MP16-02 "GETTING TO ZERO": PHENOTYPE, SYMPTOM SEVERITY AND TREATMENT IN CHRONIC PROSTATITIS/CHRONIC PELVIC PAIN SYNDROME PATIENTS WHO SELF REPORT SYMPTOM RESOLUTION

Abstract

You have accessJournal of UrologyInfections/Inflammation of the Genitourinary Tract: Prostate & Genitalia1 Apr 2014MP16-02 "GETTING TO ZERO": PHENOTYPE, SYMPTOM SEVERITY AND TREATMENT IN CHRONIC PROSTATITIS/CHRONIC PELVIC PAIN SYNDROME PATIENTS WHO SELF REPORT SYMPTOM RESOLUTION Chad Reichard, Irene Makovey, and Daniel Shoskes Chad ReichardChad Reichard More articles by this author , Irene MakoveyIrene Makovey More articles by this author , and Daniel ShoskesDaniel Shoskes More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.575AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The NIH-Chronic Prostatitis Symptom Index (CPSI) was developed to quantify the extent and severity of symptoms in chronic pelvic pain syndrome (CPPS) and impact on quality of life. It is responsive to symptom change and a 6 point drop correlates with perceived patient improvement. Symptom improvement is not equivalent to "cure" and no studies have examined CPSI score targets in patients who consider their CPPS completely resolved. Indeed, there are sufficient non-specific questions in the CPSI that would allow many otherwise normal patients to have a score greater than zero. The aim of this study was to identify a cohort of CPPS patients who considered their symptoms completely resolved and analyze their demographics, clinical phenotype, treatments and CPSI scores. METHODS We identified 27 CPPS patients seen at our tertiary referral center who at the follow up visits reported that they felt their symptoms to be completely resolved ("cured"). Demographics, UPOINT phenotypes, treatments, and pre and post CPSI scores were examined. We also compared these variables to an existing database of 220 CPPS patients previously evaluated and phenotyped at our clinic. RESULTS Patients ranged in age from 22 to 68 years. Median follow up was 11 months (range 3 to 73 months). There were a median of 3 UPOINT domains positive (range 1-5) and a median of 3 treatments prescribed (range 1-6). UPOINT positive domains were 67% urinary, 26% psychosocial, 63% organ specific, 11% infectious, 26% neurologic, and 70% musculoskeletal tenderness. Mean change in CPSI subscores before and after therapy were pain 9.7 to 3.0, urinary 3.6 to 1.2, QOL 8.1 to 2.4, and total 21.4 to 6.7 (all p<0.0001). Of note, only 5 (19%) patients reported a total score of 0. Comparing this "cured" group to a previously published cohort of phenotyped CPPS patients, the "cured" group had lower starting total and pain CPSI scores (21.4 vs 25.0 p=0.008; 9.7 vs 11.5 p=0.02 respectively). There were no differences in number of UPOINT domains, age or proportion of positive domains between the two data sets. CONCLUSIONS Many men with CPPS can reach a subjective cure, however having done so, the majority do not reach a CPSI score of 0. This group of "cured" patients is similar to our typical tertiary referral cohort in terms of age and phenotype but differs in having slightly lower starting CPSI pain scores. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e153-e154 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Chad Reichard More articles by this author Irene Makovey More articles by this author Daniel Shoskes More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...