephone: 314-362-3788; E-mail Address: [email protected] https://orcid.org/0000-0002-4613-8107 Division of Public Health Sciences, Department of Surgery, Alvin J. Siteman Cancer Center, Washington University School of Medicine, St Louis, Missouri Department of Obstetrics and Gynecology, Washington University School of Medicine, St Louis, Missouri More articles by this author , Craig NewcombCraig Newcomb Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania More articles by this author , Catherine S. BradleyCatherine S. Bradley Department of Obstetrics and Gynecology, Carver College of Medicine, University of Iowa, Iowa City, Iowa More articles by this author , J. Quentin ClemensJ. Quentin Clemens Department of Urology, University of Michigan, Ann Arbor, Michigan More articles by this author , Bradley EricksonBradley Erickson Department of Urology, Carver College of Medicine, University of Iowa, Iowa City, Iowa More articles by this author , Priyanka GuptaPriyanka Gupta Department of Urology, University of Michigan, Ann Arbor, Michigan More articles by this author , H. Henry LaiH. Henry Lai Division of Urologic Surgery, Department of Surgery,Washington University School of Medicine, St Louis, Missouri Department of Anesthesiology, Washington University School of Medicine, St Louis, Missouri More articles by this author , Bruce NaliboffBruce Naliboff Department of Medicine, Geffen School of Medicine, University of California–Los Angeles, Los Angeles, California More articles by this author , Eric StrachanEric Strachan Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington More articles by this author , and Alisa Stephens-ShieldsAlisa Stephens-Shields Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania More articles by this author for the MAPP Research Network View All Author Informationhttps://doi.org/10.1097/JU.0000000000003155AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Most studies on interstitial cystitis/bladder pain syndrome and chronic prostatitis/chronic pelvic pain syndrome use typical or average levels of pelvic pain or urological symptom intensity as their outcome, as both are associated with reduced quality of life. Symptom exacerbations or “flares” have also been found to be associated with reduced quality of life, but no studies, to our knowledge, have investigated whether these associations are independent of typical pelvic pain levels and thus might be useful additional outcome measures (or stated differently, whether reducing flare frequency even without reducing mean pain intensity may be important to patients). Materials and Methods: We used screening visit and weekly run-in period data from the Multidisciplinary Approach to the Study of Chronic Pelvic Pain Symptom Patterns Study to investigate associations between flare frequency and multiple measures of illness impact and health care seeking activity, independent of typical nonflare and overall pelvic pain levels. Results: Among the 613 eligible participants, greater flare frequency was associated with worse condition-specific illness impact (standardized β coefficients=0.11-0.68, P trends < .0001) and health care seeking activity (odds ratios=1.52-3.94, P trends .0039 to < .0001) in analyses adjusted for typical nonflare and overall pelvic pain levels. Experiencing ≥1/d was also independently associated with worse general illness impact (standardized β coefficients=0.11-0.25). Conclusions: Our findings suggest that flare frequency and possibly other flare characteristics may be worth considering as additional outcome measures in urological chronic pelvic pain syndrome research to support the development of new preventive and therapeutic flare strategies. REFERENCES 1. . Urological chronic pelvic pain syndrome flares and their impact: qualitative analysis in the MAPP network. Int Urogynecol J. 2015; 26(7):1047-1060. Crossref, Medline, Google Scholar 2. . 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Crossref, Medline, Google Scholar 18. . The interstitial cystitis symptom index and problem index. Urology. 1997; 49(5):58-63. Crossref, Medline, Google Scholar Submitted July 15, 2022; accepted December 29, 2022; published January 11, 2023. Support: This work was supported by the U.S. National Institutes of Health/National Institute of Diabetes and Digestive and Kidney Diseases (U01 DK082315, U01 DK82316, U01 DK82325, U01 DK82333, U01 DK82342, U01 DK82344, U01 DK82345, and U01 DK82370). Conflict of Interest: CSB: American Urogynecologic Society: travel for Board activities, Elsevier: Editor travel and textbook royalties, American Board of Obstetrics and Gynecology: travel and honorarium-Board Examiner, Division Member; HHL: Midwest Stone Institute, Medtronic, Neuspera, American Board of Obstetrics and Gynecology: travel and honorarium, Board Examiner, Division Member; AS-S: Gilead Sciences. Ethics Statement: This study received Institutional Review Board approval (IRB No. 201504075). All human subjects provided written informed consent with guarantees of confidentiality. Data Availability: Data from this manuscript can be obtained from the NIDDK repository (https://repository.niddk.nih.gov/home/). Submission History: The content of this manuscript was presented at the International Continence Society Annual Meeting in Vienna, Austria, in September 2022. © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue 4April 2023Page: 719-725Supplementary Materials Peer Review Report Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.Keywordsprostatitissymptom flare upcystitis, interstitialACKNOWLEDGMENTWe thank the research staff at the MAPP clinical sites and the data coordinating center for implementing the MAPP Symptom Patterns Study, and the participants for their generous participation.MetricsAuthor Information Siobhan Sutcliffe Division of Public Health Sciences, Department of Surgery, Alvin J. Siteman Cancer Center, Washington University School of Medicine, St Louis, Missouri Department of Obstetrics and Gynecology, Washington University School of Medicine, St Louis, Missouri *Correspondence: Division of Public Health Sciences, Department of Surgery, Alvin J. Siteman Cancer Center, Washington University School of Medicine, Taylor Avenue Building, 600 S Taylor Ave, 2nd Floor, Rm 208S, MSC 8100-04-02, St Louis, MO 63108 telephone: 314-362-3788; E-mail Address: [email protected] More articles by this author Craig Newcomb Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania More articles by this author Catherine S. Bradley Department of Obstetrics and Gynecology, Carver College of Medicine, University of Iowa, Iowa City, Iowa More articles by this author J. Quentin Clemens Department of Urology, University of Michigan, Ann Arbor, Michigan More articles by this author Bradley Erickson Department of Urology, Carver College of Medicine, University of Iowa, Iowa City, Iowa More articles by this author Priyanka Gupta Department of Urology, University of Michigan, Ann Arbor, Michigan More articles by this author H. Henry Lai Division of Urologic Surgery, Department of Surgery,Washington University School of Medicine, St Louis, Missouri Department of Anesthesiology, Washington University School of Medicine, St Louis, Missouri More articles by this author Bruce Naliboff Department of Medicine, Geffen School of Medicine, University of California–Los Angeles, Los Angeles, California More articles by this author Eric Strachan Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington More articles by this author Alisa Stephens-Shields Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania More articles by this author Expand All Submitted July 15, 2022; accepted December 29, 2022; published January 11, 2023. Support: This work was supported by the U.S. National Institutes of Health/National Institute of Diabetes and Digestive and Kidney Diseases (U01 DK082315, U01 DK82316, U01 DK82325, U01 DK82333, U01 DK82342, U01 DK82344, U01 DK82345, and U01 DK82370). Conflict of Interest: CSB: American Urogynecologic Society: travel for Board activities, Elsevier: Editor travel and textbook royalties, American Board of Obstetrics and Gynecology: travel and honorarium-Board Examiner, Division Member; HHL: Midwest Stone Institute, Medtronic, Neuspera, American Board of Obstetrics and Gynecology: travel and honorarium, Board Examiner, Division Member; AS-S: Gilead Sciences. Ethics Statement: This study received Institutional Review Board approval (IRB No. 201504075). All human subjects provided written informed consent with guarantees of confidentiality. Data Availability: Data from this manuscript can be obtained from the NIDDK repository (https://repository.niddk.nih.gov/home/). Submission History: The content of this manuscript was presented at the International Continence Society Annual Meeting in Vienna, Austria, in September 2022. Advertisement PDF downloadLoading ...