Clinical Presentation of Urologic Chronic Pelvic Pain Syndrome (UCPPS) Varies With Presenting Age - Implication on Patient Evaluation

OBJECTIVE To compare the clinical presentation of UCPPS from a large clinical practice grouped by their presenting age to improve the evaluation of this condition. METHODS A total of 223 male and female patients seeking care for their UCPPS were recruited to study their urologic and non-urologic presentation. Their evaluation included cystoscopy and multiple questionnaires to assess their pelvic pain, non-urologic pain, urinary symptoms, somatic symptoms, and psychosocial health. Patients were then grouped by age into the following groups: less than 30 years of age, between the ages of 30 and 60, and older than 60. These groups were then compared on multiple domains. RESULTS Patients between the ages of 60 and 30 were most likely to have concomitant COPC (such as fibromyalgia or migraine headaches), more widespread distribution of non-urologic pain, higher somatic symptom burden, and depression. Patients 30 years old or younger were more likely to have more severe urologic and non-urologic pain, and urinary pain symptoms that are less typical of IC/BPS (eg, pain worsened during or after urination). Patients older than 60 were more likely to have Hunner lesion (55.6% vs 23.8% vs 8.6% among those who had cystoscopy, in decreasing age, P < .001). CONCLUSION Our findings support the evaluation of non-urologic pain, COPC and psychosocial health in middle-aged patients; Hunner lesion in older patients; and a higher clinical suspicion of other confusable diagnoses when younger patients present with atypical symptoms. (C) 2021 Elsevier Inc.