Division of Urologic Surgery, Washington University School of Medicine, St. Louis, Missouri; Department of Surgery and Department of Anesthesiology and Washington University Pain Center, Washington University School of Medicine, St. Louis, Missouri.
Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
J Urol. 2017 Sep;198(3):622-631. doi: 10.1016/j.juro.2017.03.132. Epub 2017 Mar 31.
We characterized the location and spatial distribution of whole body pain in patients with urological chronic pelvic pain syndrome using a body map. We also compared the severity of urinary symptoms, pelvic pain, nonpelvic pain and psychosocial health among patients with different pain patterns.
A total of 233 women and 191 men with urological chronic pelvic pain syndrome enrolled in a multicenter, 1-year observational study completed a battery of baseline measures, including a body map describing the location of pain during the last week. Participants were categorized with pelvic pain if they reported pain in the abdomen and pelvis only. Participants who reported pain beyond the pelvis were further divided into 2 subgroups based on the number of broader body regions affected by pain, including an intermediate group with 1 or 2 additional regions outside the pelvis and a widespread pain group with 3 to 7 additional regions.
Of the 424 enrolled patients 25% reported pelvic pain only and 75% reported pain beyond the pelvis, of whom 38% reported widespread pain. Participants with a greater number of pain locations had greater nonpelvic pain severity (p <0.0001), sleep disturbance (p = 0.035), depression (p = 0.005), anxiety (p = 0.011), psychological stress (p = 0.005) and negative affect scores (p = 0.0004), and worse quality of life (p ≤0.021). No difference in pelvic pain and urinary symptom severity was observed according to increasing pain distribution.
Three-quarters of the men and women with urological chronic pelvic pain syndrome reported pain outside the pelvis. Widespread pain was associated with greater severity of nonpelvic pain symptoms, poorer psychosocial health and worse quality of life but not with worse pelvic pain or urinary symptoms.
我们使用身体图谱描绘了泌尿科慢性盆腔疼痛综合征患者的全身疼痛位置和空间分布，并比较了不同疼痛模式患者的尿症状、盆腔疼痛、非盆腔疼痛和心理社会健康的严重程度。
共纳入 233 名女性和 191 名男性泌尿科慢性盆腔疼痛综合征患者，他们参加了一项多中心、为期 1 年的观察性研究，完成了一整套基线评估，包括描述过去一周疼痛位置的身体图谱。仅报告腹部和骨盆疼痛的患者被归类为盆腔疼痛。报告骨盆外疼痛的患者根据受疼痛影响的更广泛身体区域的数量进一步分为 2 个亚组，包括有 1 或 2 个额外骨盆外区域的中间组和有 3 至 7 个额外区域的广泛疼痛组。
在 424 名入组患者中，25%仅报告盆腔疼痛，75%报告骨盆外疼痛，其中 38%报告广泛疼痛。疼痛部位较多的患者非盆腔疼痛严重程度更高（p<0.0001）、睡眠障碍（p=0.035）、抑郁（p=0.005）、焦虑（p=0.011）、心理压力（p=0.005）和负性情绪评分（p=0.0004）更差，生活质量更差（p≤0.021）。根据疼痛分布的增加，盆腔疼痛和尿症状严重程度没有差异。
四分之三的泌尿科慢性盆腔疼痛综合征患者报告骨盆外疼痛。广泛疼痛与非盆腔疼痛症状更严重、心理社会健康状况更差、生活质量更差相关，但与盆腔疼痛或尿症状无相关性。
