Most studies on interstitial cystitis/bladder pain syndrome and chronic prostatitis/chronic pelvic pain syndrome use typical or average levels of pelvic pain or urologic symptom intensity as their outcome, as both are associated with reduced quality of life (QOL). Symptom exacerbations or "flares" have also been found to be associated with reduced QOL, but no studies, to our knowledge, have investigated whether these associations are independent of typical pelvic pain levels and thus might be useful additional outcome measures (or stated differently, whether reducing flare frequency even without reducing mean pain intensity may be important to patients).
We used screening visit and weekly run-in period data from the Multidisciplinary Approach to the Study of Chronic Pelvic Pain Symptom Patterns Study to investigate associations between flare frequency and multiple measures of illness impact and health care seeking activity, independent of typical non-flare and overall pelvic pain levels.
Among the 613 eligible participants, greater flare frequency was associated with worse condition-specific illness impact (standardized β coefficients=0.11-0.68, p-trends <0.0001) and health care seeking activity (odds ratios=1.52-3.94, p-trends=0.0039-<0.0001) in analyses adjusted for typical non-flare and overall pelvic pain levels. Experiencing ≥1/day was also independently associated with worse general illness impact (standardized β coefficients=0.11-0.25).
Our findings suggest that flare frequency and possibly other flare characteristics may be worth considering as additional outcome measures in UCPPS research to support the development of new preventive and therapeutic flare strategies.
The Journal of urology. 2023 Jan 11 [Epub ahead of print]
Siobhan Sutcliffe, Craig Newcomb, Catherine S Bradley, J Quentin Clemens, Bradley Erickson, Priyanka Gupta, H Henry Lai, Bruce Naliboff, Eric Strachan, Alisa Stephens-Shields
Division of Public Health Sciences, Department of Surgery; Alvin J. Siteman Cancer Cancer; and the Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri., Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania., Department of Obstetrics and Gynecology, Carver College of Medicine, University of Iowa, Iowa City, Iowa., Department of Urology, University of Michigan, Ann Arbor, Michigan., Department of Urology, Carver College of Medicine, University of Iowa, Iowa City, Iowa., Division of Urologic Surgery, Department of Surgery; and the Department of Anesthesiology, Washington University School of Medicine, St Louis, Missouri., Department of Medicine, Geffen School of Medicine, University of California - Los Angeles, Los Angeles, California., Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington.