Transitions from Regional to Widespread Pain in Urologic Chronic Pelvic Pain Syndrome: A Multidisciplinary Approach to the Study of Chronic Pelvic Pain II Research Network Study.

Abstract

We used prospective data from a well-characterized urologic chronic pelvic pain syndrome (UCPPS) cohort (including interstitial cystitis/bladder pain syndrome and chronic prostatitis/chronic pelvic pain syndrome) to identify transitions between localized pelvic pain (LP) and widespread pain (WP) and characteristics associated with these transitions. A total of 311 individuals (195 women; 116 men) with UCPPS were recruited from 6 sites and followed for 3 years. Participants completed 5 weekly "run-in" assessments at baseline, followed by quarterly symptom assessments. Responses on a self-reported body pain map were used to define LP vs WP (≥2 nonpelvic body map regions with pain). Multivariable modeling was used to evaluate 74 baseline characteristics related to transitions between LP and WP. At baseline, 126 participants (41%) reported LP, 13 (10.3%) of whom transitioned to WP. Conversely, 17 of the 66 participants (26%) with WP transitioned to LP at follow-up. Progression from LP to WP was associated with: (1) not living with a partner/spouse and (2) a higher Somatic Awareness Score on the complex multisymptom inventory. Conversely, transition from WP to LP was associated with: (3) lower urinary urgency symptoms on the complex multisymptom inventory and (4) higher frequency of sensation of not emptying bladder completely. Greater levels of baseline nonpainful somatic symptoms were associated with progression to WP, suggesting that high baseline somatic symptoms may predict the development of future pain. Not living with a spouse/partner was also associated with progression to WP, highlighting the importance of social support in UCPPS. ClinicalTrials.gov Identifier: NCT02514265-MAPP Research Network: Trans-MAPP Study of UCPPS: Symptom Patterns Study.