1581 IMPACT OF SYMPTOM DURATION ON BASELINE CHARACTERISTICS OF THE MULTIDISCIPLINARY APPROACH TO PELVIC PAIN (MAPP) STUDY COHORT

Abstract

You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Female Urology (I)1 Apr 20131581 IMPACT OF SYMPTOM DURATION ON BASELINE CHARACTERISTICS OF THE MULTIDISCIPLINARY APPROACH TO PELVIC PAIN (MAPP) STUDY COHORT Larissa Rodriguez, Alisa Stephens, JQuentin Clemens, Claire Yang, Henry Lai, Deborah Buchwald, Cate Bradley, and John Krieger Larissa RodriguezLarissa Rodriguez Los Angeles, CA More articles by this author , Alisa StephensAlisa Stephens Philadelphia, PA More articles by this author , JQuentin ClemensJQuentin Clemens Ann Harbor, Macedonia More articles by this author , Claire YangClaire Yang Seattle, WA More articles by this author , Henry LaiHenry Lai St. Louis, Macedonia More articles by this author , Deborah BuchwaldDeborah Buchwald Seattle, WA More articles by this author , Cate BradleyCate Bradley Iowa City, IA More articles by this author , and John KriegerJohn Krieger Seattle, WA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.3131AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Symptom severity in patients with urologic chronic pelvic pain syndromes (UCPPS), has been associated with symptom duration. Compared with the general population, UCPPS patients have higher rates of other somatic syndromes, such as fibromyalgia (FM), irritable bowel syndrome (IBS) and chronic fatigue syndrome (CFS), and mental health comorbidities. We hypothesized that UCPPS patients with longer duration of symptoms would also be more likely to report these comorbid conditions. We evaluated cross-sectional associations between symptom duration and 1) symptom severity, and 2) presence of other somatic syndromes and mental health symptoms. METHODS Baseline data were analyzed from the MAPP Epidemiology and Phenotyping Study, a NIH-sponsored multi-center observational study of patients with UCPPS. Patients were stratified by symptom duration as a discrete (< or >= 2 years) or continuous variable. Symptom severity was assessed by the Genitourinary Pain Index (GUPI), the IC Symptom and Problem Index, and Likert scales for pelvic pain, urgency and frequency. Depression and anxiety were evaluated with the Hospital Anxiety and Depression Scale (HADS) and stress with the Perceived Stress Scale (PSS). RESULTS 442 participants were included. Males (not females) with symptoms >= 2 years had more severe symptoms than those with < 2 years (p<0.05). When evaluating symptom duration as a continuous variable, adjusting for age and gender, there was an increase in GUPI total and GUPI pain subscale scores for each additional year of symptoms (p<0.01). Females were 62% more likely than males to have other somatic syndromes (p<0.03). On multivariable analysis, there was a significant increase in the likelihood of patients experiencing CFS (1.043/yr) and FM (1.041/yr), but not IBS for each additional year of UCPPS symptoms (p<0.015). CONCLUSIONS Females with UCPPS symptoms <2 years experienced more severe urinary symptoms, higher levels of stress, anxiety and depression than males with symptoms <2 years. Symptom duration was associated with increased severity of urinary symptoms and risk for concomitant somatic disorders. These findings point to gender-specific differences in the likelihood of comorbid conditions and symptom severity in UCPPS patients with longer symptom duration. Questionnaire MALES FEMALES p-value (<2yr male vs. female) < 2 yrs ≥ 2 yrs < 2 yrs ≥ 2 yrs N 87 100 89 166 Mean+/−s.d. Mean+/−s.d. p-value Mean+/s.d. Mean+/−s.d. p-value GUPI total (0-45) 23.4+/−7.1 25.5+/− 9.0 0.072 27.1+/− 8.3 26.5+/− 9.1 0.652 0.001 GUPI pain subscale (0-23) 11.7+/−3.7 12.6+/−4.7 0.223 12.9+/−4.3 13.1+/−4.7 0.595 0.038 GUPI urinary subscale (0-10) 4.2+/−2.8 5.2+/−2.8 0.013 6.0+/−2.7 5.6+/−3.1 0.341 <0.001 Urgency scale (0-10) 4.1+/−2.5 5.3+/− 2.5 0.002 5.4+/− 2.5 5.3+/−2.5 0.768 <0.001 Frequency scale (0-10) 4.2+/−2.7 5.1+/− 2.4 0.025 5.1+/− 2.4 5.1+/−2.6 0.743 0.012 Pelvic pain scale (0-10) 4.6+/−2.1 5.0+/− 2.3 0.176 5.3+/− 2.0 5.3+/−2.2 0.921 0.020 ICSI (0-20) 7.3+/−4.2 9.7+/−4.8 <0.001 10.7+/− 4.3 10.8+/−4.6 0.969 <0.001 ICPI (0-16) 6.3+/−4.3 8.3+/−4.5 0.002 9.6+/− 3.9 9.5+/−4.1 0.733 <0.001 Anxiety (0-21) 7.4+/−4.4 7.5+/−4.3 0.696 8.9+/− 4.8 7.6+/−4.5 0.048 0.030 Depression (0-21) 5.2+/−4.1 5.9+/−4.1 0.201 6.2+/− 4.7 5.4+/−4.2 0.218 0.160 Stress (0-40) 15.7+/−7.2 15.2+/−7.1 0.508 19.8+/− 8.9 16.6+/−7.8 0.006 0.003 © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e649-e650 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Larissa Rodriguez Los Angeles, CA More articles by this author Alisa Stephens Philadelphia, PA More articles by this author JQuentin Clemens Ann Harbor, Macedonia More articles by this author Claire Yang Seattle, WA More articles by this author Henry Lai St. Louis, Macedonia More articles by this author Deborah Buchwald Seattle, WA More articles by this author Cate Bradley Iowa City, IA More articles by this author John Krieger Seattle, WA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...