Predictors of worsening outcomes in urological chronic pelvic pain syndromes
Presence of widespread pain, nonurological symptom and poorer general health are significant predictors of worse pain and urinary outcomes in men and women with urological chronic pelvic pain syndromes, according to a large multisite prospective study.
Researchers recruited a total of 221 female and 176 male patients with urological chronic pelvic pain syndromes from six academic medical centres in the United States and evaluated them at baseline with a comprehensive battery of symptom, psychosocial and illness-impact measures.
Participant outcomes were classified as worse, stable or improved on pain and urinary symptom severity using a functional clustering procedure based on biweekly symptom reports. Finally, researchers used cumulative logistic modelling to examine individual predictors associated with 12-month symptom change as well as multiple predictor combinations and interactions.
Of the patients, about 60 percent had stable symptoms, with smaller numbers (13 to 22 percent) demonstrating clear symptom worsening or improvement. The extent of widespread pain, amount of nonurological symptoms and poorer overall health were risk factors of worsening pain and urinary outcomes.
Anxiety, depression and general mental health did not significantly predict outcomes. However, pain catastrophizing and self-reported stress were associated with pain outcome.
No significant difference was seen in prediction models between men and women. Furthermore, they were independent of symptom duration and age for the most part.
“The results point to the importance of broad-based assessment for urological chronic pelvic pain syndromes and future studies of the mechanisms that underlie these findings,” according to researchers.