Clinical and Psychosocial Predictors of Urological Chronic Pelvic Pain Symptom Change in 1 Year

A Prospective Study from the MAPP Research Network

MAPP Research Network

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Purpose We examined baseline clinical and psychosocial characteristics that predict 12-month symptom change in men and women with urological chronic pelvic pain syndromes. Materials and Methods A total of 221 female and 176 male patients with urological chronic pelvic pain syndromes were recruited from 6 academic medical centers in the United States and evaluated at baseline with a comprehensive battery of symptom, psychosocial and illness-impact measures. Based on biweekly symptom reports, a functional clustering procedure classified participant outcome as worse, stable or improved on pain and urinary symptom severity. Cumulative logistic modeling was used to examine individual predictors associated with symptom change as well as multiple predictor combinations and interactions. Results About 60% of participants had stable symptoms with smaller numbers (13% to 22%) showing clear symptom worsening or improvement. For pain and urinary outcomes the extent of widespread pain, amount of nonurological symptoms and poorer overall health were predictive of worsening outcomes. Anxiety, depression and general mental health were not significant predictors of outcomes but pain catastrophizing and self-reported stress were associated with pain outcome. Prediction models did not differ between men and women and for the most part they were independent of symptom duration and age. Conclusions These results demonstrate for the first time in a large multisite prospective study that presence of widespread pain, nonurological symptoms and poorer general health are risk factors for poorer pain and urinary outcomes in men and women. The results point to the importance of broad based assessment for urological chronic pelvic pain syndromes and future studies of the mechanisms that underlie these findings.

Original languageEnglish (US)
Pages (from-to)848-857
Number of pages10
JournalJournal of Urology
Volume198
Issue number4
DOIs
StatePublished - Oct 1 2017

Fingerprint

Pelvic Pain
Chronic Pain
Prospective Studies
Pain
Research
Catastrophization
Health
Cluster Analysis
Mental Health
Anxiety
Depression

Keywords

  • cystitis
  • interstitial
  • pelvic pain
  • prostate
  • prostatitis
  • urinary bladder

ASJC Scopus subject areas

  • Urology

Cite this

@article{7d8225953083408aa34c5616709eb4a8,
title = "Clinical and Psychosocial Predictors of Urological Chronic Pelvic Pain Symptom Change in 1 Year: A Prospective Study from the MAPP Research Network",
abstract = "Purpose We examined baseline clinical and psychosocial characteristics that predict 12-month symptom change in men and women with urological chronic pelvic pain syndromes. Materials and Methods A total of 221 female and 176 male patients with urological chronic pelvic pain syndromes were recruited from 6 academic medical centers in the United States and evaluated at baseline with a comprehensive battery of symptom, psychosocial and illness-impact measures. Based on biweekly symptom reports, a functional clustering procedure classified participant outcome as worse, stable or improved on pain and urinary symptom severity. Cumulative logistic modeling was used to examine individual predictors associated with symptom change as well as multiple predictor combinations and interactions. Results About 60{\%} of participants had stable symptoms with smaller numbers (13{\%} to 22{\%}) showing clear symptom worsening or improvement. For pain and urinary outcomes the extent of widespread pain, amount of nonurological symptoms and poorer overall health were predictive of worsening outcomes. Anxiety, depression and general mental health were not significant predictors of outcomes but pain catastrophizing and self-reported stress were associated with pain outcome. Prediction models did not differ between men and women and for the most part they were independent of symptom duration and age. Conclusions These results demonstrate for the first time in a large multisite prospective study that presence of widespread pain, nonurological symptoms and poorer general health are risk factors for poorer pain and urinary outcomes in men and women. The results point to the importance of broad based assessment for urological chronic pelvic pain syndromes and future studies of the mechanisms that underlie these findings.",
keywords = "cystitis, interstitial, pelvic pain, prostate, prostatitis, urinary bladder",
author = "{MAPP Research Network} and Naliboff, {Bruce D.} and Stephens, {Alisa J.} and Lai, {H. Henry} and Griffith, {James W} and Clemens, {J. Quentin} and Susan Lutgendorf and Rodriguez, {Larissa V.} and Craig Newcomb and Siobhan Sutcliffe and Wensheng Guo and Kusek, {John W.} and Landis, {J. Richard}",
year = "2017",
month = "10",
day = "1",
doi = "10.1016/j.juro.2017.05.065",
language = "English (US)",
volume = "198",
pages = "848--857",
journal = "Journal of Urology",
issn = "0022-5347",
publisher = "Elsevier Inc.",
number = "4",

}

Clinical and Psychosocial Predictors of Urological Chronic Pelvic Pain Symptom Change in 1 Year : A Prospective Study from the MAPP Research Network. / MAPP Research Network.

In: Journal of Urology, Vol. 198, No. 4, 01.10.2017, p. 848-857.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Clinical and Psychosocial Predictors of Urological Chronic Pelvic Pain Symptom Change in 1 Year

T2 - A Prospective Study from the MAPP Research Network

AU - MAPP Research Network

AU - Naliboff, Bruce D.

AU - Stephens, Alisa J.

AU - Lai, H. Henry

AU - Griffith, James W

AU - Clemens, J. Quentin

AU - Lutgendorf, Susan

AU - Rodriguez, Larissa V.

AU - Newcomb, Craig

AU - Sutcliffe, Siobhan

AU - Guo, Wensheng

AU - Kusek, John W.

AU - Landis, J. Richard

PY - 2017/10/1

Y1 - 2017/10/1

N2 - Purpose We examined baseline clinical and psychosocial characteristics that predict 12-month symptom change in men and women with urological chronic pelvic pain syndromes. Materials and Methods A total of 221 female and 176 male patients with urological chronic pelvic pain syndromes were recruited from 6 academic medical centers in the United States and evaluated at baseline with a comprehensive battery of symptom, psychosocial and illness-impact measures. Based on biweekly symptom reports, a functional clustering procedure classified participant outcome as worse, stable or improved on pain and urinary symptom severity. Cumulative logistic modeling was used to examine individual predictors associated with symptom change as well as multiple predictor combinations and interactions. Results About 60% of participants had stable symptoms with smaller numbers (13% to 22%) showing clear symptom worsening or improvement. For pain and urinary outcomes the extent of widespread pain, amount of nonurological symptoms and poorer overall health were predictive of worsening outcomes. Anxiety, depression and general mental health were not significant predictors of outcomes but pain catastrophizing and self-reported stress were associated with pain outcome. Prediction models did not differ between men and women and for the most part they were independent of symptom duration and age. Conclusions These results demonstrate for the first time in a large multisite prospective study that presence of widespread pain, nonurological symptoms and poorer general health are risk factors for poorer pain and urinary outcomes in men and women. The results point to the importance of broad based assessment for urological chronic pelvic pain syndromes and future studies of the mechanisms that underlie these findings.

AB - Purpose We examined baseline clinical and psychosocial characteristics that predict 12-month symptom change in men and women with urological chronic pelvic pain syndromes. Materials and Methods A total of 221 female and 176 male patients with urological chronic pelvic pain syndromes were recruited from 6 academic medical centers in the United States and evaluated at baseline with a comprehensive battery of symptom, psychosocial and illness-impact measures. Based on biweekly symptom reports, a functional clustering procedure classified participant outcome as worse, stable or improved on pain and urinary symptom severity. Cumulative logistic modeling was used to examine individual predictors associated with symptom change as well as multiple predictor combinations and interactions. Results About 60% of participants had stable symptoms with smaller numbers (13% to 22%) showing clear symptom worsening or improvement. For pain and urinary outcomes the extent of widespread pain, amount of nonurological symptoms and poorer overall health were predictive of worsening outcomes. Anxiety, depression and general mental health were not significant predictors of outcomes but pain catastrophizing and self-reported stress were associated with pain outcome. Prediction models did not differ between men and women and for the most part they were independent of symptom duration and age. Conclusions These results demonstrate for the first time in a large multisite prospective study that presence of widespread pain, nonurological symptoms and poorer general health are risk factors for poorer pain and urinary outcomes in men and women. The results point to the importance of broad based assessment for urological chronic pelvic pain syndromes and future studies of the mechanisms that underlie these findings.

KW - cystitis

KW - interstitial

KW - pelvic pain

KW - prostate

KW - prostatitis

KW - urinary bladder

UR - http://www.scopus.com/inward/record.url?scp=85027581184&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85027581184&partnerID=8YFLogxK

U2 - 10.1016/j.juro.2017.05.065

DO - 10.1016/j.juro.2017.05.065

M3 - Article

VL - 198

SP - 848

EP - 857

JO - Journal of Urology

JF - Journal of Urology

SN - 0022-5347

IS - 4

ER -