Poster, Podium & Video Sessions
Presentation Authors: R. Christopher Doiron*, Victoria Tolls, J. Curtis Nickel, Kingston, Canada
Introduction: Advancements in clinical phenotyping and treatment modalities seems to be changing the clinical face of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). We sought to retrospectively analyze trends in CP/CPPS patients presenting to our chronic prostatitis (CP) clinic for evaluation and treatment over a 16-year period.
Methods: CP/CPPS patients were evaluated between 1998 and 2014 with chronic prostatitis symptom index (CPSI) and comprehensive assessment allowing retrospective (1998-2009) and prospective (2010-2014) UPOINT categorization. Patients were then stratified in four cohorts, based on year of presentation: 1998-2001, 2002-2005, 2006-2009 and 2010-2014 and variations in symptom scores and patterns, UPOINT categorization and treatment modalities amongst cohorts were analyzed. Continuous variables were analyzed using ANOVA while categorical variables were analyzed using chi-squared test for trend in proportions.
Results: A total of 1349 patients with CP were evaluated in a single tertiary referral clinic. Bacterial prostatitis patients (n=39) were excluded. Mean age of the 1310 CP/CPPS patients was 44.7, while mean CPSI pain, urination, quality of life (QOL) and total scores were 10.6, 4.8, 7.9 and 23.3 respectively. Overall, the most prevalent UPOINT domain, urinary (U) (71.8%) predicted for a higher CPSI urination score (6.3), more frequent penile tip pain (37%), dysuria (48%) and more treatment with alpha-blockers (70%). Increase in UPOINT domains predicted higher CPSI pain, QOL and total scores. Pain location did not predict UPOINT domain or treatment modality. Trends over time included increased prevalence of psychosocial (P), organ (O) and tenderness (T) domains as well as increased use of alpha-blockers, neuromodulation and phytotherapy as treatment modalities. There was little variation in age, CPSI scores and pain locations over time.
Conclusions: The changing clinical face of CP/CPPS reflects the increased recognition of psychosocial and pelvic floor pathology along with the concomitant use of associated therapies. There was little variation of pain/urinary symptom patterns and QOL. The more things &[Prime]appear&[Prime] to change, the more they stay the same.
Source Of Funding: Canadian Institute for Health Research
Queen's University, Department of Urology
Chris Doiron is a PGY-4 resident in Urology at Queen's University in Kingston, ON, Canada. He has an interest in Reconstructive Urology, Urologic Pain Disorders and Global Urology. He hopes to pursue a GURS fellowship in Reconstructive Urology and graduate studies in Public Health following completion of his residency. He recently received a traveling resident scholarship from IVU Med and is interested in exploring the role of the Urologist in Global Surgery. Chris will be presenting a podium presentation on a large database of prostatitis patients.