MP63-01 PAIN CATASTROPHIZING IS ASSOCIATED WITH WORSE PAIN OUTCOMES FOR SPECIALIZED PELVIC PT

Abstract

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Non-neurogenic Voiding Dysfunction II (MP63)1 Sep 2021MP63-01 PAIN CATASTROPHIZING IS ASSOCIATED WITH WORSE PAIN OUTCOMES FOR SPECIALIZED PELVIC PT Shashank S. Pandya, Daniel Alaiev, Danielle Wang, Katelyn Kunkle, Lindsey Nyman, Jennifer Fariello-Moldwin, Stephanie Goldstein, and Robert M. Moldwin Shashank S. PandyaShashank S. Pandya More articles by this author , Daniel AlaievDaniel Alaiev More articles by this author , Danielle WangDanielle Wang More articles by this author , Katelyn KunkleKatelyn Kunkle More articles by this author , Lindsey NymanLindsey Nyman More articles by this author , Jennifer Fariello-MoldwinJennifer Fariello-Moldwin More articles by this author , Stephanie GoldsteinStephanie Goldstein More articles by this author , and Robert M. MoldwinRobert M. Moldwin More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002103.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Pain catastrophizing consists of exaggerated ruminating negative thoughts and emotions brought on by an actual, perceived, or an anticipated painful stimulus. Pain catastrophizing leads to less improvement over time. We sought to predict the relationship between pain catastrophizing and the outcomes of specialized pelvic floor physical therapy (PT). METHODS: Data was collected retrospectively between 2019-2020 from 39 patients (35 females and 4 males between the ages 18-72) diagnosed with UCPPS with pelvic floor myalgia who underwent 6 weeks of 1-2 sessions/week of specialized pelvic PT. All patients filled out the short version of the Pain Catastrophizing Scale (PCS; 0-24) and the Genitourinary Pain Index (GUPI; 0-45) before and after 6 six weeks of PT. Sets of Bayesian binomial regression models were generated to predict changes in pain scores using the full GUPI, GUPI Pain Subscale (0-23), Visual Analog Score (VAS; 0-10), and PCS split into terciles, quartiles, or maximum/minimum. A standard null model was fit as a benchmark against other models. PSIS-LOO cross-validation with pseudo-BMA weighting was used to select the best performing model. RESULTS: The best performing model predicted a significant clinical change in VAS after six weeks of PT for minimum/non-pain catastrophizers (NC; 0 PCS) and maximum/extreme pain catastrophizers (EC; 24 PCS). Table 1 shows the predictions for the change in VAS from baseline (ΔVAS=Week 6-initial VAS) after six weeks of PT. For example, at a baseline VAS of 6 and an initial PCS of 0 (NC), 97.1 % (posterior probability) of the time, the model predicts a median improvement of 3 points after with 95% (Bayesian credible interval) of the predictions falling between an improvement of 1 to 6 points. With the same baseline VAS of 6, if the initial PCS was 24 (EC), 97.1% of the time, the model predicts a median improvement of 0 with 95% of the predictions falling between an improvement of 2 points to a worsening of 3 points. CONCLUSIONS: NC’s were predicted to have improved VAS scores than EC’s after 6 weeks of PT. Unlike the Pain Subscale or GUPI, which are composite scores, VAS is better at predicting change over time (test-retest reliability). This has implications for future studies’ choice of instrument for tracking pain over time. A significant limitation of this model is the small sample size. Source of Funding: N/A © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e1101-e1101 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Shashank S. Pandya More articles by this author Daniel Alaiev More articles by this author Danielle Wang More articles by this author Katelyn Kunkle More articles by this author Lindsey Nyman More articles by this author Jennifer Fariello-Moldwin More articles by this author Stephanie Goldstein More articles by this author Robert M. Moldwin More articles by this author Expand All Advertisement Loading ...