Urological Symptoms in a Subset of Patients with Urological Chronic Pelvic Pain Syndrome and a Polysymptomatic, Polysyndromic Pattern of Presentation

Abstract

Purpose To characterize the urologic symptoms of a subset of urologic chronic pelvic pain syndrome (UCPPS) patients who have both a high somatic symptom burden and a wide symptom distribution fitting a “poly-symptomatic, poly-syndromic” (PSPS) pattern of presentation. Materials and Methods 81 UCPPS patients enrolled in the NIDDK MAPP Research Network Study at the Washington University in St. Louis and the University of Alabama at Birmingham sites completed a symptom questionnaire to assess their somatic symptom burden and its distribution, the Genitourinary Pain Index (GUPI) to assess their UCPPS symptoms and impact on quality of life, and self-reported treatment-seeking behaviors for their UCPPS symptoms. The PSPS symptom pattern was defined as self-report of numerous painful and non-painful somatic symptoms across many organ systems and symptom categories on the PSPS questionnaire. Results UCPPS patients with the PSPS pattern reported more severe genitourinary pain on a Likert scale, more frequent pain in the past week, and more widespread distribution of the pain in the genital and pelvic areas compared to UCPPS patients without PSPS. PSPS patients also had significantly higher scores on the pain subscale, quality of life subscale (worse), and the total scores on the GUPI questionnaire than patients without PSPS. Patients with the PSPS pattern reported significantly more treatment-seeking behaviors than other patients. Conclusion The PSPS pattern might be an important phenotypic factor to assess in the evaluation of UCPPS with clinical and research implications. This may be a distinct clinical subgroup among UCPPS patients.

Psychosocial co‐morbidities in Interstitial Cystitis/Bladder Pain syndrome (IC/BPS): A systematic review

“…Gender was also shown to impact symptom presentation, although these results are mixed. Women are more likely to present with polysymptomatic complaints . The examination of abuse prevalence has occurred predominately in females.…”

“…Women are more likely to present with polysymptomatic complaints. 9,23,34 The examination of abuse prevalence has occurred predominately in females. In the most comprehensive psychological study to date, comparing gender, Naliboff et al 9 found that women are more likely to report early life and adult trauma exposure, greater helplessness, and poorer functionality than men-irrespective of symptom severity or age.…”

Systemic Nonurological Symptoms in Patients with Overactive Bladder

“…The PSPS-Q has been utilized in two previous studies to characterize systemic symptoms in patients with IC/BPS. 10, 11 For this and previous studies, 10, 11 widespread systemic symptoms were operationalized as having ≥25 symptoms in ≥9 symptom groups in women, or ≥20 symptoms in ≥8 symptom groups in men. The operational definition was different between men and women because men do not have gynecological symptoms.…”

Immune-metabolic genesis of pathological processes

“…With all thefindings on immunological and metabolic parameters from various scientific literature being combined in a single table (see Table 1), it can be seen that the following parameters were the key parameters of the standard formula of the immune system disorders in acute cystitis: T cytotoxic , Ig M, MWM, all with a stimulating vector of the 3 rd degree. Chronic cystitis was characterized by a decrease in the number of T-helpers, IgA with the accumulation of pro-inflammatory interleukin 8 (Lai et al 2014). The complication of chronic cystitis with chronic pyelonephritis resulted in leukocytosis, T-cell deficiency, inhibition of the phagocyte absorption function of the 3 rddegree (Amano and Shimizu 2014).…”