Rodríguez Larissa V, Stephens Alisa J, Clemens J Quentin, Buchwald Dedra, Yang Claire, Lai Henry H, Krieger John N, Newcomb Craig, Bradley Cate S, Naliboff Bruce
Departments of Urology and Obstetrics and Gynecology, Institute of Urology, University of Southern California, Los Angeles, CA.
Data Coordinating Core, Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.
Urology. 2019 Feb;124:14-22. doi: 10.1016/j.urology.2018.11.015. Epub 2018 Nov 16.
To evaluate if patients with urologic chronic pelvic pain syndromes (UCPPS) with longer duration of symptoms experience more severe pain and urologic symptoms, higher rates of chronic overlapping pain conditions (COPC) and psychosocial comorbidities than those with a more recent onset of the condition. We evaluated cross-sectional associations between UCPPS symptom duration and (1) symptom severity, (2) presence of COPC, and (3) mental health comorbidities.
We analyzed baseline data from the Multidisciplinary Approach to the Study of Chronic Pelvic Pain. Symptom severity, COPC, and mental health comorbidities were compared between patients with symptom duration of < 2 vs ≥ 2 years. Symptom severity was assessed by the Genitourinary Pain Index, the Interstitial Cystitis Symptom and Problem Index, and Likert scales for pelvic pain, urgency, and frequency. Depression and anxiety were evaluated with the Hospital Anxiety and Depression Scale and stress with the Perceived Stress Scale.
Males (but not females) with UCPPS symptom duration ≥2 years had more severe symptoms than those with <2 years. Participants with short (<2 years) and longer (≥2 years) symptom duration were as likely to experience COPC.
Longer UCPPS symptom duration was associated with more severe symptoms only in limited patient subpopulations. Symptom duration was not associated with risk for COPC or mental health comorbidities. Females with longer UCPPS duration had decreased distress, but the association was largely attributable to age.
评估与症状近期发作的患者相比,症状持续时间较长的泌尿生殖系统慢性盆腔疼痛综合征(UCPPS)患者是否经历更严重的疼痛和泌尿系统症状、更高的慢性重叠疼痛病症(COPC)发生率及心理社会共病率。我们评估了UCPPS症状持续时间与(1)症状严重程度、(2)COPC的存在情况以及(3)心理健康共病之间的横断面关联。
我们分析了慢性盆腔疼痛研究多学科方法的基线数据。比较了症状持续时间<2年与≥2年的患者之间的症状严重程度、COPC和心理健康共病情况。症状严重程度通过泌尿生殖系统疼痛指数、间质性膀胱炎症状与问题指数以及盆腔疼痛、尿急和尿频的李克特量表进行评估。使用医院焦虑抑郁量表评估抑郁和焦虑,使用感知压力量表评估压力。
UCPPS症状持续时间≥2年的男性(而非女性)比症状持续时间<2年的男性症状更严重。症状持续时间短(<2年)和长(≥2年)的参与者经历COPC的可能性相同。
仅在有限的患者亚组中,较长的UCPPS症状持续时间与更严重的症状相关。症状持续时间与COPC风险或心理健康共病无关。UCPPS持续时间较长的女性痛苦程度降低,但这种关联在很大程度上归因于年龄。