AUA 2019: Pain Profile Discovery in Urologic Chronic Pelvic Pain Syndrome: Consensus Clustering Findings from the MAPP Research Network

Chicago, IL ( The goal of the MAPP Research Network Epidemiology and Phenotyping Study (EPS) was to introduce clinical subgroups of patients with Urologic Chronic Pelvic Pain Syndrome (UCPPS). UCPPS is defined as interstitial cystitis/bladder pain syndrome (IC/BPS) in women and chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) in men.

Brief Pain Inventory body map was utilized to document 45 potential pain sites. These data were assigned to 4 patient groups with various pain profiles using Consensus clustering technique. The study cohort included 233 women with IC/BPS and 191 men with CP/CPPS. Data analysis showed that the most common pain sites were pelvis (85%), lower back (39%), lower abdomen (33%), front of the head (27%), and back of the neck (22%)(Figure 1).

AUA 2019 brief pain inventory body map
Figure 1

Cluster 1 research participants reported pelvic pain only. Patients in Cluster 2 identified both pelvic pain and some minimal pain beyond pelvis. Cluster 3 subjects indicated pelvic pain, minimal pain beyond pelvic area, and a 100% back pain. Cluster 4 participants had pelvic pain and widespread pain at other sites (Figure 2).

AUA 2019 pain item cluster location
Figure 2

Chronic overlapping pain conditions were noted. They included irritable bowel syndrome (IBS), fibromyalgia (FM), chronic fatigue syndrome (CFS), migraine, and temporomandibular joint dysfunction (TMJ). There was a statistically significant difference in symptom improvement in patients in Cluster 1 compared to 3 other groups (Figure 3).

AUA 2019 figure 3 longitudinal model
Figure 3

The study identified four distinct clusters of patients with UCPPS. Cluster one was significantly associated with urologic pelvic pain severity. Lower back pain was an important determinant of a difference in pain between the groups. Research should expend to other symptoms to improve scientific knowledge of the condition.

Presented by: Kenneth Locke, Jr., PhD candidate, University of Pennsylvania, Philadelphia, Pennsylvania 

Written by: Hanna Stambakio, BS, Clinical Research Coordinator, Division of Urology, University of Pennsylvania, @AStambakio at American Urological Association's 2019 Annual Meeting (AUA 2019), May 3 – 6, 2019 in Chicago, Illinois