A longitudinal analysis of urological chronic pelvic pain syndrome flares in the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network

Siobhan Sutcliffe*, Robert Gallop, Hing Hung Henry Lai, Gerald L. Andriole, Catherine S. Bradley, Gisela Chelimsky, Thomas Chelimsky, James Quentin Clemens, Graham A. Colditz, Bradley Erickson, James W Griffith, Jayoung Kim, John N. Krieger, Jennifer Labus, Bruce D. Naliboff, Larissa V. Rodriguez, Suzette E. Sutherland, Bayley J. Taple, John Richard Landis

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

Objective: 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. Participants and Methods: 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. Results: 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. Conclusion: 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.

Original languageEnglish (US)
JournalBJU International
DOIs
StatePublished - Jan 1 2019

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Pelvic Pain
Chronic Pain
Research
Longitudinal Studies
Hypersensitivity
Epidemiology
Urinary Bladder
Incidence

Keywords

  • epidemiology
  • interstitial cystitis
  • prostatitis
  • symptom flare-up

ASJC Scopus subject areas

  • Urology

Cite this

Sutcliffe, Siobhan ; Gallop, Robert ; Henry Lai, Hing Hung ; Andriole, Gerald L. ; Bradley, Catherine S. ; Chelimsky, Gisela ; Chelimsky, Thomas ; Quentin Clemens, James ; Colditz, Graham A. ; Erickson, Bradley ; Griffith, James W ; Kim, Jayoung ; Krieger, John N. ; Labus, Jennifer ; Naliboff, Bruce D. ; Rodriguez, Larissa V. ; Sutherland, Suzette E. ; Taple, Bayley J. ; Landis, John Richard. / A longitudinal analysis of urological chronic pelvic pain syndrome flares in the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network. In: BJU International. 2019.
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title = "A longitudinal analysis of urological chronic pelvic pain syndrome flares in the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network",
abstract = "Objective: 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. Participants and Methods: 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. Results: 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. Conclusion: 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.",
keywords = "epidemiology, interstitial cystitis, prostatitis, symptom flare-up",
author = "Siobhan Sutcliffe and Robert Gallop and {Henry Lai}, {Hing Hung} and Andriole, {Gerald L.} and Bradley, {Catherine S.} and Gisela Chelimsky and Thomas Chelimsky and {Quentin Clemens}, James and Colditz, {Graham A.} and Bradley Erickson and Griffith, {James W} and Jayoung Kim and Krieger, {John N.} and Jennifer Labus and Naliboff, {Bruce D.} and Rodriguez, {Larissa V.} and Sutherland, {Suzette E.} and Taple, {Bayley J.} and Landis, {John Richard}",
year = "2019",
month = "1",
day = "1",
doi = "10.1111/bju.14783",
language = "English (US)",
journal = "BJU International",
issn = "1464-4096",
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Sutcliffe, S, Gallop, R, Henry Lai, HH, Andriole, GL, Bradley, CS, Chelimsky, G, Chelimsky, T, Quentin Clemens, J, Colditz, GA, Erickson, B, Griffith, JW, Kim, J, Krieger, JN, Labus, J, Naliboff, BD, Rodriguez, LV, Sutherland, SE, Taple, BJ & Landis, JR 2019, '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. https://doi.org/10.1111/bju.14783

A longitudinal analysis of urological chronic pelvic pain syndrome flares in the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network. / Sutcliffe, Siobhan; Gallop, Robert; Henry Lai, Hing Hung; Andriole, Gerald L.; Bradley, Catherine S.; Chelimsky, Gisela; Chelimsky, Thomas; Quentin Clemens, James; Colditz, Graham A.; Erickson, Bradley; Griffith, James W; Kim, Jayoung; Krieger, John N.; Labus, Jennifer; Naliboff, Bruce D.; Rodriguez, Larissa V.; Sutherland, Suzette E.; Taple, Bayley J.; Landis, John Richard.

In: BJU International, 01.01.2019.

Research output: Contribution to journalArticle

TY - JOUR

T1 - A longitudinal analysis of urological chronic pelvic pain syndrome flares in the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network

AU - Sutcliffe, Siobhan

AU - Gallop, Robert

AU - Henry Lai, Hing Hung

AU - Andriole, Gerald L.

AU - Bradley, Catherine S.

AU - Chelimsky, Gisela

AU - Chelimsky, Thomas

AU - Quentin Clemens, James

AU - Colditz, Graham A.

AU - Erickson, Bradley

AU - Griffith, James W

AU - Kim, Jayoung

AU - Krieger, John N.

AU - Labus, Jennifer

AU - Naliboff, Bruce D.

AU - Rodriguez, Larissa V.

AU - Sutherland, Suzette E.

AU - Taple, Bayley J.

AU - Landis, John Richard

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Objective: 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. Participants and Methods: 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. Results: 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. Conclusion: 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.

AB - Objective: 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. Participants and Methods: 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. Results: 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. Conclusion: 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.

KW - epidemiology

KW - interstitial cystitis

KW - prostatitis

KW - symptom flare-up

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