“Getting to Zero": Phenotype, Symptom Severity and Treatment in Chronic

Abstract ID 14-440
Glickman Urological and Kidney
“Getting to Zero": Phenotype, Symptom Severity and Treatment in Chronic
Prostatitis/Chronic Pelvic Pain Syndrome Patients Who Self Report Symptom Resolution
Chad Reichard MD; Irene Makovey MD; Daniel Shoskes MD
NIH-Chronic Prostatitis Symptom Index (CPSI) quantifies the extent and severity of
symptoms in chronic pelvic pain syndrome (CPPS) and impact on quality of life.
•A 6
point drop correlates with perceived patient improvement.
improvement is not equivalent to "cure" and no studies have examined CPSI
score targets in patients who consider their CPPS completely resolved.
are sufficient non-specific questions in the CPSI that would allow many otherwise
normal patients to have a score greater than zero.
describe a cohort of CPPS patients who considered their symptoms completely
clinical phenotype, treatments and CPSI scores were analyzed
Subject Selection
CPPS patients with initial clinic visits from January 2006 to January 2014 at our tertiary referral center
were reviewed and data complied on 35 patients who at a follow up visit subjectively self-reported that
they felt their symptoms to be completely resolved ("cured").
Data Collection
all p<0.0001
follow up was 12 months (range 3 to 93 months).
thirds of patients had no history of urologic surgery.
of the cured patients had irritable bowel syndrome.
post-void residual was 9cc and only 6% had a
residual >100 ml.
prevalent treatment: pelvic floor physical
therapy (71% of patients)
patients (26%) report total post-treatment
CPSI score of 0
report post-treatment scores range 1-21
with score = 0 still under ongoing treatment
with score >0 still under ongoing treatment
of 3 UPOINT domains positive (range 1-5)
prevalent domain: urinary (71%)
difference in age or UPOINT phenotype
between groups
group had lower total and pain CPSI scores
compared to control (pre-treatment)
Demographic information, clinical variables, UPOINT phenotypes, treatments, and pre-treatment and
post-treatment CPSI scores were examined. This data was obtained from our IRB approved Men’s
Health Registry. We also compared these variables to an existing database of 220 CPPS patients
previously evaluated and phenotyped at our clinic.
Statistical analysis
Pairwise parametric comparisons performed using Student’s t-test
Fisher’s exact test used to assess difference in categorical variables
GraphPad Prism v5.0 (significance set at p>0.05)
· Many men with CPPS can reach a subjective cure
· The majority do not reach a CPSI score of 0
· 43% overall continued on treatment at time of self-reported cure
This group of "cured" patients is similar to our typical tertiary referral cohort in terms of
age and phenotype but differs in having slightly lower starting CPSI pain scores.