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J Urol. 2017 Sep;198(3):622-631. doi: 10.1016/j.juro.2017.03.132. Epub 2017 Mar 31.

Characterization of Whole Body Pain in Urological Chronic Pelvic Pain Syndrome at Baseline: A MAPP Research Network Study.

Author information

1
Division of Urologic Surgery, Washington University School of Medicine, St. Louis, Missouri; Department of Surgery and Department of Anesthesiology and Washington University Pain Center, Washington University School of Medicine, St. Louis, Missouri. Electronic address: laih@wudosis.wustl.edu.
2
Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
3
Division of Public Health Sciences, Washington University School of Medicine, St. Louis, Missouri.
4
Department of Obstetrics and Gynecology, University of Iowa School of Medicine, Iowa City, Iowa.
5
Departments of Medicine and Psychiatry and Biobehavioral Sciences, University of California School of Medicine, Los Angeles, California.
6
Department of Anesthesiology, University of Michigan School of Medicine, Ann Arbor, Michigan.
7
Department of Surgery and Department of Anesthesiology and Washington University Pain Center, Washington University School of Medicine, St. Louis, Missouri.
8
Department of Urology, University of Iowa School of Medicine, Iowa City, Iowa.
9
Department of Urology, University of Michigan School of Medicine, Ann Arbor, Michigan.
10
Departments of Urology and Obstetrics and Gynecology, University of Southern California, Los Angeles, California.
11
Department of Urology, University of Washington School of Medicine, Seattle, Washington.
12
Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.

Abstract

PURPOSE:

We characterized the location and spatial distribution of whole body pain in patients with urological chronic pelvic pain syndrome using a body map. We also compared the severity of urinary symptoms, pelvic pain, nonpelvic pain and psychosocial health among patients with different pain patterns.

MATERIALS AND METHODS:

A total of 233 women and 191 men with urological chronic pelvic pain syndrome enrolled in a multicenter, 1-year observational study completed a battery of baseline measures, including a body map describing the location of pain during the last week. Participants were categorized with pelvic pain if they reported pain in the abdomen and pelvis only. Participants who reported pain beyond the pelvis were further divided into 2 subgroups based on the number of broader body regions affected by pain, including an intermediate group with 1 or 2 additional regions outside the pelvis and a widespread pain group with 3 to 7 additional regions.

RESULTS:

Of the 424 enrolled patients 25% reported pelvic pain only and 75% reported pain beyond the pelvis, of whom 38% reported widespread pain. Participants with a greater number of pain locations had greater nonpelvic pain severity (p <0.0001), sleep disturbance (p = 0.035), depression (p = 0.005), anxiety (p = 0.011), psychological stress (p = 0.005) and negative affect scores (p = 0.0004), and worse quality of life (p ≤0.021). No difference in pelvic pain and urinary symptom severity was observed according to increasing pain distribution.

CONCLUSIONS:

Three-quarters of the men and women with urological chronic pelvic pain syndrome reported pain outside the pelvis. Widespread pain was associated with greater severity of nonpelvic pain symptoms, poorer psychosocial health and worse quality of life but not with worse pelvic pain or urinary symptoms.

KEYWORDS:

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

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