A Case-Crossover Study of Urological Chronic Pelvic Pain Syndrome Flare Triggers in the MAPP Research Network

MAPP Research Network, Siobhan Sutcliffe, Thomas Jemielita, H. Henry Lai, Gerald L. Andriole, Catherine S. Bradley, J. Quentin Clemens, Robert Gallop, Thomas Hooton, Karl J. Kreder, John N. Krieger, John W. Kusek, Jennifer Labus, M. Scott Lucia, Sean Mackey, Bruce D. Naliboff, Nancy A. Robinson, Larissa V. Rodriguez, Alisa Stephens-Shields, Adrie van Bokhoven & 5 others Kathleen Y. Wolin, Yan Yan, Claire C. Yang, J. Richard Landis, Graham A. Colditz

Research output: Contribution to journalArticle

Abstract

Purpose: Although many factors have been proposed to trigger symptom exacerbations (flares) in patients with interstitial cystitis/bladder pain syndrome and chronic prostatitis/chronic pelvic pain syndrome, few studies have investigated these factors empirically. Therefore, we embedded a case-crossover study in the Multidisciplinary Approach to the Study of Chronic Pelvic Pain longitudinal study to evaluate a range of patient reported triggers. Materials and Methods: We assessed exposure to proposed triggers, including diet, physical activities, sedentary behaviors, stress, sexual activities, infection-like symptoms and allergies, by questionnaire a maximum of 3 times when participants reported flares and at 3 randomly selected times. We compared participant preflare to nonflare exposures by conditional logistic regression. Results: In our full analytical sample of 292 participants only 2 factors, including recent sexual activity (OR 1.44, 95% CI 1.06–1.96) and urinary tract infection symptoms (OR 3.39, 95% CI 2.02–5.68), which may overlap with those of flares, were associated with flare onset. On subanalyses restricted to flares with specific suspected triggers additional positive associations were observed for some factors such as certain dietary factors, abdominal muscle exercises, and vaginal infection-like symptoms and fever, but not for other factors (eg stress). Conclusions: Except for sexual activity our findings suggest that patient reported triggers may be individual or group specific, or they may not contribute to flares. These findings suggest caution in following rigid, global flare prevention strategies and support additional research to develop evidence-based strategies.

LanguageEnglish (US)
Pages1245-1251
Number of pages7
JournalJournal of Urology
Volume199
Issue number5
DOIs
StatePublished - May 1 2018

Fingerprint

Pelvic Pain
Chronic Pain
Sexual Behavior
Cross-Over Studies
Research
Exercise
Interstitial Cystitis
Abdominal Muscles
Prostatitis
Infection
Urinary Tract Infections
Longitudinal Studies
Hypersensitivity
Urinary Bladder
Fever
Logistic Models
Diet

Keywords

  • cystitis
  • interstitial
  • prostatitis
  • surveys and questionnaires
  • symptom flare up
  • urinary bladder

ASJC Scopus subject areas

  • Urology

Cite this

A Case-Crossover Study of Urological Chronic Pelvic Pain Syndrome Flare Triggers in the MAPP Research Network. / MAPP Research Network.

In: Journal of Urology, Vol. 199, No. 5, 01.05.2018, p. 1245-1251.

Research output: Contribution to journalArticle

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AU - Sutcliffe, Siobhan

AU - Jemielita, Thomas

AU - Lai, H. Henry

AU - Andriole, Gerald L.

AU - Bradley, Catherine S.

AU - Clemens, J. Quentin

AU - Gallop, Robert

AU - Hooton, Thomas

AU - Kreder, Karl J.

AU - Krieger, John N.

AU - Kusek, John W.

AU - Labus, Jennifer

AU - Lucia, M. Scott

AU - Mackey, Sean

AU - Naliboff, Bruce D.

AU - Robinson, Nancy A.

AU - Rodriguez, Larissa V.

AU - Stephens-Shields, Alisa

AU - van Bokhoven, Adrie

AU - Wolin, Kathleen Y.

AU - Yan, Yan

AU - Yang, Claire C.

AU - Landis, J. Richard

AU - Colditz, Graham A.

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