OBJECTIVES: To describe the full spectrum of symptom exacerbations defined by interstitial cystitis/bladder pain syndrome and chronic prostatitis/chronic pelvic pain syndrome patients as flares, and to investigate their associated health-care utilization and bother at two sites of the Trans-Multidisciplinary Approaches to the Study of Chronic Pelvic Pain (Trans-MAPP) Epidemiology and Phenotyping study.
PATIENTS AND METHODS: Participants completed a flare survey that asked them: 1) whether they had ever had flares ("symptoms that are much worse than usual") that lasted < 1 hr, >1 hr and < 1 day, and >1 day; and 2) for each duration of flare, to report their: a) average length and frequency; b) typical levels of urologic and pelvic pain symptoms; and c) levels of health-care utilization and bother. We compared participants' responses to their non-flare Trans-MAPP values and across flares using generalized linear mixed models.
RESULTS: Seventy six of 85 participants (89.4%) completed the flare survey, 72 of whom reported having flares (94.7%). Flares varied widely in terms of their duration (seconds to months), frequency (several times per day to once per year or less), and intensity and type of symptoms (e.g., pelvic pain versus urologic symptoms). Flares of all duration were associated with greater pelvic pain, urologic symptoms, disruption to participants' activities, and bother, with increasing severity of each of these factors as the duration of flares increased. Days-long flares were also associated with greater health-care utilization. In addition to duration, symptoms (pelvic pain, in particular) were also significant determinants of flare-related bother.
CONCLUSIONS: Our findings suggest that flares are common and associated with greater symptoms, health-care utilization, disruption, and bother. Our findings also inform the characteristics of flares most bothersome to patients (i.e., increased pelvic pain and duration), and thus of greatest importance to consider in future research on flare prevention and treatment.
Written by:
Sutcliffe S, Colditz GA, Goodman MS, Pakpahan R, Vetter J, Ness TJ, Andriole GL, Lai HH. Are you the author?
Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO; Alvin J. Siteman Cancer Center, Department of Surgery, Washington University School of Medicine, St. Louis, MO.
Reference: BJU Int. 2014 Apr 15. Epub ahead of print.
doi: 10.1111/bju.12778
PubMed Abstract
PMID: 24730356
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