Characterization of Whole Body Pain in Urological Chronic Pelvic Pain Syndrome at Baseline: A MAPP Research Network Study

J Urol. 2017 Sep;198(3):622-631. doi: 10.1016/j.juro.2017.03.132. Epub 2017 Mar 31.


Purpose: We characterized the location and spatial distribution of whole body pain in patients with urological chronic pelvic pain syndrome using a body map. We also compared the severity of urinary symptoms, pelvic pain, nonpelvic pain and psychosocial health among patients with different pain patterns.

Materials and methods: A total of 233 women and 191 men with urological chronic pelvic pain syndrome enrolled in a multicenter, 1-year observational study completed a battery of baseline measures, including a body map describing the location of pain during the last week. Participants were categorized with pelvic pain if they reported pain in the abdomen and pelvis only. Participants who reported pain beyond the pelvis were further divided into 2 subgroups based on the number of broader body regions affected by pain, including an intermediate group with 1 or 2 additional regions outside the pelvis and a widespread pain group with 3 to 7 additional regions.

Results: Of the 424 enrolled patients 25% reported pelvic pain only and 75% reported pain beyond the pelvis, of whom 38% reported widespread pain. Participants with a greater number of pain locations had greater nonpelvic pain severity (p <0.0001), sleep disturbance (p = 0.035), depression (p = 0.005), anxiety (p = 0.011), psychological stress (p = 0.005) and negative affect scores (p = 0.0004), and worse quality of life (p ≤0.021). No difference in pelvic pain and urinary symptom severity was observed according to increasing pain distribution.

Conclusions: Three-quarters of the men and women with urological chronic pelvic pain syndrome reported pain outside the pelvis. Widespread pain was associated with greater severity of nonpelvic pain symptoms, poorer psychosocial health and worse quality of life but not with worse pelvic pain or urinary symptoms.

Keywords: cystitis; interstitial; pelvic pain; prostate; prostatitis; urinary bladder.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Adult
  • Affect
  • Anxiety / etiology
  • Anxiety / psychology
  • Chronic Pain / complications
  • Chronic Pain / diagnosis*
  • Chronic Pain / psychology
  • Depression / etiology
  • Depression / psychology
  • Female
  • Humans
  • Lower Urinary Tract Symptoms / diagnosis
  • Lower Urinary Tract Symptoms / etiology*
  • Lower Urinary Tract Symptoms / psychology
  • Male
  • Middle Aged
  • Pain Measurement / methods
  • Pelvic Pain / complications
  • Pelvic Pain / diagnosis*
  • Pelvic Pain / psychology
  • Quality of Life
  • Severity of Illness Index
  • Sleep Wake Disorders / etiology
  • Sleep Wake Disorders / psychology
  • Stress, Psychological / etiology
  • Stress, Psychological / psychology
  • Surveys and Questionnaires