Moderated Poster
.jpg "Quentin Clemens, MD photo")
Quentin Clemens, MD
Professor of Urology
University of Michigan Medical Center
Presentation Authors: J. Quentin Clemens*, Ann Arbor, MI, Alisa Stephens-Shields, Craig Newcomb, Philadelphia, PA, Larissa Rodriguez, Los Angeles, CA, H. Henry Lai, St. Louis, MO, Catherine Bradley, Iowa City, IA, Bruce Naliboff, Los Angeles, CA, James Griffith, Chicago, IL, Siobhan Sutcliffe, St. Louis, MO, Bayley Taple, Chicago, IL, Priyanka Gupta, Ann Arbor, MI, Niloo Afari, San Diego, CA, Steve Harte, Ann Arbor, MI, Eric Strachan, Seattle, WA, J. Richard Landis, Philadelphia, PA
Introduction: Few studies have prospectively evaluated change in health-related quality of life (HRQOL) among patients with interstitial cystitis/bladder pain syndrome (IC/BPS) and chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).
Methods: A total of 191 men and 233 women with IC/BPS or CP/CPPS (referred to as urologic chronic pelvic pain syndrome(UCPPS) ) were recruited and followed for 12 months with bimonthly completion of the Short Form 12 (SF-12) mental and physical health to assess HRQOL. Participants with a baseline and at least one post-baseline assessment (n=376) were classified as having improved, stable, or worse HRQOL separately for physical and mental health using a functional clustering algorithm. Unadjusted and adjusted ordinal logistic regression models were used to determine baseline factors associated with change including age, sex, UCPPS symptom duration, pelvic pain (0-28), urinary symptom severity (0-25), number of complex non-urologic medical symptoms (eg. nausea, fatigue; CNMS, 0-34), number of body sites with pain (widespreadness, 0-45), catastrophizing (0-36), depression and anxiety as measured by the Hospital Anxiety and Depression Scale (0-21), Perceived Stress Scale (0-40), sleep disturbance (8-40), and respective baseline SF-12(0-100).
Results: The mean number of contacts per participant was 5.4. Mental HRQOL improved in 96 (25.5%), remained stable in 164 (43.3%), and worsened in 116 (30.9%) participants. Female sex and greater depression and stress were associated with less improvement in mental HRQOL. Greater pelvic pain and urinary severity, widespreadness, and CNMS were associated with less improvement in mental health in univariable models but not after adjusting for depression and stress. Physical HRQOL improved in 83 (22.1%), remained stable in 177 (47.0%), and worsened in 116 (30.9%) participants. Older age and CNMS were associated with less improvement in physical health.
Conclusions: Mental or physical HRQOL status improved in 22-25% of UCPPS participants and worsened in 30%. Changes in mental HRQOL were associated with sex, depression and stress; changes in physical HRQOL were associated with age and the number of CNMS. Severity of UCPPS symptoms had limited impact on HRQOL change. These findings support the need for a multidisciplinary treatment approach for UCPPS.
Source of Funding: Funding for the MAPP Research Network was obtained under a cooperative agreement from National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health (NIH) (DK82370, DK82342, DK82315, DK82344, DK82325, DK82345, DK82