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泌尿科慢性盆腔疼痛综合征患者 1 年生活质量变化的相关因素:多学科慢性盆腔疼痛研究网络(MAPP 研究网络)的研究结果。

Correlates of 1-Year Change in Quality of Life in Patients with Urologic Chronic Pelvic Pain Syndrome: Findings from the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network.

机构信息

Department of Urology, Michigan Medicine, Ann Arbor, Michigan.

Department of Biostatistics, Epidemiology & Informatics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.

出版信息

J Urol. 2020 Oct;204(4):754-759. doi: 10.1097/JU.0000000000001080. Epub 2020 Apr 15.

Abstract

PURPOSE

We evaluated and identified baseline factors associated with change in health related quality of life among patients with interstitial cystitis/bladder pain syndrome and chronic prostatitis/chronic pelvic pain syndrome.

MATERIALS AND METHODS

A total of 191 men and 233 women with interstitial cystitis/bladder pain syndrome or chronic prostatitis/chronic pelvic pain syndrome (collectively referred to as urologic chronic pelvic pain syndrome) were followed for 12 months with bimonthly completion of the Short Form 12 to assess general mental and physical health related quality of life, and with biweekly assessment of condition specific health related quality of life using the Genitourinary Pain Index. A functional clustering algorithm was used to classify participants as improved, stable or worsened for each health related quality of life measure. Ordinal logistic regression was used to determine baseline factors associated with change.

RESULTS

Physical health related quality of life improved in 22% of the participants, mental health related quality of life improved in 25% and condition specific health related quality of life improved in 47%. Better baseline physical health related quality of life, older age and the presence of nonurological symptoms were associated with lower likelihood of improvement in physical health related quality of life. Better baseline mental health related quality of life, female sex, and greater baseline depression and stress were associated with a lower likelihood of improvement in mental health related quality of life. Better baseline condition specific health related quality of life and more severe baseline urologic chronic pelvic pain syndrome pain symptoms were associated with a lower likelihood of improvement in condition specific health related quality of life.

CONCLUSIONS

While several nonurologic chronic pelvic pain syndrome factors influenced the trajectory of general health related quality of life over time, only condition specific baseline health related quality of life and urologic chronic pelvic pain syndrome symptoms were associated with urologic chronic pelvic pain syndrome specific health related quality of life change. Significant differences in how urologic chronic pelvic pain syndrome impacts various aspects of health related quality of life suggest a multidisciplinary approach to assessment and treatment of these patients.

摘要

目的

我们评估并确定了与间质性膀胱炎/膀胱疼痛综合征和慢性前列腺炎/慢性盆腔疼痛综合征患者健康相关生活质量变化相关的基线因素。

材料与方法

共有 191 名男性和 233 名女性患有间质性膀胱炎/膀胱疼痛综合征或慢性前列腺炎/慢性盆腔疼痛综合征(统称为泌尿科慢性盆腔疼痛综合征),接受了为期 12 个月的随访,每两个月完成一次简短 12 项评估以评估一般心理健康相关的生活质量,并且每两周使用泌尿生殖疼痛指数评估特定于疾病的健康相关生活质量。使用功能聚类算法将参与者按每种健康相关生活质量测量的改善、稳定或恶化进行分类。有序逻辑回归用于确定与变化相关的基线因素。

结果

22%的参与者的身体健康相关生活质量得到改善,25%的心理健康相关生活质量得到改善,47%的特定疾病健康相关生活质量得到改善。更好的基线身体健康相关生活质量、年龄较大和存在非泌尿系统症状与身体健康相关生活质量改善的可能性降低有关。更好的基线心理健康相关生活质量、女性性别以及更大的基线抑郁和压力与心理健康相关生活质量改善的可能性降低有关。更好的基线特定疾病健康相关生活质量和更严重的基线泌尿科慢性盆腔疼痛综合征疼痛症状与特定疾病健康相关生活质量改善的可能性降低有关。

结论

虽然一些非泌尿科慢性盆腔疼痛综合征因素影响了一般健康相关生活质量随时间的变化轨迹,但只有特定疾病的基线健康相关生活质量和泌尿科慢性盆腔疼痛综合征症状与泌尿科慢性盆腔疼痛综合征特定健康相关生活质量的变化相关。泌尿科慢性盆腔疼痛综合征对健康相关生活质量各个方面的影响存在显著差异,这表明需要采用多学科方法来评估和治疗这些患者。

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