Changes in symptoms during urologic chronic pelvic pain syndrome symptom flares: findings from one site of the MAPP Research Network

Neurourol Urodyn. 2015 Feb;34(2):188-95. doi: 10.1002/nau.22534. Epub 2013 Nov 23.

Abstract

Aims: To provide the first description and quantification of symptom changes during interstitial cystitis/bladder pain syndrome and chronic prostatitis/chronic pelvic pain syndrome symptom exacerbations ("flares").

Methods: Participants at one site of the Trans-Multidisciplinary Approaches to the study of chronic Pelvic Pain Epidemiology and Phenotyping Study completed two 10-day diaries over the 1-year study follow-up period, one at baseline and one during their first flare (if not at baseline). On each day of the diary, participants reported whether they were currently experiencing a flare, defined as "symptoms that are much worse than usual" for at least 1 day, and their levels of urination-related pain, pelvic pain, urgency, and frequency on a scale of 0-10. Linear mixed models were used to calculate mean changes in symptoms between non-flare and flare days from the same participant.

Results: Eighteen of 27 women and 9 of 29 men reported at least one flare during follow-up, for a total of 281 non-flare and 210 flare days. Of these participants, 44.4% reported one flare, 29.6% reported two flares, and 25.9% reported ≥ 3 flares over the combined 20-day diary observation period, with reported flares ranging in duration from 1 day to >2 weeks. During these flares, each of the main symptoms worsened significantly by a mean of at least two points and total symptoms worsened by a mean of 11 points for both sexes (all P ≤ 0.01).

Conclusions: Flares are common and correspond to a global worsening of urologic and pelvic pain symptoms.

Keywords: bladder pain syndrome; chronic pelvic pain syndrome; chronic prostatitis; flare; interstitial cystitis; symptom exacerbation.

Publication types

  • Observational Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Chronic Disease
  • Cystitis, Interstitial / diagnosis
  • Cystitis, Interstitial / physiopathology*
  • Disease Progression*
  • Female
  • Follow-Up Studies
  • Humans
  • Linear Models
  • Longitudinal Studies
  • Male
  • Medical Records
  • Middle Aged
  • Pelvic Pain / diagnosis
  • Pelvic Pain / physiopathology*
  • Prostatitis / diagnosis
  • Prostatitis / physiopathology*
  • Severity of Illness Index*
  • Syndrome
  • Time Factors
  • Young Adult