Predictors of quality of life and pain in chronic prostatitis/chronic pelvic pain syndrome: findings from the National Institutes of Health Chronic Prostatitis Cohort Study

Tripp, Dean A.; Nickel, J. Curtis; Landis, J. Richard; Wang, Yan Lin; Knauss, Jill

doi:10.1111/j.1464-410x.2004.05157.x

Cited by 108 publications

(81 citation statements)

References 25 publications

(37 reference statements)

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“…20 Turner et al, 22 examining men in primary-care settings for QOL, reported that worse QOL was associated with greater pain and urinary symptoms and that pain was more robustly associated with worse QOL than were urinary symptoms. Recently, Tripp et al 23 also reported that pain intensity and urinary symptoms were independent predictors of QOL, with pain intensity the strongest predictor. The hallmark of CP/CPPS is its symptom complex, and, therefore, controlling the symptom profile is an integral part of managing this complex condition.…”

Section: Discussionmentioning

confidence: 98%

More effects of extracorporeal magnetic innervation and terazosin therapy than terazosin therapy alone for non-inflammatory chronic pelvic pain syndrome: a pilot study

Paick

2006

Prostate Cancer Prostatic Dis

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The objective of this study was to evaluate whether extracorporeal magnetic innervation (ExMI) combined with a-blocker therapy is more effective than a-blocker monotherapy for patients with non-inflammatory chronic prostatitis (CP)/chronic pelvic pain syndrome (CPPS), category IIIB. Patients were randomized to either terazosin monotherapy (group 1, n ¼ 21) or terazosin combined with ExMI therapy (group 2, n ¼ 19). Patients in group 2 had 12 treatment sessions of ExMI twice a week during 6 weeks. None of the patients experienced any side effects from treatment. The changes in each domain of the National Institutes of Health (NIH)-Chronic Prostatitis Symptom Index (CPSI) measured on week 6 were not significantly different between the groups. However, the difference (median, 25-75th percentiles) between the two groups in total NIH-CPSI scores was À4 (À11.5, À2) for group 1 and À12 (À17.3, À2.3) for group 2, respectively (P ¼ 0.047). At 6 weeks, 47.6% (10 of 21) of group 1 had a 425% decrease in total NIH-CPSI compared with 78.9% (15 of 19) of group 2 (P ¼ 0.041). Also, more patients in group 2 (78.9%) were rated as responders with a 6-point decrease in NIH-CPSI compared with group 1 (47.6%) (P ¼ 0.041). The early results suggest that ExMI combined with a-blocker therapy has better effect than a-blocker monotherapy for the treatment of CP/CPPS.

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Section: Discussionmentioning

confidence: 98%

More effects of extracorporeal magnetic innervation and terazosin therapy than terazosin therapy alone for non-inflammatory chronic pelvic pain syndrome: a pilot study

Paick

2006

Prostate Cancer Prostatic Dis

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“…The factors that contributed most to the reduced quality of life were pain intensity and quality of life subscale of the NIH-chronic prostatitis symptom index [36]. The general state of anxiety was higher in patients compared to their spouses and remained unchanged two years later [37].…”

Section: Psychosocial Factorsmentioning

confidence: 98%

Proposed New Pathophysiology of Chronic Prostatitis/Chronic Pelvic Pain Syndrome

Cho

Min

2015

Urogenit Tract Infect

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The most common type of prostatitis is category III, also known as chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). The current National Institutes of Health definition of CP/CPPS includes genitourinary pain with or without voiding symptoms in the absence of uropathogenic bacteria, as detected by standard microbiological methods, or other identifiable causes such as malignancy. Many different etiologies and mechanisms of pathogenesis of CP/CPPS have been proposed with a suggested role for immunological, neurological, endocrine, and psychological factors. We examined the data supporting the role of each of these areas and also examined the possible interrelationship of these factors in producing the symptoms of CP/CPPS. Prostatitis types IIIa and IIIb are classified according to the presence of pain without concurrent presence of bacteria; however, it is becoming more evident that, although levels of bacteria are not directly associated with levels of pain, the presence of bacteria might act as the initiating factor that drives primary activation of mast-cell-mediated inflammation in the prostate. The gate control theory provides a neurologic basis for the influence of both somatic and psychological factors on pain. Acceptance of chronic pain as a diagnosis may be difficult for the clinician and patient, however it is an important concept in the care of CP/CPPS, which enables the use of pain-directed therapies. Management of CP/CPPS will remain challenging; however, this review provides a better understanding of the condition and improved management strategies based on the newest evidence and concepts available. Keywords: Prostatitis; Chronic pain; Physiopathology INTRODUCTIONChronic prostatitis/chronic pelvic pain syndrome (CP/ CPPS) is a condition of chronic pelvic pain in men [1]. It has been estimated that between 2% and 14% of men worldwide may have symptoms of CP/CPPS [2,3]. The diagnosis is made on the basis of symptoms of pain with or without voiding symptoms in the absence of other identifiable causes [4]. The etiology of symptoms in a given patient can be from many causes. Whether there are identifiable, repeatable patterns of causes of symptoms, or just individual patients with distinct individual phenotypes are unknown. Because CP/CPPS is a common condition associated with significant physical, mental, and social burden, the medical community has made tremendous efforts to understand the condition and improve management strategies. Despite these efforts, answers remain elusive. Robust tools to measure symptom severity Our improved understanding of the etiology and clinical phenotypes associated with CP/CPPS has made the condition less of a clinical enigma. Acceptance of clinical definitions (and classification system) and validated, reliable outcome questionnaire (the CP symptom index) has led to high-quality treatment evidenced from randomized placebo-controlled trials. This article is a very timely review of the topic and provides the clinician with an improved understanding of CP/CPPS a...

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“…In the mental QoL model, the catastrophizing mediation suggests that in men suffering from CP/CPPS, symptoms may become disabling through cognitive mechanisms, where catastrophizing creates an inability to disengage from negative pain ruminations. 27 This previously-identified style of negative CP/CPPS processing 5,7,10,12,14 can be modified, and reductions in catastrophizing have been shown to be associated with reductions in CP/CPPS symptoms. 28 This study also strongly indicated that illness-focused coping is an important target in improving patients' mental and physical QoL.…”

Section: Discussionmentioning

confidence: 99%

“…The biopsychosocial experience of patients with CP/CPPS is critical for improved patient well-being, and a deeper understanding of the negative pain-QoL relationship is needed to advance patient management. 10 The urology and pain literature indicates that mood, cognitive appraisals (i.e., catastrophizing), and behavioural pain coping strategies are predictors for pain and QoL. Depression is elevated in CP/CPPS, 11 and catastrophizing is associated with greater pain in CP/CPPS, 12 as well as female chronic pelvic pain.…”

Section: Introductionmentioning

confidence: 99%

“…9 CP/CPPS pain is associated with diminished QoL even when controlling for age, urinary symptoms, depressive symptoms, and partner status. 10 Although studies show that psychosocial factors can predict diminished CP/CPPS QoL, specified mechanisms of these observed relations have not been examined. The biopsychosocial experience of patients with CP/CPPS is critical for improved patient well-being, and a deeper understanding of the negative pain-QoL relationship is needed to advance patient management.…”

Section: Introductionmentioning

confidence: 99%

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Psychosocial mechanisms of the pain and quality of life relationship for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS)

Krsmanovic

Tripp

Nickel

et al. 2014

CUAJ

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Introduction: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a prevalent, chronic pelvic pain condition largely unresponsive to medical interventions. Psychosocial risk factors are associated with poor outcomes in CP/CPPS, but have not been examined for their intervening roles between pain and reduced quality of life (QoL). This study aimed to determine if psychosocial risk factors (i.e., patient coping and catastrophizing) mediate the association between pain and QoL.Methods: Using a cross sectional design, 175 men with CP/CPPS (mean age 46.83; SD 10.86) were recruited from tertiary care urology clinics and completed questionnaires on demographics, pain, QoL, pain coping, depression, and catastrophizing. An exploratory factor analysis was conducted and aggregate factor scores were examined to improve the amount of meaningful measurement to be used in multiple mediations. The models specified multiple risk factors as mechanisms between pain and both physical and mental QoL as the primary outcome measurements.Results: Four aggregate psychosocial factor scores were produced from the psychosocial measures (i.e., illness and wellness-focused behavioural coping, depression and catastrophizing). Illness focusedcoping partially mediated the relationship between pain and physical QoL. However, catastrophizing and illness-focused coping fully mediated the relation between pain and mental QoL, showing the association between pain and mental QoL was no longer significant when catastrophizing and illness-focused coping were in the model.Conclusion: Psychosocial factors function as mechanisms between higher pain and they are associated diminished mental QoL. These results introduce illness-focused coping as an important biopsychosocial target in CP/CPPS management.

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Predictors of quality of life and pain in chronic prostatitis/chronic pelvic pain syndrome: findings from the National Institutes of Health Chronic Prostatitis Cohort Study

Cited by 108 publications

References 25 publications

More effects of extracorporeal magnetic innervation and terazosin therapy than terazosin therapy alone for non-inflammatory chronic pelvic pain syndrome: a pilot study

More effects of extracorporeal magnetic innervation and terazosin therapy than terazosin therapy alone for non-inflammatory chronic pelvic pain syndrome: a pilot study

Proposed New Pathophysiology of Chronic Prostatitis/Chronic Pelvic Pain Syndrome

Psychosocial mechanisms of the pain and quality of life relationship for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS)

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