Painful Bladder Filling and Painful Urgency are Distinct Characteristics in Men and Women with Urological Chronic Pelvic Pain Syndromes: A MAPP Research Network Study

Abstract

Purpose To describe bladder-associated symptoms in patients with urologic chronic pelvic pain syndromes (UCPPS) and to correlate these symptoms with urologic, non-urologic, psychosocial, and quality of life measures. Methods Participants were 233 women and 191 men with interstitial cystitis/bladder pain syndrome or chronic prostatitis/chronic pelvic pain syndrome in a multi-center study. They completed a battery of measures, including items asking if their pain worsened with bladder filling (“painful filling”) or if their urge to urinate was due to pain, pressure, or discomfort (“painful urgency”). Participants were categorized into 3 groups: 1) “both” painful filling and painful urgency, 2) “either” painful filling or painful urgency, or 3) “neither.” Results Seventy-five percent of men and 88% of women were categorized as “both” or “either.” These bladder characteristics were associated with more severe urologic symptoms (increased pain, frequency, urgency), higher somatic symptom burden, depression, and worse quality of life (all p<0.01, 3-group trend test). A gradient effect was observed across groups (both > either > neither). Compared to those in the “neither” group, men categorized as “both” or “either” reported more frequent UCPPS symptom flares, catastrophizing, and irritable bowel syndrome, and women categorized as “both” or “either” were more likely to have negative affect and chronic fatigue syndrome. Conclusions Men and women with bladder symptoms characterized as painful filling or painful urgency had more severe urologic symptoms, more generalized symptoms, and worse quality of life than participants who reported neither characteristic, suggesting that these symptom characteristics might represent important subsets of UCPPS patients.

Clinical and Psychosocial Predictors of Urological Chronic Pelvic Pain Symptom Change in 1 Year: A Prospective Study from the MAPP Research Network

“…Other MAPP analyses examining cross-sectional clinical and neuroimaging data have also found more similarity than differences across men and women with UCPPS 5, 2930 . Also, neither income level (as a marker of social economic status) nor UCPPS chronicity were significant predictors of outcome.…”

Correlates of Health Care Seeking Activities in Patients with Urological Chronic Pelvic Pain Syndromes: Findings from the MAPP Cohort

“…By definition, all women in the MAPP cohort were diagnosed with IC/BPS, while men may have either IC/BPS or CP/CPPS. Therefore, the female MAPP participants were found to exhibit more ‘bladder-centric’ symptoms than the male participants 16 . This could potentially have an impact on HCS, as bladder-centric symptoms could increase the likelihood of certain treatments/procedures to manage pain (e.g., cystoscopy, bladder instillations).…”

Chronic Prostatitis/Chronic Pelvic Pain Syndrome and Male Bladder Pain Syndrome/Interstitial Cystitis: How Are They Related?

“…Painful filling is described as pain that worsens with the degree of bladder filling. The pain may be relieved at least partially by urination [26][27][28]. Painful urgency is described as the urge to urinate due mainly to pain, pressure, or discomfort, but not to fear of incontinence [26].…”

“…The organ specific-bladder domain was positive in 33% of their patients. A research network study showed that 75% of all men with BPS/IC or CP/CPPS had painful filling or painful urgency [26].…”