The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA.
The Smith Institute for Urology at Northwell Health, Lake Success, New York, USA.
Neurourol Urodyn. 2023 Apr;42(4):837-844. doi: 10.1002/nau.25145. Epub 2023 Feb 25.
Chronic pelvic pain syndromes (CPPS) are commonly encountered by urologists and urogynecologists and pose diagnostic and therapeutic challenges. Body maps have been helpful adjuncts to verbal descriptions of pain and may serve a role in phenotyping what is known to be a heterogeneous patient population. The aim of this study was to assess whether patterns of pain as marked on a body map of the pelvis exist among common CPPS diagnoses. The secondary aim was to investigate the association between the total number of pain locations marked on the map and clinical indices in patients with 1 to 3 CPPS diagnoses.
Data was collected on patients who visited the Northwell Health Pelvic Pain Treatment Center (PPTC) from January to May 2022 and were diagnosed with at least one of four major CPPS diagnoses: interstitial cystitis/bladder pain syndrome (IC/BPS), pelvic floor myalgia (PFM), chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), and vulvodynia. Demographic data as well as survey data from pelvic pain maps, Genitourinary Pain Index (GUPI) forms, and the short form-6 of the Pain Catastrophizing Scale (PCS-6) were recorded. Descriptive statistics among CPPS groups and Pearson correlations among the number of CPPS diagnoses were computed.
One hundred seventy females and 125 males with CPPS were included in the study. Significant cross-over in mapping patterns was notable between IC/BPS and PFM groups, both most commonly marking "abdomen" and "genital" regions. The most distinct pattern of pain was seen in patients with CP/CPPS and in patients with vulvodynia. Among the total sample, as the mean number of pain locations marked within the pelvis increased, GUPI and PCS scores increased (p < 0.05). As the number of CPPS diagnoses increased, the strength of the relationship independently increased.
Pelvic body mapping demonstrated that different forms of CPPS displayed different distributions of pain, but mapping was not predictive of any diagnostic group. Nevertheless, the pelvic body map proved useful in identifying precise locations of pain and may help uncover regions of pain that cannot be easily communicated. The total number of pain sites marked appeared to correlate with worse clinical features.
慢性盆腔疼痛综合征（CPPS）是泌尿科医生和泌尿妇科医生常见的疾病，具有诊断和治疗上的挑战。身体图谱对于疼痛的口头描述有帮助，并且可能在表型方面发挥作用，因为众所周知，CPPS 患者群体是异质的。本研究的目的是评估在常见 CPPS 诊断中，是否存在盆腔体图上标记的疼痛模式。次要目的是研究在 1 至 3 种 CPPS 诊断的患者中，在体图上标记的疼痛部位总数与临床指标之间的关联。
数据采集于 2022 年 1 月至 5 月期间到 Northwell Health 盆腔疼痛治疗中心（PPTC）就诊的至少患有四种主要 CPPS 诊断之一的患者，包括间质性膀胱炎/膀胱疼痛综合征（IC/BPS）、盆底肌痛（PFM）、慢性前列腺炎/慢性盆腔疼痛综合征（CP/CPPS）和外阴痛。记录人口统计学数据以及盆腔疼痛图、泌尿生殖疼痛指数（GUPI）表和简短形式的疼痛灾难化量表（PCS-6）的调查数据。在 CPPS 组之间进行描述性统计，计算 CPPS 诊断数量之间的 Pearson 相关性。
研究纳入了 170 名女性和 125 名 CPPS 男性患者。IC/BPS 和 PFM 组之间明显存在图谱模式的交叉，两者都最常标记“腹部”和“生殖器”区域。CP/CPPS 患者和外阴痛患者的疼痛模式最明显。在总样本中，随着盆腔内标记的疼痛部位的平均数量增加，GUPI 和 PCS 评分也增加（p<0.05）。随着 CPPS 诊断数量的增加，这种关系的强度独立增加。
盆腔体图显示不同形式的 CPPS 显示出不同的疼痛分布，但图谱不能预测任何诊断组。然而，盆腔体图在确定疼痛的确切部位方面很有用，并且可能有助于发现难以表达的疼痛区域。标记的疼痛部位总数似乎与更差的临床特征相关。
