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Clin J Pain. 2019 Sep 26. doi: 10.1097/AJP.0000000000000769. [Epub ahead of print]

A MAPP Network Case-Control Study of Urologic Chronic Pelvic Pain Compared with Non-Urologic Pain Conditions.

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VA Center of Excellence for Stress & Mental Health and Department of Psychiatry, University of California, San Diego.
Elson S Floyd College of Medicine, Washington State University.
Departments of Anesthesiology, Medicine, and Psychiatry, University of Michigan.
Department of Psychiatry, Washington University School of Medicine.
Department of Biostatistics, Epidemiology & Informatics, University of Pennsylvania.
Department of Urology, University of Washington.
National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health.



Limited research suggests commonalities between urologic chronic pelvic pain syndromes (UCPPS) and other non-urologic chronic overlapping pain conditions (COPCs) including fibromyalgia, chronic fatigue syndrome, and irritable bowel syndrome. The goal of this case-control study was to examine similarities and differences between UCPPS and these other COPCs.


As part of the Multidisciplinary Approach to the Study of Chronic Pelvic Pain Research Network, we examined 1,039 individuals with UCPPS (n=424), non-urologic COPCs (n=200), and healthy controls (n=415). Validated standardized measures were used to assess urological symptoms, non-urological pain symptoms, and psychosocial symptoms and traits.


Participants with UCPPS had more urologic symptoms than non-urologic COPCs or healthy controls (P<0.001); non-urological COPC group also had significantly worse urological symptoms than healthy controls (P<0.001). Participants with non-urological COPCs reported more widespread pain than those with UCPPS (P<0.001), yet both groups had similarly increased symptoms of anxiety, depression, negative affect, perceived stress, neuroticism, and lower levels of extraversion than healthy controls (P<0.001). Participants with UCPPS with and without COPCs reported more catastrophizing than those with non-urological COPCs (P<0.001).


Findings are consistent with the hypothesis of common underlying biopsychosocial mechanisms and can guide the comprehensive assessment and treatment of these conditions regardless of the primary site of pain or diagnosis. Heightened catastrophizing in UCPPS should be examined to inform psychosocial interventions and improve patient care.

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