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Longitudinal Changes in the Pelvic Pain Only and Widespread Pain Phenotypes Over One Year in the MAPP-I Urologic Chronic Pelvic Pain Syndrome (UCPPS) Cohort - 17/03/22

Doi : 10.1016/j.urology.2021.12.016 
Henry Lai 1, , Emine O. Bayman 2, 3, Michael O. Bishop 2, Richard Landis 4, Steven E. Harte 5, Quentin Clemens 6, Larissa V. Rodriguez 7, Siobhan Sutcliffe 8, Bayley J. Taple 9, Bruce D. Naliboff 10

the MAPP Research Network11

  see Appendix for MAPP-I Research Network Study Group.

1 Departments of Surgery (Urology) and Anesthesiology, Washington University School of Medicine, St Louis, MO 
2 Department of Biostatistics, University of Iowa, Iowa City, IA 
3 Department of Anesthesiology, University of Iowa, Iowa City, IA 
4 Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 
5 Chronic Pain and Fatigue Research Center, Department of Anesthesiology, University of Michigan, Ann Arbor, MI 
6 Department of Urology, University of Michigan, Ann Arbor, MI 
7 Departments of Urology, and Obstetrics and Gynecology, University of Southern California, Los Angeles, CA 
8 Departments of Surgery (Public Health Sciences), Washington University School of Medicine, St Louis, MO 
9 Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 
10 Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA 

Address correspondence to: H. Henry Lai, M.D., Division of Urologic Surgery, Washington University School of Medicine, 4960 Children's Place, Campus Box 8242, St Louis, MO 63110.Division of Urologic SurgeryWashington University School of Medicine4960 Children's Place, Campus Box 8242St LouisMO63110

Abstract

Objective

To examine how often urologic chronic pelvic pain syndrome (UCPPS) patients progressed from Pelvic Pain Only at baseline to Widespread Pain, or vice versa, during 1-year longitudinal follow-up.

Methods

Men and women with UCPPS enrolled in the MAPP-I Epidemiology and Phenotyping Study completed a self-report body map to indicate their locations of pain every 2 months over 12 months. Patients were categorized at each assessment into one of three pain phenotypes: (1) Pelvic Pain Only, (2) an Intermediate group, (3) Widespread Pain. Only patients who completed 3 or more follow-ups were included in this longitudinal analysis. The primary outcome measure was pain classification at the majority (≥60%) of follow-up assessments. Longitudinal trends of somatic symptom burden were also assessed.

Results

Among the 93 UCPPS participants with Pelvic Pain Only at baseline, only 2% (n = 2) showed a Widespread Pain phenotype for the majority of assessments over 12 months. Among the 121 participants who had Widespread Pain at baseline, 6% (n = 7) demonstrated Pelvic Pain Only for the majority of assessments over 12 months. Over half of participants (≥53%) stayed in their baseline phenotypic group. Somatic symptom burden remained stable over 12 months for each of the groups with high intra-class correlation coefficient (0.67 to 0.82).

Conclusion

It was uncommon for UCPPS patients to progress from Pelvic Pain Only to Widespread Pain, or vice versa, over 12 months. These data suggest that Pelvic Pain Only and Widespread Pain are distinct UCPPS phenotypes that are relatively stable over 12 months of follow up.

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Abbreviations : CMSI, CP/CPPS, IC/BPS, ICC, IP, MAPP, PPO, UCPPS, WP


Plan


 Clinical Trial: ClinicalTrials.gov Identifier: NCT01098279.
 Funding: The MAPP Research Network acknowledges support through NIH grants: U01 DK823 Funding for the MAPP Research Network was obtained under a cooperative agreement from National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health (NIH) [DK082315 (Andriole, G; Lai, H), DK082316 (Landis, J), DK082325 (Buchwald, D), DK082333 (Lucia, M), DK082342 (Klumpp, D; Schaeffer A), DK082344 (Kreder, K), DK082345 (Clauw, D; Clemens, JQ), DK082370 (Mayer, E; Rodriguez L), DK103227 (Moses, M), DK103260 (Anger, J; Freeman, M), DK103271 (Nickel, J)].


© 2021  Publié par Elsevier Masson SAS.
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Vol 161

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