Naliboff Bruce D, McWilliams Tara, Clemens J Quentin, Pontari Michael A, Stephens-Shields Alisa J, Moldwin Robert, Sutcliffe Siobhan, Mullins Chris, Landis J Richard
Department of Medicine, University of California, Los Angeles, California, USA.
Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Neurourol Urodyn. 2025 Feb;44(2):400-408. doi: 10.1002/nau.25648. Epub 2024 Dec 20.
To assess differences in clinical presentation and illness impact in men and women presenting with urologic chronic pelvic pain syndrome (UCPPS) and between men diagnosed with interstitial cystitis/bladder pain syndrome (IC/BPS) or chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).
356 men and 605 women from six sites across the United States were assessed using a comprehensive set of demographic, symptom, and illness impact measures. Multivariable regression analyses examined differences between men and women and between men previously diagnosed with CP/CPPS or IC/BPS. In a stepwise manner, analyses tested group differences, controlling for demographic variables including symptom duration and presence of bladder pain that varied with filling and voiding.
Men diagnosed with IC/BPS had the most severe UCPPS symptoms, followed by women with IC/BPS, and then men with CP/CPPS only. While men and women showed similar patterns of symptoms across most of the variables, women had increased widespread non-pelvic pain, greater pelvic floor tenderness on exam, and higher self-reported sensory sensitivity compared to men. About 60% of men diagnosed with CP/CPPS only reported bladder symptoms of painful filling or relief with voiding.
A generally shared symptom pattern was found across men and women irrespective of diagnostic labels suggesting the use of key marker symptoms, such as severity of bladder symptoms and widespread pain, to better identify subgroups of UCPPS rather than diagnostic category. Women may have an increased likelihood of increased sensitivity and central sensitization than men, including those men with IC/BPS.
ClinicalTrials.gov Identifier: NCT02514265 - MAPP Research Network: Trans-MAPP Study of Urologic Chronic Pelvic Pain: Symptom Patterns Study (SPS).
评估患有泌尿系统慢性盆腔疼痛综合征（UCPPS）的男性和女性之间，以及被诊断为间质性膀胱炎/膀胱疼痛综合征（IC/BPS）或慢性前列腺炎/慢性盆腔疼痛综合征（CP/CPPS）的男性之间，在临床表现和疾病影响方面的差异。
对来自美国六个地点的356名男性和605名女性，使用一套全面的人口统计学、症状和疾病影响测量方法进行评估。多变量回归分析检查了男性和女性之间，以及先前被诊断为CP/CPPS或IC/BPS的男性之间的差异。分析以逐步方式测试组间差异，控制包括症状持续时间和随充盈及排尿而变化的膀胱疼痛的存在等人口统计学变量。
被诊断为IC/BPS的男性具有最严重的UCPPS症状，其次是患有IC/BPS的女性，然后是仅患有CP/CPPS的男性。虽然男性和女性在大多数变量上表现出相似的症状模式，但与男性相比，女性广泛的非盆腔疼痛增加、检查时盆底压痛更明显，且自我报告的感觉敏感性更高。仅被诊断为CP/CPPS的男性中约60%报告有膀胱充盈疼痛或排尿缓解的症状。
无论诊断标签如何，男性和女性之间发现了一种普遍共享的症状模式，这表明使用关键标记症状，如膀胱症状的严重程度和广泛疼痛，来更好地识别UCPPS的亚组，而不是诊断类别。女性可能比男性，包括患有IC/BPS的男性，更有可能出现敏感性增加和中枢致敏。
ClinicalTrials.gov标识符：NCT02514265 - MAPP研究网络：泌尿系统慢性盆腔疼痛的跨MAPP研究：症状模式研究（SPS）
