Does Pollen Trigger Urologic Chronic Pelvic Pain Syndrome Flares? A Case-Crossover Analysis in the Multidisciplinary Approach to the Study of Chronic Pelvic Pain Research Network.

To determine whether pollen triggers urologic chronic pelvic pain syndrome (UCPPS) flares.

We assessed flare status every two weeks for one year as part of the Multidisciplinary Approach to the study of Chronic Pelvic Pain (MAPP) case-crossover study of flare triggers. Flare symptoms, flare start date, and exposures in the three days before a flare were queried for the first three flares and at three randomly selected non-flare times. These data were linked to daily pollen count by date and the first three digits of participants' zip codes. Pollen count in the 3 days before and day of a flare, as well as pollen rises past established thresholds, were compared to non-flare values by conditional logistic regression. Poisson regression was used to estimate flare rates in the three weeks following pollen rises past established thresholds in the full longitudinal study. Analyses were performed in all participants and separately in those who reported allergies or respiratory tract disorders.

Although no associations were observed for daily pollen count and flare onset, positive associations were observed for pollen count rises past medium or higher thresholds in participants with allergies or respiratory tract disorders in the case-crossover (odds ratio=1.31, 95% confidence interval [CI]: 1.04-1.66) and full longitudinal (relative rate=1.23, 95% CI: 1.03-1.46) samples.

We found some evidence to suggest that rising pollen count may trigger UCPPS flares. If confirmed in future studies, these findings may help to inform flare pathophysiology, prevention, treatment, and control over the unpredictability of flares.

The Journal of urology. 2020 Dec 21 [Epub ahead of print]

Irum Javed, Tiange Yu, Jieni Li, Ratna Pakpahan, Melissa Milbrandt, Gerald L Andriole, Jerry L Lowder, H Henry Lai, Graham A Colditz, Siobhan Sutcliffe

Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri., Division of Urological Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri., Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri., Department of Anesthesiology, Washington University School of Medicine, St. Louis, Missouri.

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