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
N1 - Funding Information:
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).
Publisher Copyright:
© 2019 The Authors BJU International © 2019 BJU International Published by John Wiley & Sons Ltd
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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U2 - 10.1111/bju.14783
DO - 10.1111/bju.14783
M3 - Article
C2 - 31012513
AN - SCOPUS:85066501549
SN - 1464-4096
VL - 124
SP - 522
EP - 531
JO - British Journal of Urology
JF - British Journal of Urology
IS - 3
ER -