We characterized the location and spatial distribution of whole body pain among patients with urologic chronic pelvic pain syndrome (UCPPS) using a body map; and compared the severity of urinary symptoms, pelvic pain, non-pelvic pain, and psychosocial health among patients with different pain patterns.
233 women and 191 men with UCPPS enrolled in a multi-center, one-year observational study completed a battery of baseline measures, including a body map describing the location of pain during the past week. Participants were categorized as having "pelvic pain only" if they reported pain in the abdomen and pelvis only. Participants who reported pain beyond the pelvis were further divided into two sub-groups based on the number of broader body regions affected by pain: an "intermediate" group (1-2 additional regions outside the pelvis) and a "widespread pain" group (3-7 additional regions).
Of the 424 enrolled patients 25% reported pelvic pain only, and 75% reported pain beyond the pelvis of which 38% reported widespread pain. Participants with greater number of pain locations had greater non-pelvic pain severity (p<0.0001), sleep disturbance (p=0.035), depression (p=0.005), anxiety (p=0.011), psychological stress (p=0.005), negative affect scores (p=0.0004), and worse quality of life (p≤0.021). No difference in pelvic pain and urinary symptom severity were observed by increasing pain distribution.
Three-quarters of men and women with UCPPS reported pain outside the pelvis. Widespread pain was associated with greater severity of non-pelvic pain symptoms, poorer psychosocial health and worse quality of life, but not worse pelvic pain or urinary symptoms.
The Journal of urology. 2017 Mar 31 [Epub ahead of print]
H Henry Lai, Thomas Jemielita, Siobhan Sutcliffe, Catherine S Bradley, Bruce Naliboff, David A Williams, Robert W Gereau, Karl Kreder, J Quentin Clemens, Larissa V Rodriguez, John N Krieger, John T Farrar, Nancy Robinson, J Richard Landis, MAPP Research Network
Division of Urologic Surgery; Department of Anesthesiology and Washington University Pain Center, Washington University School of Medicine, St Louis, MO., Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA., Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St Louis, MO., Department of Obstetrics and Gynecology, University of Iowa School of Medicine, Iowa City, IA., Department of Medicine and Psychiatry and Biobehavioral Sciences, University of California School of Medicine, Los Angeles, CA., Department of Anesthesiology, University of Michigan School of Medicine, Ann Arbor, MI., Department of Anesthesiology and Washington University Pain Center, Washington University School of Medicine, St Louis, MO., Department of Urology, University of Iowa School of Medicine, Iowa City, IA., Department of Urology, University of Michigan School of Medicine, Ann Arbor, MI., Departments of Urology and Obstetrics and Gynecology, University of Southern California, Los Angeles, CA., Department of Urology, University of Washington School of Medicine, Seattle, WA., Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.