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

doi: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

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

Medical Social Sciences

Research output: Contribution to journal › Article › peer-review

14 Scopus citations

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 language	English (US)
Pages (from-to)	522-531
Number of pages	10
Journal	BJU International
Volume	124
Issue number	3
DOIs	https://doi.org/10.1111/bju.14783
State	Published - 2019

Funding

We thank the research staff at the MAPP discovery sites and the data coordinating centre for implementing the MAPP Study, and the participants for their generous involvement in the study. This work was supported by the US National Institutes of Health/National Institute of Diabetes and Digestive and Kidney disease (U01 DK082315, U01 DK82316, U01 DK82325, U01 DK82333, U01 DK82342, U01 DK82344, U01 DK82345, and U01 DK82370).

Keywords

epidemiology
interstitial cystitis
prostatitis
symptom flare-up

ASJC Scopus subject areas

Urology

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10.1111/bju.14783

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Sutcliffe, S., Gallop, R., Henry Lai, H. H., Andriole, G. L., Bradley, C. S., Chelimsky, G., Chelimsky, T., Quentin Clemens, J., Colditz, G. A., Erickson, B., Griffith, J. W., Kim, J., Krieger, J. N., Labus, J., Naliboff, B. D., Rodriguez, L. V., Sutherland, S. E., Taple, B. J., & Landis, J. R. (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, 124(3), 522-531. https://doi.org/10.1111/bju.14783

@article{34e6a135633849379e3891841745462c,

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 ({\textquoteleft}flares{\textquoteright}), 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 ({\textquoteleft}urological or pelvic pain symptoms that are much worse than usual{\textquoteright}) 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{\textquoteright} 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}",

note = "Publisher Copyright: {\textcopyright} 2019 The Authors BJU International {\textcopyright} 2019 BJU International Published by John Wiley & Sons Ltd",

year = "2019",

doi = "10.1111/bju.14783",

language = "English (US)",

volume = "124",

pages = "522--531",

journal = "BJU International",

issn = "1464-4096",

publisher = "John Wiley and Sons Inc.",

number = "3",

}

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, vol. 124, no. 3, pp. 522-531. https://doi.org/10.1111/bju.14783

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

Y1 - 2019

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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DO - 10.1111/bju.14783

M3 - Article

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AN - SCOPUS:85066501549

SN - 1464-4096

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JO - BJU International

JF - BJU International

IS - 3

ER -

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

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