Chronic Pelvic Pain And Lower Urinary Tract Symptoms In Both Sexes: Analysis Of 2749 Participants Of An Urban Health Screening Project

Main Category: Urology / Nephrology
Also Included In: Clinical Trials / Drug Trials
Article Date: 16 May 2008 - 5:00 PST

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UroToday.com - Symptoms of chronic pelvic pain are evident in both sexes, though the underlying causes are poorly understood. Former chronic abacterial prostatitis (NIH IIIa/b), now named chronic pelvic pain syndrome and interstitial cystitis, now bladder pain syndrome may share etiologic factors leading to similar symptoms in different sexes.

As sex neutral questionnaires for symptom assessment in this field do not exist, we adopted the NIH-CPSI questionnaire to a sex neutral version by adding questions on pelvic pain with respect to the female participants of our survey.

This survey was conducted on 1768 male and 981 female participants of a public health screening project in Vienna, Austria, which is free of charge and equally accessible to all city citizens. The higher prevalence of chronic pelvic pain symptoms found in females indicates that chronic pelvic pain is a condition experienced in both sexes and again highlights the question whether there is a common underlying cause. One potential etiologic factor might be mucosal alteration of the bladder endothelium as a variant of interstitial cystitis/BPS in males, leading to inadequate pain perception and allowing abacterial inflammatory response. Though the diagnosis of interstitial cystitis/BPS in mostly found in females, the symptoms of around 30% of males with CPPS also could qualify for IC/BPS. The importance of this question is becoming evident when looking at quality of life of the study participants, becoming worse with increasing symptoms, being significantly worse in women compared to men, coming along with a higher risk of erectile dysfunction in males with chronic pelvic pain.

Summarizing the results of our analysis, the significant prevalence of chronic pelvic pain symptoms in females questions on the etiologic role of the prostate in the development of the Chronic Pelvic Pain Syndrome in males. The role of the urothelium in patients with CPPS will be one target of future investigations aimed to allow a better understanding of the pathophysiology as well as the definition of risk factors for CPPS.

Limitations of the study are that the adopted questionnaire was not formerly validated for women and the lack of a formal urological evaluation of each participant. However, all participants underwent a detailed health investigation.

Written by Martin Marszalek, MD, as part of Beyond the Abstract on UroToday.com.

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