P-056 - Prevalence of Multidisciplinary Pelvic Symptoms at Intake of Patients with Chronic Pelvic Pain to a Single Academic Institution.

Abstract Title: Prevalence of Multidisciplinary Pelvic Symptoms at Intake of Patients with Chronic Pelvic Pain to a Single Academic Institution.

Background: Chronic pelvic pain (CPP) is a complex condition of heterogeneous etiology that is experienced by an estimated 4-27% of women in the United States. Worldwide, an estimated 6-30% of people experience CPP. CPP is also responsible for numerous surgical procedures, which oftentimes lead to disability and depression. Untreated, CPP can be debilitating and significantly impair one’s quality of life. The prevalence of multidisciplinary symptoms in those presenting with chronic pelvic pain is poorly understood.

Purpose/Objectives: We hypothesized that in our single-center cohort of comprehensive multidisciplinary electronic new patient intake forms, that patients with pelvic pain would show a strong prevalence of sexual, urinary, gastrointestinal, psychological, and neurological symptomatology.

Methods: 259 patients completed the electronic intake for our subspecialized adult Urogynecology and Reconstructive Pelvic Surgery (URPS) clinic. Of the 259 patients 114 reported “yes” to pelvic pain, and 138 reported “no”; the remaining 7 patients did not answer the question. 38 (14.7%) were male, 215 (83%) female, and 6 (2.3%) identified as transgender. Statistical analysis included unpaired t-tests. Validated measures were: POPDI-6, autonomic symptom score, PHQ4 (anxiety and depression), UDI-6 (urinary symptoms), neuro-urological symptoms, PISQIR (sexual health and function), CRAD-8 (lower urinary tract symptoms, GUPI pain subscales/total and quality of life scores (genitourinary pain), AUASS (urinary symptoms) and SHIM (sexual health inventory).

Results: Patients with pelvic pain reported significantly higher POPDI-6 scores (mean 39.4 ± 21.5 vs. 23.1 ± 18.3, respectively, t value = -5.3, p value < 0.001), autonomic symptoms (mean 6.7 ± 6.2 vs. 3.4 ± 3.5, respectively, t value = -4.1, p value < 0.001), PHQ-4 scores (mean 3.5 ± 3.3 vs. 1.8 ± 2.8, respectively, t value = -4.4, p value < 0.001) UDI-6 scores (mean 50.4 ± 24.9 vs. 40.1 ± 23.4, respectively, p value = 0.009, t value = -2.7), more neuro-urological symptoms (mean 3.5 ± 2.7 vs. 1.6 ± 2.2, respectively, p value < 0.001, t value = -6.1), worse PISQR scores (mean 3.2 ± 0.7 vs. 3.6 ± 0.6, respectively, t value = -2.3, p value = 0.03), higher CRAD-8 scores (mean 27.4 ± 20.7 vs. 21.0 ± 20.0, respectively, t value = -2.2, p value = 0.03), higher GUPI pain subscale scores (mean 12.8 ± 4.9 vs. 0.8, ± 1.1, respectively, t value = -24.5, p value < 0.001) and worse GUPI quality of life (mean 8.9 ± 2.9 vs. 3.9 ± 1.7, t value = -16.3, p value < 0.001) and higher GUPI total scores (mean 4.7 ± 1.3 vs. 4.0 ± 1.6, respectively, t value = – 3.9, p value < 0.001) versus those without pain. Pelvic pain did not correlate with AUASS and SHIM in the smaller male population.

Conclusions/Implications for future research and/or clinical care: Our findings suggest a significant association between pelvic pain and sexual, urinary, bowel, pelvic, psychological, neurological and autonomic symptoms. A multidisciplinary approach is recommended when managing CPP in order to achieve optimal outcomes in pelvic symptomatology.

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