Clustering of Patients with Interstitial Cystitis/Bladder Pain Syndrome and Chronic Prostatitis/Chronic Pelvic Pain Syndrome.

To use clustering analysis of patient symptoms to discover common patient subtypes in females and males with interstitial cystitis/bladder pain syndrome (IC/BPS) or chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).

Clinical variables included in the k-means clustering included the severity of urologic pain (0-10 numeric rating scale, NRS), urinary urgency (0-10 NRS), frequency (0-10 NRS), non-urologic pain (0-10 NRS), and either a yes or no to each of the six UPOINT domains.

211 UCPPS patients seeking care of their IC/BPS or CP/CPPS were included. K-means clustering algorithm identified 3 clusters of IC/BPS and CP/CPPS patients: (1) a mild pelvic symptom cluster in about 30% of patients; (2) a severe pelvic symptom cluster in about 40% of patients; and (3) a systemic symptom cluster in about 30% of patients. Patients in the systemic cluster were younger (by about 5-7 years), more likely to be female, had the most severe urinary symptoms (urgency, frequency, painful bladder filling), the most severe pelvic pain and non-pelvic pain. They were also more likely to have chronic overlapping pain conditions (COPCs), psychosocial issues (depression, anxiety, somatic symptoms), and poorer quality of life than the two other pelvic clusters. They were not less likely to have Hunner lesions inside the bladder.

Symptom-based clustering has identified 3 clusters of IC/BPS and CP/CPPS patients. These patient subtypes have different pelvic and systemic presentation. Patients within the systemic cluster may benefit from interdisciplinary therapies. Future studies to elucidate the differences in pathophysiology among these clusters are needed.

The Journal of urology. 2019 Mar 27 [Epub ahead of print]

H Henry Lai, James H L Thu, Frederick V Moh, Alethea Paradis, Joel Vetter

Division of Urologic Surgery, Department of Surgery , and.