PURPOSE: We sought to determine the time-lagged, bidirectional relationships among clinical variables of pelvic pain, urinary symptoms, negative mood, nonpelvic pain and quality of life in men and women with urological chronic pelvic pain syndrome, incorporating interstitial cystitis/bladder pain syndrome and chronic prostatitis/chronic pelvic pain syndrome. MATERIALS AND METHODS: A total of 204 female and 166 male patients were assessed up to 24 times over a 48-week period on the 5 primary outcomes. A lagged autoregressive analysis was applied to determine the directional relationship of one variable to another 2 weeks later, beyond that of the concurrent relationships at each time point and autocorrelations and trends over time. RESULTS: The results show clear evidence for a bidirectional positive relationship between changes in pelvic pain severity and urinary symptom severity. Increases in either variable predicted significant increases in the other 2 weeks later, beyond that explained by their concurrent relationship at each time point. Pelvic pain and to a lesser degree urinary frequency also showed similar bidirectional relationships with negative mood and decreased quality of life. Interestingly, neither pelvic pain or urinary symptom severity showed lagged relationships with nonpelvic pain severity. CONCLUSIONS: Results document for the first time specific short-term positive feedback between pelvic pain and urinary symptoms, and between symptoms of urological chronic pelvic pain syndrome, mood and quality of life. The feedforward aspects of these relationships can facilitate a downward spiral of increased symptoms and worsening psychosocial function, and suggest the need for multifaceted treatments and assessment to address this possibility in individual patients.
PURPOSE: We sought to determine the time-lagged, bidirectional relationships among clinical variables of pelvic pain, urinary symptoms, negative mood, nonpelvic pain and quality of life in men and women with urological chronic pelvic pain syndrome, incorporating interstitial cystitis/bladder pain syndrome and chronic prostatitis/chronic pelvic pain syndrome. MATERIALS AND METHODS: A total of 204 female and 166 male patients were assessed up to 24 times over a 48-week period on the 5 primary outcomes. A lagged autoregressive analysis was applied to determine the directional relationship of one variable to another 2 weeks later, beyond that of the concurrent relationships at each time point and autocorrelations and trends over time. RESULTS: The results show clear evidence for a bidirectional positive relationship between changes in pelvic pain severity and urinary symptom severity. Increases in either variable predicted significant increases in the other 2 weeks later, beyond that explained by their concurrent relationship at each time point. Pelvic pain and to a lesser degree urinary frequency also showed similar bidirectional relationships with negative mood and decreased quality of life. Interestingly, neither pelvic pain or urinary symptom severity showed lagged relationships with nonpelvic pain severity. CONCLUSIONS: Results document for the first time specific short-term positive feedback between pelvic pain and urinary symptoms, and between symptoms of urological chronic pelvic pain syndrome, mood and quality of life. The feedforward aspects of these relationships can facilitate a downward spiral of increased symptoms and worsening psychosocial function, and suggest the need for multifaceted treatments and assessment to address this possibility in individual patients.
Authors: Anne M Suskind; Sandra H Berry; Brett A Ewing; Marc N Elliott; Marika J Suttorp; J Quentin Clemens Journal: J Urol Date: 2012-11-16 Impact factor: 7.450
Authors: Bruce D Naliboff; Alisa J Stephens; H Henry Lai; James W Griffith; J Quentin Clemens; Susan Lutgendorf; Larissa V Rodriguez; Craig Newcomb; Siobhan Sutcliffe; Wensheng Guo; John W Kusek; J Richard Landis Journal: J Urol Date: 2017-05-18 Impact factor: 7.450
Authors: J Quentin Clemens; Elizabeth A Calhoun; Mark S Litwin; Mary McNaughton-Collins; John W Kusek; Evelyn M Crowley; J Richard Landis Journal: Urology Date: 2009-10-02 Impact factor: 2.649
Authors: Philip M Hanno; David Allen Burks; J Quentin Clemens; Roger R Dmochowski; Deborah Erickson; Mary Pat Fitzgerald; John B Forrest; Barbara Gordon; Mikel Gray; Robert Dale Mayer; Diane Newman; Leroy Nyberg; Christopher K Payne; Ursula Wesselmann; Martha M Faraday Journal: J Urol Date: 2011-04-16 Impact factor: 7.600
Authors: Niloofar Afari; Dedra Buchwald; Daniel Clauw; Barry Hong; Xiaoling Hou; John N Krieger; Chris Mullins; Alisa J Stephens-Shields; Marianna Gasperi; David A Williams Journal: Clin J Pain Date: 2019-09-26 Impact factor: 3.423
Authors: J Richard Landis; David A Williams; M Scott Lucia; Daniel J Clauw; Bruce D Naliboff; Nancy A Robinson; Adrie van Bokhoven; Siobhan Sutcliffe; Anthony J Schaeffer; Larissa V Rodriguez; Emeran A Mayer; H Henry Lai; John N Krieger; Karl J Kreder; Niloofar Afari; Gerald L Andriole; Catherine S Bradley; James W Griffith; David J Klumpp; Barry A Hong; Susan K Lutgendorf; Dedra Buchwald; Claire C Yang; Sean Mackey; Michel A Pontari; Philip Hanno; John W Kusek; Chris Mullins; J Quentin Clemens Journal: BMC Urol Date: 2014-08-01 Impact factor: 2.264