A Review of Techniques used for Evaluating Lower Urinary Tract Symptoms and the Level of Quality of Life in Patients with Chronic Pelvic Pain Syndrome

Abstract

Although the prevalence of CPPS is somewhat uncertain, the cost to society in order to manage it is huge. CPPS presents itself with a variety of symptoms attaining multiple systems. The symptoms and discomfort have been evaluated using questionnaires (e.g. MPQ-DLV, PDI, NIH-CPSI, ICSI, and PUF). Very different results have been found. This indicates that results from one questionnaire cannot be used for overall conclusions concerning pain intensity and QoL, although for bladder symptoms the results seem more corresponding. No gender difference has been found in questionnaire based symptom scores. Women with CPPS are less sexually active and have a higher impact on the QoL compared to men. The result of treatment, will greatly depend on an accurate diagnosis. A thorough clinical assessment using a ‘four step plan’ with special attention to the musculoskeletal system is very valuable The physical examination including palpation and neurodynamic assessment can help indicate pain points and peripheral neuropathies. Constant current perception threshold (CPTs) in healthy volunteers showed that for all measures the female CPTs were lower than these of men. But determining normative CPTs proved problematic: A weak intraclass correlation has been shown with one week interval. Both for the pudendal and the median nerves deviating values in healthy volunteers using sinusoidal stimulation have been found. Our normative CPTs showed almost no agreement with control groups in other studies. The search for a reliable and reproducible semi-objective evaluation of sensory function in CPPS patients must be continued.