Transitions From Regional to Widespread Pain in Urologic Chronic Pelvic Pain Syndrome: A Multidisciplinary Approach to the Study of Chronic Pelvic Pain II Research Network Study

PURPOSE: We used prospective data from a well-characterized urologic chronic pelvic pain syndrome (UCPPS) cohort (including interstitial cystitis/bladder pain syndrome and chronic prostatitis/chronic pelvic pain syndrome) to identify transitions between localized pelvic pain (LP) and widespread pain (WP) and characteristics associated with these transitions. MATERIAL AND METHODS: A total of 311 individuals (195 women; 116 men) with UCPPS were recruited from 6 sites and followed for 3 years. Participants completed 5 weekly "run-in" assessments at baseline, followed by quarterly symptom assessments. Responses on a self-reported body pain map were used to define LP vs WP (≥2 nonpelvic body map regions with pain). Multivariable modeling was used to evaluate 74 baseline characteristics related to transitions between LP and WP. RESULTS: At baseline, 126 participants (41%) reported LP, 13 (10.3%) of whom transitioned to WP. Conversely, 17 of the 66 participants (26%) with WP transitioned to LP at follow-up. Progression from LP to WP was associated with: (1) not living with a partner/spouse and (2) a higher Somatic Awareness Score on the complex multisymptom inventory. Conversely, transition from WP to LP was associated with: (3) lower urinary urgency symptoms on the complex multisymptom inventory and (4) higher frequency of sensation of not emptying bladder completely. CONCLUSIONS: Greater levels of baseline nonpainful somatic symptoms were associated with progression to WP, suggesting that high baseline somatic symptoms may predict the development of future pain. Not living with a spouse/partner was also associated with progression to WP, highlighting the importance of social support in UCPPS. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02514265-MAPP Research Network: Trans-MAPP Study of UCPPS: Symptom Patterns Study.