title: Urological symptoms in a subset of patients with urological chronic pelvic pain syndrome and a polysymptomatic, polysyndromic pattern of presentation.
abstract: OBJECTIVE
  We characterized urological symptoms in a subset of patients with urological chronic pelvic pain syndrome who have a high somatic symptom burden and a wide symptom distribution fitting a polysymptomatic, polysyndromic presentation pattern.
  
  
  METHODS
  A total of 81 patients with urological chronic pelvic pain syndrome enrolled in the National Institute of Diabetes and Digestive and Kidney Diseases MAPP Research Network Study at Washington University in St. Louis and University of Alabama at Birmingham sites. They completed a symptom questionnaire to assess the somatic symptom burden and its distribution, and GUPI (Genitourinary Pain Index) to assess urological chronic pelvic pain syndrome symptoms, impact on quality of life and self-reported treatment seeking behaviors for urological chronic pelvic pain symptoms. The polysymptomatic, polysyndromic symptom pattern was defined by self-report of numerous painful and nonpainful somatic symptoms across many organ systems and by symptom categories on the polysymptomatic, polysyndromic questionnaire.
  
  
  RESULTS
  Patients with urological chronic pelvic pain syndrome and the symptom pattern reported more severe genitourinary pain on a Likert scale, more frequent pain in the last week and more widespread pain distribution in the genital and pelvic areas than patients with urological chronic pelvic pain syndrome without the pattern. Patients with the symptom pattern also had significantly higher scores on the GUPI pain subscale, quality of life subscale (worse) and total questionnaire scores than patients without the pattern. Patients with the pattern reported significantly more treatment seeking behavior than others.
  
  
  CONCLUSIONS
  The polysymptomatic, polysyndromic pattern might be an important phenotypic factor to assess in the evaluation of urological chronic pelvic pain syndrome with clinical and research implications. This may be a distinct clinical subgroup among patients with urological chronic pelvic pain syndrome.
authors.affiliation: Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri. Electronic address: laih@wustl.edu.
authors.forename: H Henry
authors.initials: HH
authors.lastname: Lai
authors.affiliation: Departments of Psychiatry and Surgery/Division of Emergency Medicine, North Texas Veterans Affairs Health Care System and University of Texas Southwestern Medical Center, Dallas, Texas.
authors.forename: Carol S
authors.initials: CS
authors.lastname: North
authors.affiliation: Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri.
authors.forename: Gerald L
authors.initials: GL
authors.lastname: Andriole
authors.affiliation: Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri.
authors.forename: Lori
authors.initials: L
authors.lastname: Cupps
authors.affiliation: Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri.
authors.forename: David
authors.initials: D
authors.lastname: Song
authors.affiliation: Department of Anesthesiology, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Ness
authors.affiliation: Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri.
authors.forename: Barry A
authors.initials: BA
authors.lastname: Hong
mesh_terms: D000328:Adult; D000368:Aged; D059350:Chronic Pain / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000150:complications* / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods*; D017699:Pelvic Pain / Q000175:diagnosis* / Q000209:etiology; D011379:Prognosis; D011788:Quality of Life; D012189:Retrospective Studies; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013577:Syndrome
keywords: chronic pain; cystitis; interstitial; prostatitis; somatosensory disorders; urinary bladder