title: Changes in symptoms during urologic chronic pelvic pain syndrome symptom flares: findings from one site of the MAPP Research Network.
abstract: OBJECTIVE
  To provide the first description and quantification of symptom changes during interstitial cystitis/bladder pain syndrome and chronic prostatitis/chronic pelvic pain syndrome symptom exacerbations ("flares").
  
  
  METHODS
  Participants at one site of the Trans-Multidisciplinary Approaches to the study of chronic Pelvic Pain Epidemiology and Phenotyping Study completed two 10-day diaries over the 1-year study follow-up period, one at baseline and one during their first flare (if not at baseline). On each day of the diary, participants reported whether they were currently experiencing a flare, defined as "symptoms that are much worse than usual" for at least 1 day, and their levels of urination-related pain, pelvic pain, urgency, and frequency on a scale of 0-10. Linear mixed models were used to calculate mean changes in symptoms between non-flare and flare days from the same participant.
  
  
  RESULTS
  Eighteen of 27 women and 9 of 29 men reported at least one flare during follow-up, for a total of 281 non-flare and 210 flare days. Of these participants, 44.4% reported one flare, 29.6% reported two flares, and 25.9% reported ≥ 3 flares over the combined 20-day diary observation period, with reported flares ranging in duration from 1 day to >2 weeks. During these flares, each of the main symptoms worsened significantly by a mean of at least two points and total symptoms worsened by a mean of 11 points for both sexes (all P ≤ 0.01).
  
  
  CONCLUSIONS
  Flares are common and correspond to a global worsening of urologic and pelvic pain symptoms.
authors.affiliation: Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri; Alvin J. Siteman Cancer Center, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri.
authors.forename: Siobhan
authors.initials: S
authors.lastname: Sutcliffe
authors.forename: Graham A
authors.initials: GA
authors.lastname: Colditz
authors.forename: Ratna
authors.initials: R
authors.lastname: Pakpahan
authors.forename: Catherine S
authors.initials: CS
authors.lastname: Bradley
authors.forename: Melody S
authors.initials: MS
authors.lastname: Goodman
authors.forename: Gerald L
authors.initials: GL
authors.lastname: Andriole
authors.forename: H Henry
authors.initials: HH
authors.lastname: Lai
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D018856:Cystitis, Interstitial / Q000175:diagnosis / Q000503:physiopathology*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D017699:Pelvic Pain / Q000175:diagnosis / Q000503:physiopathology*; D011472:Prostatitis / Q000175:diagnosis / Q000503:physiopathology*; D012720:Severity of Illness Index; D013577:Syndrome; D013997:Time Factors; D055815:Young Adult
keywords: bladder pain syndrome; chronic pelvic pain syndrome; chronic prostatitis; flare; interstitial cystitis; symptom exacerbation