Chronic Pelvic Pain: Assessment, Evaluation, and Objectivation

Maria Beatrice Passavanti, Vincenzo Pota, Pasquale Sansone, Caterina Aurilio, Lorenzo De Nardis, Maria Caterina Pace, Maria Beatrice Passavanti, Vincenzo Pota, Pasquale Sansone, Caterina Aurilio, Lorenzo De Nardis, Maria Caterina Pace

Abstract

Chronic Pelvic Pain (CPP) and Chronic Pelvic Pain Syndrome (CPPS) have a significant impact on men and women of reproductive and nonreproductive age, with a considerable burden on overall quality of life (QoL) and on psychological, functional, and behavioural status. Moreover, diagnostic and therapeutic difficulties are remarkable features in many patients. Therefore evaluation, assessment and objectivation tools are often necessary to properly address each patient and consequently his/her clinical needs. Here we review the different tools for pain assessment, evaluation, and objectivation; specific features regarding CPP/CPPS will be highlighted. Also, recent findings disclosed with neuroimaging investigations will be reviewed as they provide new insights into CPP/CPPS pathophysiology and may serve as a tool for CPP assessment and objectivation.

References

    1. .
    1. Engeler D. S., Baranowski A. P., Dinis-Oliveira P., et al. The 2013 EAU guidelines on chronic pelvic pain: Is management of chronic pelvic pain a habit, a philosophy, or a science? 10 years of development. European Urology. 2013;64(3):431–439. doi: 10.1016/j.eururo.2013.04.035.
    1. ACOG Practice Bulletin No. 51. Chronic pelvic pain. ACOG Committee on Practice Bulletins-Gynecology. Obstetrics & Gynecology. 2004;103(3):589–605. doi: 10.1097/00006250-200403000-00045.
    1. Nyberg L. M., Krieger J. N., Nickel J. C. Textbook of Prostatitis. In: Nickel J. C., editor. National Institutes of Health Classification of Chronic Prostatitis. Vol. 28. London, UK: CRC Press; 1999.
    1. Sigalos J. T., Pastuszak A. W. Chronic orchialgia: epidemiology, diagnosis and evaluation. Translational Andrology and Urology. 2017;6(Supplement 1):S37–S43. doi: 10.21037/tau.2017.05.23.
    1. Aljumaily A., Al-Khazraji H., Gordon A., Lau S., Jarvi K. A. Characteristics and etiologies of chronic scrotal pain: A common but poorly understood condition. Pain Research & Management. 2017;2017 doi: 10.1155/2017/3829168.3829168
    1. Anaf V., Simon P., El Nakadi I., et al. Hyperalgesia, nerve infiltration and nerve growth factor expression in deep adenomyotic nodules, peritoneal and ovarian endometriosis. Human Reproduction. 2002;17(7):1895–1900. doi: 10.1093/humrep/17.7.1895.
    1. Malykhina A. P. Neural mechanisms of pelvic organ cross-sensitization. Neuroscience. 2007;149(3):660–672. doi: 10.1016/j.neuroscience.2007.07.053.
    1. Brawn J., Morotti M., Zondervan K. T., Becker C. M., Vincent K. Central changes associated with chronic pelvic pain and endometriosis. Human Reproduction Update. 2014;20(5):737–747. doi: 10.1093/humupd/dmu025.dmu025
    1. Whitaker L. H. R., Reid J., Choa A., et al. An exploratory study into objective and reported characteristics of neuropathic pain in women with chronic pelvic pain. PLoS ONE. 2016;11(4) doi: 10.1371/journal.pone.0151950.e0151950
    1. Wang G., Tokushige N., Markham R., Fraser I. S. Rich innervation of deep infiltrating endometriosis. Human Reproduction. 2009;24(4):827–834. doi: 10.1093/humrep/den464.
    1. George A. K., Sadek M. A., Saluja S. S., Fariello J. Y., Whitmore K. E., Moldwin R. M. The impact of neuropathic pain in the chronic pelvic pain population. The Journal of Urology. 2012;188(5):1783–1787. doi: 10.1016/j.juro.2012.07.034.
    1. Dargie E., Gilron I., Pukall C. F. Self-Reported Neuropathic Pain Characteristics of Women With Provoked Vulvar Pain: A Preliminary Investigation. The Journal of Sexual Medicine. 2017;14(4):577–591. doi: 10.1016/j.jsxm.2017.02.008.
    1. .
    1. Fauconnier A., Dallongeville E., Huchon C., Ville Y., Falissard B. Measurement of acute pelvic pain intensity in gynecology: A comparison of five methods. Obstetrics & Gynecology. 2009;113(2):260–269. doi: 10.1097/AOG.0b013e318195bd6c.
    1. Vercellini P., Somigliana E., Viganò P., Abbiati A., Barbara G., Fedele L. Chronic pelvic pain in women: etiology, pathogenesis and diagnostic approach. Gynecological Endocrinology. 2009;25(3):149–158. doi: 10.1080/09513590802549858.
    1. Ahangari A. Prevalence of chronic pelvic pain among women: An updated review. Pain Physician. 2014;17(2):E141–E147.
    1. Díaz Mohedo E., Wärnberg J., Barón López F. J., Mera Velasco S., Cabello Burgos A. Chronic pelvic pain in Spanish women: Prevalence and associated risk factors. A cross-sectional study. Clinical and Experimental Obstetrics & Gynecology. 2014;41(3):243–248. doi: 10.12891/ceog16632014.
    1. Díaz-Mohedo E., Hita-Contreras F., Luque-Suárez A., Walker-Chao C., Zarza-Luciáñez D., Salinas-Casado J. Prevalence and risk factors of pelvic pain. Actas Urológicas Españolas. 2014;38(5):298–303. doi: 10.1016/j.acuro.2013.09.006.
    1. Ayorinde A. A., Bhattacharya S., Druce K. L., Jones G. T., Macfarlane G. J. Chronic pelvic pain in women of reproductive and post-reproductive age: a population-based study. European Journal of Pain. 2017;21(3):445–455. doi: 10.1002/ejp.938.
    1. Ayorinde A. A., Macfarlane G. J., Saraswat L., Bhattacharya S. Chronic pelvic pain in women: An epidemiological perspective. Women's Health Journal (WHJ) 2015;11(6):851–864. doi: 10.2217/whe.15.30.
    1. Suskind A. M., Berry S. H., Ewing B. A., Elliott M. N., Suttorp M. J., Clemens J. Q. The prevalence and overlap of interstitial cystitis/bladder pain syndrome and chronic prostatitis/chronic pelvic pain syndrome in men: Results of the rand interstitial cystitis epidemiology male study. The Journal of Urology. 2013;189(1):141–145. doi: 10.1016/j.juro.2012.08.088.
    1. Bharucha A. E., Lee T. H. Anorectal and Pelvic Pain. Mayo Clinic Proceedings. 2016;91(10):1471–1486. doi: 10.1016/j.mayocp.2016.08.011.
    1. Hedelin H., Johannisson H., Welin L. Prevalence of the chronic prostatitis/chronic pelvic pain syndrome among 40-69-year-old men residing in a temperate climate. Scandinavian Journal of Urology. 2013;47(5):390–392. doi: 10.3109/00365599.2012.756930.
    1. Polackwich A. S., Shoskes D. A. Chronic prostatitis/chronic pelvic pain syndrome: a review of evaluation and therapy. Prostate Cancer and Prostatic Diseases. 2016;19(2):132–138. doi: 10.1038/pcan.2016.8.
    1. Forrest J. B., Schmidt S. Interstitial cystitis, chronic nonbacterial prostatitis and chronic pelvic pain syndrome in men: A common and frequently identical clinical entity. The Journal of Urology. 2004;172(6):2561–2562. doi: 10.1097/01.ju.0000145102.40773.43.
    1. Shoskes D. A., Landis J. R., Wang Y., Nickel J. C., Zeitlin S. I., Nadler R. Impact of post-ejaculatory pain in men with category III chronic prostatitis/chronic pelvic pain syndrome. The Journal of Urology. 2004;172(2):542–547. doi: 10.1097/01.ju.0000132798.48067.23.
    1. Zhang Y., Zheng T., Tu X., et al. Erectile dysfunction in chronic prostatitis/chronic pelvic pain syndrome: Outcomes from a multi-center study and risk factor analysis in a single center. PLoS ONE. 2016;11(4) doi: 10.1371/journal.pone.0153054.e0153054
    1. Shoskes D. A., Berger R., Elmi A., Landis J. R., Propert K. J., Zeitlin S. Muscle tenderness in men with chronic prostatitis/chronic pelvic pain syndrome: The chronic prostatitis cohort study. The Journal of Urology. 2008;179(2):556–560. doi: 10.1016/j.juro.2007.09.088.
    1. Tripp D. A., Nickel J. C., Ross S., Mullins C., Stechyson N. Prevalence, symptom impact and predictors of chronic prostatitis-like symptoms in Canadian males aged 16-19 years. BJU International. 2009;103(8):1080–1084. doi: 10.1111/j.1464-410X.2008.08157.x.
    1. Tripp D. A., Nickel J. C., Pikard J. L., Katz L. Chronic prostatitis-like symptoms in African males aged 16-19 years. Canadian Journal of Urology. 2012;19(1):6081–6087.
    1. Strebel R. T., Leippold T., Luginbuehl T., Muentener M., Praz V., Hauri D. Chronic scrotal pain syndrome: management among urologists in Switzerland. European Urology. 2005;47(6):812–816. doi: 10.1016/j.eururo.2005.01.003.
    1. Ciftci H., Savas M., Yeni E., Verit A., Topal U. Chronic orchialgia and associated diseases. Current Urology Reports. 2010;4(2):67–70. doi: 10.1159/000253415.
    1. Berger R. E., Ciol M. A., Rothman I., Turner J. A. Pelvic tenderness is not limited to the prostate in chronic prostatitis/chronic pelvic pain syndrome (CPPS) type IIIA and IIIB: Comparison of men with and without CP/CPPS. BMC Urology. 2007;7, article no. 17 doi: 10.1186/1471-2490-7-17.
    1. Lai H. H., Jemielita T., Sutcliffe S., et al. Characterization of Whole Body Pain in Urological Chronic Pelvic Pain Syndrome at Baseline: A MAPP Research Network Study. The Journal of Urology. 2017;198(3):622–631. doi: 10.1016/j.juro.2017.03.132.
    1. Anderson R. U., Sawyer T., Wise D., Morey A., Nathanson B. H. Painful Myofascial Trigger Points and Pain Sites in Men With Chronic Prostatitis/Chronic Pelvic Pain Syndrome. The Journal of Urology. 2009;182(6):2753–2758. doi: 10.1016/j.juro.2009.08.033.
    1. Tu F. F., Kane J. N., Hellman K. M. Noninvasive experimental bladder pain assessment in painful bladder syndrome. BJOG: An International Journal of Obstetrics & Gynaecology. 2017;124(2):283–291. doi: 10.1111/1471-0528.14433.
    1. Loving S., Thomsen T., Jaszczak P., Nordling J. Pelvic floor muscle dysfunctions are prevalent in female chronic pelvic pain: A cross-sectional population-based study. European Journal of Pain. 2014;18(9):1259–1270. doi: 10.1002/j.1532-2149.2014.485.x.
    1. Breivik H., Collett B., Ventafridda V., Cohen R., Gallacher D. Survey of chronic pain in Europe: prevalence, impact on daily life, and treatment. European Journal of Pain. 2006;10(4):287–333. doi: 10.1016/j.ejpain.2005.06.009.
    1. Baranowski A. P. Chronic pelvic pain. Best Practice & Research Clinical Gastroenterology. 2009;23(4):593–610. doi: 10.1016/j.bpg.2009.04.013.
    1. Riegel B., Bruenahl C. A., Ahyai S., Bingel U., Fisch M., Löwe B. Assessing psychological factors, social aspects and psychiatric co-morbidity associated with Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) in men—a systematic review. Journal of Psychosomatic Research. 2014;77(5):333–350. doi: 10.1016/j.jpsychores.2014.09.012.
    1. Krieger J. N., Stephens A. J., Landis J. R., et al. Relationship between chronic nonurological associated somatic syndromes and symptom severity in urological chronic pelvic pain syndromes: Baseline evaluation of the MAPP study. The Journal of Urology. 2015;193(4):1254–1262. doi: 10.1016/j.juro.2014.10.086.
    1. Bryant C., Cockburn R., Plante A.-F., Chia A. The psychological profile of women presenting to a multidisciplinary clinic for chronic pelvic pain: High levels of psychological dysfunction and implications for practice. Journal of Pain Research. 2016;9:1049–1056. doi: 10.2147/JPR.S115065.
    1. Naliboff B. D., Stephens A. J., Afari N., et al. Widespread psychosocial difficulties in men and women with urologic chronic pelvic pain syndromes: Case-control findings from the multidisciplinary approach to the study of chronic pelvic pain research network. Urology. 2015;85(6):1319–1327. doi: 10.1016/j.urology.2015.02.047.
    1. Flink I. L., Boersma K., Linton S. J. Pain Catastrophizing as Repetitive Negative Thinking: A Development of the Conceptualization. Cognitive Behaviour Therapy. 2013;42(3):215–223. doi: 10.1080/16506073.2013.769621.
    1. Martin C. E., Johnson E., Wechter M. E., Leserman J., Zolnoun D. A. Catastrophizing: A predictor of persistent pain among women with endometriosis at 1 year. Human Reproduction. 2011;26(11):3078–3084. doi: 10.1093/humrep/der292.
    1. Kwon J. K., Chang I. H. Pain, catastrophizing, and depression in chronic prostatitis/chronic pelvic pain syndrome. International Neurourology Journal. 2013;17(2):48–58. doi: 10.5213/inj.2013.17.2.48.
    1. Yosef A., Allaire C., Williams C., et al. Multifactorial contributors to the severity of chronic pelvic pain in women. American Journal of Obstetrics & Gynecology. 2016;215(6):760–760.e14. doi: 10.1016/j.ajog.2016.07.023.
    1. Payne L. A., Rapkin A. J., Lung K. C., Seidman L. C., Zeltzer L. K., Tsao J. C. I. Pain catastrophizing predicts menstrual pain ratings in adolescent girls with chronic pain. Pain Medicine. 2016;17(1):16–24. doi: 10.1111/pme.12869.
    1. Tripp D. A., Nickel J. C., Wang Y., et al. Catastrophizing and Pain-Contingent Rest Predict Patient Adjustment in Men With Chronic Prostatitis/Chronic Pelvic Pain Syndrome. The Journal of Pain. 2006;7(10):697–708. doi: 10.1016/j.jpain.2006.03.006.
    1. Craft R. M., Mogil J. S., Aloisi A. M. Sex differences in pain and analgesia: the role of gonadal hormones. European Journal of Pain. 2004;8(5):397–411. doi: 10.1016/j.ejpain.2004.01.003.
    1. Bajaj P., Arendt-Nielsen L., Madsen H. Sensory changes during the ovulatory phase of the menstrual cycle in healthy women. European Journal of Pain. 2001;5(2):135–144. doi: 10.1053/eujp.2001.0236.
    1. Pace M. C., Mazzariello L., Passavanti M. B., Sansone P., Barbarisi M., Aurilio C. Neurobiology of pain. Journal of Cellular Physiology. 2006;209(1):8–12. doi: 10.1002/jcp.20693.
    1. Wang D., Zhao J., Wang J., Li J., Yu S., Guo X. Deficiency of female sex hormones augments PGE2 and CGRP levels within midbrain periaqueductal gray. Journal of the Neurological Sciences. 2014;346(1-2):107–111. doi: 10.1016/j.jns.2014.08.002.
    1. Pota V., Quagliariello V., Armenia E., et al. CGRP and Visceral Pain: The Role of Sex Hormones in In Vitro Experiment. Journal of Cellular Biochemistry. 2017;118(3):510–517. doi: 10.1002/jcb.25680.
    1. Wu Y.-W., Hao T., Kou X.-X., Gan Y.-H., Ma X.-C. Synovial TRPV1 is upregulated by 17-β-estradiol and involved in allodynia of inflamed temporomandibular joints in female rats. Archives of Oral Biolog. 2015;60(9):1310–1318. doi: 10.1016/j.archoralbio.2015.05.011.
    1. Craft R. M., Ulibarri C. Sexual differentiation of rat reproductive versus opioid antinociceptive systems. Gender Medicine. 2009;6(2):208–224. doi: 10.1016/j.genm.2009.03.003.
    1. Affaitati G., Ceccarelli I., Fiorenzani P., et al. Sex differences in the analgesic effects of ICI 182,780 and Flutamide on ureteral calculosis in rats. Hormones and Behavior. 2011;59(1):9–13. doi: 10.1016/j.yhbeh.2010.09.008.
    1. Aloisi A. M., Affaitati G., Ceccarelli I., et al. Estradiol and testosterone differently affect visceral pain-related behavioural responses in male and female rats. European Journal of Pain. 2010;14(6):602–607. doi: 10.1016/j.ejpain.2009.10.016.
    1. Greenspan J. D., Craft R. M., LeResche L., et al. Studying sex and gender differences in pain and analgesia: a consensus report. PAIN. 2007;132(supplement 1):S26–S45. doi: 10.1016/j.pain.2007.10.014.
    1. Loyd D. R., Murphy A. Z. The neuroanatomy of sexual dimorphism in opioid analgesia. Experimental Neurology. 2014;259:57–63. doi: 10.1016/j.expneurol.2014.04.004.
    1. Pieretti S., Di Giannuario A., Di Giovannandrea R., et al. Gender differences in pain and its relief. Annali Dell’Istituto Superiore Di Sanità. 2016;52(2):184–189. doi: 10.4415/ANN_16_02_09.
    1. Daniels J., Gray R., Hills R. K., et al. Laparoscopic uterosacral nerve ablation for alleviating chronic pelvic pain: A randomized controlled trial. Journal of the American Medical Association. 2009;302(9):955–961. doi: 10.1001/jama.2009.1268.
    1. McDonald J. S. Diagnosis and treatment issues of chronic pelvic pain. World Journal of Urology. 2001;19(3):200–207. doi: 10.1007/s003450100204.
    1. Steege J. F. Pelvic pain phenotyping: The key to progress. Obstetrics & Gynecology. 2009;113(2):258–259. doi: 10.1097/AOG.0b013e3181969bcd.
    1. Staikou C., Kokotis P., Kyrozis A., et al. Differences in pain perception between men and women of reproductive age: A laser-evoked potentials study. Pain Medicine. 2016 doi: 10.1093/pm/pnw167.
    1. Cheong Y. C., Smotra G., Williams A. C. D. C. Non-surgical interventions for the management of chronic pelvic pain. Cochrane Database of Systematic Reviews. 2014;3, article CD008797
    1. Lapotka M., Ruz M., Salamanca Ballesteros A., Ocón Hernández O. Cold pressor gel test: A safe alternative to the cold pressor test in fMRI. Magnetic Resonance in Medicine. 2016 doi: 10.1002/mrm.26529.
    1. Bourdel N., Alves J., Pickering G., Ramilo I., Roman H., Canis M. Systematic review of endometriosis pain assessment: How to choose a scale? Human Reproduction Update. 2015;21(1):136–152. doi: 10.1093/humupd/dmu046.
    1. Chien C.-W., Bagraith K. S., Khan A., Deen M., Strong J. Comparative responsiveness of verbal and numerical rating scales to measure pain intensity in patients with chronic pain. The Journal of Pain. 2013;14(12):1653–1662. doi: 10.1016/j.jpain.2013.08.006.
    1. Mohan H., Ryan J., Whelan B., Wakai A. The end of the line? The Visual Analogue Scale and Verbal Numerical Rating Scale as pain assessment tools in the emergency department. Emergency Medicine Journal. 2010;27(5):372–375. doi: 10.1136/emj.2007.048611.
    1. Williamson A., Hoggart B. Pain: a review of three commonly used pain rating scales. Journal of Clinical Nursing. 2005;14(7):798–804. doi: 10.1111/j.1365-2702.2005.01121.x.
    1. Melzack R. The McGill pain questionnaire: from description to measurement. Anesthesiology. 2005;103(1):199–202. doi: 10.1097/00000542-200507000-00028.
    1. Melzack R. The short-form McGill pain questionnaire. PAIN. 1987;30(2):191–197. doi: 10.1016/0304-3959(87)91074-8.
    1. Caraceni A., Mendoza T. R., Mencaglia E., et al. A validation study of an Italian version of the brief pain inventory (Breve questionario per la valutazione del dolore) PAIN. 1996;65(1):87–92. doi: 10.1016/0304-3959(95)00156-5.
    1. Galer B. S., Jensen M. P. Development and preliminary validation of a pain measure specific to neuropathic pain: the Neuropathic Pain Scale. Neurology. 1997;48(2):332–338. doi: 10.1212/wnl.48.2.332.
    1. Freynhagen R., Baron R., Gockel U., Tölle T. R. painDETECT: a new screening questionnaire to identify neuropathic components in patients with back pain. Current Medical Research and Opinion. 2006;22(10):1911–1920. doi: 10.1185/030079906x132488.
    1. Bennett M. I., Smith B. H., Torrance N., Potter J. The S-LANSS score for identifying pain of predominantly neuropathic origin: validation for use in clinical and postal research. The Journal of Pain. 2005;6(3):149–158. doi: 10.1016/j.jpain.2004.11.007.
    1. Portenoy R. Development and testing of a neuropathic pain screening questionnaire: ID Pain. Current Medical Research and Opinion. 2006;22(8):1555–1565. doi: 10.1185/030079906X115702.
    1. Bouhassira D., Attal N., Fermanian J., et al. Development and validation of the Neuropathic Pain Symptom Inventory. Pain. 2004;108(3):248–257. doi: 10.1016/j.pain.2003.12.024.
    1. Bouhassira D., Attal N., Alchaar H., et al. Comparison of pain syndromes associated with nervous or somatic lesions and development of a new neuropathic pain diagnostic questionnaire (DN4) PAIN. 2005;114(1-2):29–36. doi: 10.1016/j.pain.2004.12.010.
    1. Hamdan A., Luna J. D., Del Pozo E., Gálvez R. Diagnostic accuracy of two questionnaires for the detection of neuropathic pain in the Spanish population. European Journal of Pain. 2014;18(1):101–109. doi: 10.1002/j.1532-2149.2013.00350.x.
    1. Backonja M.-M., Krause S. J. Neuropathic pain questionnaire—short form. The Clinical Journal of Pain. 2003;19(5):315–316. doi: 10.1097/00002508-200309000-00005.
    1. Quaghebeur J., Wyndaele J. Comparison of questionnaires used for the evaluation of patients with chronic pelvic pain. Neurourology and Urodynamics. 2013;32(8):1074–1079. doi: 10.1002/nau.22364.
    1. O'Leary M. P., Sant G. R., Fowler F. J., Jr., Whitmore K. E., Spolarich-Kroll J. The interstitial cystitis symptom index and problem index. Urology. 1997;49(5):58–63. doi: 10.1016/S0090-4295(99)80333-1.
    1. Lubeck D. P., Whitmore K., Sant G. R., Alvarez-Horine S., Lai C. Psychometric validation of the O'Leary-Sant Interstitial Cystitis Symptom Index in a clinical trial of pentosan polysulfate sodium. Urology. 2001;57(6):62–66. doi: 10.1016/S0090-4295(01)01126-8.
    1. Propert K. J., Mayer R. D., Wang Y., et al. Responsiveness of symptom scales for interstitial cystitis. Urology. 2006;67(1):55–59. doi: 10.1016/j.urology.2005.07.014.
    1. Kuo Y.-C., Kuo H.-C. O’leary-sant symptom index predicts the treatment outcome for onabotulinumtoxin a injections for refractory interstitial cystitis/bladder pain syndrome. Toxins. 2015;7(8):2860–2871. doi: 10.3390/toxins7082860.
    1. Humphrey L., Arbuckle R., Moldwin R., et al. The bladder pain/interstitial cystitis symptom score: Development, validation, and identification of a cut score. European Urology. 2012;61(2):271–279. doi: 10.1016/j.eururo.2011.10.004.
    1. Goin J. E., Olaleye D., Peters K. M., Steinert B., Habicht K., Wynant G. Psychometric analysis of the university of wisconsin interstitial cystitis scale: Implications for use in randomized clinical trials. The Journal of Urology. 1998;159(3):1085–1090. doi: 10.1016/S0022-5347(01)63840-0.
    1. .
    1. Litwin M. S., McNaughton-Collins M., Fowler F. J., Jr., et al. The National Institutes of Health chronic prostatitis symptom index: Development and validation of a new outcome measure. The Journal of Urology. 1999;162(2):369–375. doi: 10.1016/S0022-5347(05)68562-X.
    1. Davis S. N. P., Binik Y. M., Amsel R., Carrier S. A subtype based analysis of urological chronic pelvic pain syndrome in men. The Journal of Urology. 2013;190(1):118–123. doi: 10.1016/j.juro.2013.01.020.
    1. Propert K. J., Litwin M. S., Wang Y., et al. Responsiveness of the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) Quality of Life Research. 2006;15(2):299–305. doi: 10.1007/s11136-005-1317-1.
    1. Clemens J. Q., Calhoun E. A., Litwin M. S., et al. Rescoring the NIH chronic prostatitis symptom index: Nothing new. Prostate Cancer and Prostatic Diseases. 2009;12(3):285–287. doi: 10.1038/pcan.2009.22.
    1. Wagenlehner F. M. E., Van Till J. W. O., Magri V., et al. National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) symptom evaluation in multinational cohorts of patients with chronic prostatitis/chronic pelvic pain syndrome. European Urology. 2013;63(5):953–959. doi: 10.1016/j.eururo.2012.10.042.
    1. Clemens J. Q., Calhoun E. A., Litwin M. S., et al. Validation of a Modified National Institutes of Health Chronic Prostatitis Symptom Index to Assess Genitourinary Pain in Both Men and Women. Urology. 2009;74(5):983–e3. doi: 10.1016/j.urology.2009.06.078.
    1. Díaz Mohedo E., Barõn Lõpez F. J., Pineda Galán C., Dawid Milner M. S., Suárez Serrano C., Medrano Sánchez E. Discriminating power of CPPQ-Mohedo: A new questionnaire for chronic pelvic pain. Journal of Evaluation in Clinical Practice. 2013;19(1):94–99. doi: 10.1111/j.1365-2753.2011.01778.x.
    1. Shoskes D. A., Nickel J. C., Dolinga R., Prots D. Clinical Phenotyping of Patients With Chronic Prostatitis/Chronic Pelvic Pain Syndrome and Correlation With Symptom Severity. Urology. 2009;73(3):538–542. doi: 10.1016/j.urology.2008.09.074.
    1. Nickel J. C., Shoskes D., Irvine-Bird K. Clinical Phenotyping of Women With Interstitial Cystitis/Painful Bladder Syndrome: A Key to Classification and Potentially Improved Management. The Journal of Urology. 2009;182(1):155–160. doi: 10.1016/j.juro.2009.02.122.
    1. Samplaski M. K., Li J., Shoskes D. A. Clustering of UPOINT domains and subdomains in men with chronic prostatitis/chronic pelvic pain syndrome and contribution to symptom severity. The Journal of Urology. 2012;188(5):1788–1793. doi: 10.1016/j.juro.2012.07.036.
    1. Shoskes D. A., Nickel J. C. Classification and treatment of men with chronic prostatitis/chronic pelvic pain syndrome using the UPOINT system. World Journal of Urology. 2013;31(4):755–760. doi: 10.1007/s00345-013-1075-6.
    1. Polackwich A. S., Li J., Shoskes D. A. Patients with pelvic floor muscle spasm have a superior response to pelvic floor physical therapy at specialized centers. The Journal of Urology. 2015;194(4):1002–1006. doi: 10.1016/j.juro.2015.03.130.
    1. Shoskes D. A., Nickel J. C., Kattan M. W. Phenotypically directed multimodal therapy for chronic prostatitis/chronic pelvic pain syndrome: a prospective study using UPOINT. Urology. 2010;75(6):1249–1253. doi: 10.1016/j.urology.2010.01.021.
    1. Guan X., Zhao C., Ou Z.-Y., et al. Use of the UPOINT phenotype system in treating Chinese patients with chronic prostatitis/chronic pelvic pain syndrome: a prospective study. Asian Journal of Andrology. 2015;17(1):120–123. doi: 10.4103/1008-682x.138189.
    1. Magri V., Marras E., Restelli A., Wagenlehner F. M. E., Perletti G. Multimodal therapy for category III chronic prostatitis/chronic pelvic pain syndrome in UPOINTS phenotyped patients. Experimental and Therapeutic Medicine. 2015;9(3):658–666. doi: 10.3892/etm.2014.2152.
    1. Goldstein A. T., Pukall C. F., Brown C., Bergeron S., Stein A., Kellogg-Spadt S. Vulvodynia: Assessment and Treatment. The Journal of Sexual Medicine. 2016;13(4):572–590. doi: 10.1016/j.jsxm.2016.01.020.
    1. Neelakantan D., Omojole F., Clark T. J., Gupta J. K., Khan K. S. Quality of life instruments in studies of chronic pelvic pain: A systematic review. Journal of Obstetrics & Gynaecology. 2004;24(8):851–858. doi: 10.1080/01443610400019138.
    1. Rabin R., De Charro F. EQ-5D: a measure of health status from the EuroQol Group. Annals of Medicine. 2001;33(5):337–343. doi: 10.3109/07853890109002087.
    1. Tait R. C., Chibnall J. T., Krause S. The pain disability index: psychometric properties. PAIN. 1990;40(2):171–182. doi: 10.1016/0304-3959(90)90068-o.
    1. Amtmann D., Cook K. F., Jensen M. P., et al. Development of a PROMIS item bank to measure pain interference. PAIN. 2010;150(1):173–182. doi: 10.1016/j.pain.2010.04.025.
    1. Schober J. M., Meyer-Bahlburg H. F. L., Dolezal C. Self-ratings of genital anatomy, sexual sensitivity and function in men using the 'Self-Assessment of Genital Anatomy and Sexual Function, Male' questionnaire. BJU International. 2009;103(8):1096–1103. doi: 10.1111/j.1464-410X.2008.08166.x.
    1. Schober J. M., Meyer-Bahlburg H. F. L., Ransley P. G. Self-assessment of genital anatomy, sexual sensitivity and function in women: Implications for genitoplasty. BJU International. 2004;94(4):589–594. doi: 10.1111/j.1464-410X.2004.05006.x.
    1. Brünahl C. A., Riegel B., Höink J., Kutup A., Eichelberg E., Löwe B. Psychosomatic aspects of chronic pelvic pain syndrome. Psychometric results from the pilot phase of an interdisciplinary outpatient clinic. Der Schmerz. 2014;28(3):311–318. doi: 10.1007/s00482-014-1422-6.
    1. Sullivan M. J. L., Bishop S. R., Pivik J. The pain catastrophizing scale: development and validation. Psychological Assessment. 1995;7(4):524–532. doi: 10.1037/1040-3590.7.4.524.
    1. Hellman K. M., Patanwala I. Y., Pozolo K. E., Tu F. F. Multimodal nociceptive mechanisms underlying chronic pelvic pain Presented in poster format at the 21st annual meeting of the International Pelvic Pain Society, Orlando, FL, Oct. 18-19, 2013. American Journal of Obstetrics & Gynecology. 2015;213(6):827–827.e9. doi: 10.1016/j.ajog.2015.08.038.
    1. Davis S. N. P., Maykut C. A., Binik Y. M., Amsel R., Carrier S. Tenderness as measured by pressure pain thresholds extends beyond the pelvis in chronic pelvic pain syndrome in men. The Journal of Sexual Medicine. 2011;8(1):232–239. doi: 10.1111/j.1743-6109.2010.02041.x.
    1. Bleustein C. B., Eckholdt H., Arezzo J. C., Melman A. Quantitative somatosensory testing of the penis: Optimizing the clinical neurological examination. The Journal of Urology. 2003;169(6):2266–2269. doi: 10.1097/01.ju.0000065824.35996.c8.
    1. Fenton B. W., Palmieri P. A., Durner C., Fanning J. Quantification of abdominal wall pain using pain pressure threshold algometry in patients with chronic pelvic Pain pnet. The Clinical Journal of Pain. 2009;25(6):500–505. doi: 10.1097/AJP.0b013e31819a3cf9.
    1. Tu F. F., Fitzgerald C. M., Kuiken T., Farrell T., Norman H. R. Comparative measurement of pelvic floor pain sensitivity in chronic pelvic pain. Obstetrics & Gynecology. 2007;110(6):1244–1248. doi: 10.1097/.
    1. Tu F. F., Fitzgerald C. M., Kuiken T., Farrell T., Norman Harden R. Vaginal pressure-pain thresholds: Initial validation and reliability assessment in healthy women. The Clinical Journal of Pain. 2008;24(1):45–50. doi: 10.1097/AJP.0b013e318156db13.
    1. Phillips N., Brown C., Bachmann G., et al. Relationship between nongenital tender point tenderness and intravaginal muscle pain intensity: ratings in women with provoked vestibulodynia and implications for treatment. American Journal of Obstetrics & Gynecology. 2016;215(6):751–751.e5. doi: 10.1016/j.ajog.2016.06.047.
    1. Pukall C. F., Young R. A., Roberts M. J., Sutton K. S., Smith K. B. The vulvalgesiometer as a device to measure genital pressure-pain threshold. Physiological Measurement. 2007;28(12):1543–1550. doi: 10.1088/0967-3334/28/12/008.
    1. Sutton K., Pukall C., Wild C., Johnsrude I., Chamberlain S. Cognitive, Psychophysical, and Neural Correlates of Vulvar Pain in Primary and Secondary Provoked Vestibulodynia: A Pilot Study. The Journal of Sexual Medicine. 2015;12(5):1283–1297. doi: 10.1111/jsm.12863.
    1. Morin M., Binik Y. M., Bourbonnais D., Khalifé S., Ouellet S., Bergeron S. Heightened Pelvic Floor Muscle Tone and Altered Contractility in Women With Provoked Vestibulodynia. The Journal of Sexual Medicine. 2017;14(4):592–600. doi: 10.1016/j.jsxm.2017.02.012.
    1. Cyr M.-P., Bourbonnais D., Pinard A., Dubois O., Morin M. Reliability and convergent validity of the algometer for vestibular pain assessment in women with provoked vestibulodynia. Pain Medicine. 2016;17(7):1220–1228. doi: 10.1093/pm/pnv069.
    1. Lee J. C., Yang C. C., Kromm B. G., Berger R. E. Neurophysiologic testing in chronic pelvic pain syndrome: A pilot study. Urology. 2001;58(2):246–250. doi: 10.1016/S0090-4295(01)01143-8.
    1. Yang C. C., Lee J. C., Kromm B. G., Ciol M. A., Berger R. E. Pain sensitization in male chronic pelvic pain syndrome: Why are symptoms so difficult to treat? The Journal of Urology. 2003;170(3):823–826. doi: 10.1097/01.ju.0000082710.47402.03.
    1. Korkmaz S., Karadag M. A., Hamamcioglu K., Sofikerim M., Aksu M. Electrophysiological identification of central sensitization in patients with chronic prostatitis. Urology Journal. 2015;12(4):2280–2284.
    1. Kogan M. I., Belousov I. I., Shornikov P. V. Neurophysiologic evaluation of patients with chronic prostatitis (III B chronic pain syndrome) Urologiia. 2012;4:37–42.
    1. De Laet K., De Wachter S., Wyndaele J.-J. Current perception thresholds in the lower urinary tract: Sine- and square-wave currents studied in young healthy volunteers. Neurourology and Urodynamics. 2005;24(3):261–266. doi: 10.1002/nau.20095.
    1. Fujihara A., Ukimura O., Iwata T., Miki T. Neuroselective measure of the current perception threshold of A-delta and C-fiber afferents in the lower urinary tract. International Journal of Urology. 2011;18(5):341–349. doi: 10.1111/j.1442-2042.2011.02749.x.
    1. Kuo H.-C., Chuang Y.-C., Michael B. Chancellor Neurourology, Diet, and Painful Bladder Highlights. Reviews in Urology. 2008;10(1):70–72. Highlights of the 37th Annual Conference of the International Continence Society, August 20–24, 2007, Rotterdam, Netherlands.
    1. Ukimura O., Ushijima S., Honjo H., et al. Neuroselective Current Perception Threshold Evaluation of Bladder Mucosal Sensory Function. European Urology. 2004;45(1):70–76. doi: 10.1016/j.eururo.2003.08.004.
    1. Yilmaz U., Ciol M. A., Berger R. E., Yang C. C. Sensory Perception Thresholds in Men With Chronic Pelvic Pain Syndrome. Urology. 2010;75(1):34–37. doi: 10.1016/j.urology.2009.08.013.
    1. La Cesa S., Tamburin S., Tugnoli V., et al. How to diagnose neuropathic pain? The contribution from clinical examination, pain questionnaires and diagnostic tests. Neurological Sciences. 2015;36(12):2169–2175. doi: 10.1007/s10072-015-2382-z.
    1. Martucci K. T., Mackey S. C. Imaging Pain. Anesthesiology Clinics. 2016;34(2):255–269. doi: 10.1016/j.anclin.2016.01.001.
    1. Mayer E. A., Gupta A., Kilpatrick L. A., Hong J.-Y. Imaging brain mechanisms in chronic visceral pain. PAIN. 2015;156(4):S50–S63. doi: 10.1097/j.pain.0000000000000106.
    1. Schmidt-Wilcke T. Neuroimaging of chronic pain. Best Practice & Research Clinical Rheumatology. 2015;29(1, article no. 1145):29–41. doi: 10.1016/j.berh.2015.04.030.
    1. Lee M. C., Tracey I., Colvin L., Rowbotham D. J. Imaging pain: A potent means for investigating pain mechanisms in patients. British Journal of Anaesthesia. 2013;111(1):64–72. doi: 10.1093/bja/aet174.
    1. As-Sanie S., Kim J., Schmidt-Wilcke T., et al. Functional Connectivity Is Associated with Altered Brain Chemistry in Women with Endometriosis-Associated Chronic Pelvic Pain. The Journal of Pain. 2016;17(1):1–13. doi: 10.1016/j.jpain.2015.09.008.
    1. As-Sanie S., Harris R. E., Napadow V., et al. Changes in regional gray matter volume in women with chronic pelvic pain: a voxel-based morphometry study. PAIN. 2012;153(5):1006–1014. doi: 10.1016/j.pain.2012.01.032.
    1. Beissner F., Preibisch C., Schweizer-Arau A., Popovici R. M., Meissner K. Psychotherapy With Somatosensory Stimulation for Endometriosis-Associated Pain: The Role of the Anterior Hippocampus. Biological Psychiatry. 2016 doi: 10.1016/j.biopsych.2017.01.006.
    1. Alger J. R., Ellingson B. M., Ashe-Mcnalley C., et al. Multisite, multimodal neuroimaging of chronic urological pelvic pain: Methodology of the MAPP Research Network. NeuroImage: Clinical. 2016;12:65–77. doi: 10.1016/j.nicl.2015.12.009.
    1. Martucci K. T., Shirer W. R., Bagarinao E., et al. The posterior medial cortex in urologic chronic pelvic pain syndrome: Detachment from default mode network - A resting-state study from the MAPP Research Network. PAIN. 2015;156(9):1755–1764. doi: 10.1097/j.pain.0000000000000238.
    1. Woodworth D., Mayer E., Leu K., et al. Unique microstructural changes in the brain associated with urological chronic pelvic pain syndrome (UCPPS) revealed by diffusion tensor MRI, super-resolution track density imaging, and statistical parameter mapping: A MAPP network neuroimaging study. PLoS ONE. 2015;10(10) doi: 10.1371/journal.pone.0140250.e0140250
    1. Huang L., Kutch J. J., Ellingson B. M., et al. Brain white matter changes associated with urological chronic pelvic pain syndrome: Multisite neuroimaging from a MAPP case-control study. PAIN. 2016;157(12):2782–2791. doi: 10.1097/j.pain.0000000000000703.
    1. Kutch J. J., Yani M. S., Asavasopon S., et al. Altered resting state neuromotor connectivity in men with chronic prostatitis/chronic pelvic pain syndrome: A MAPP: Research Network Neuroimaging Study. NeuroImage: Clinical. 2015;8:493–502. doi: 10.1016/j.nicl.2015.05.013.
    1. Lin Y., Bai Y., Liu P., et al. Alterations in regional homogeneity of resting-state cerebral activity in patients with chronic prostatitis/chronic pelvic pain syndrome. PLoS ONE. 2017;12, article e0184896(9) doi: 10.1371/journal.pone.0184896.
    1. Therapy-related longitudinal brain perfusion changes in patients with chronic pelvic pain syndrome. Swiss Medical Weekly. 2017;147(3132) doi: 10.4414/smw.2017.14454.
    1. Mordasini L., Weisstanner C., Rummel C., et al. Chronic pelvic pain syndrome in men is associated with reduction of relative gray matter volume in the anterior cingulate cortex compared to healthy controls. The Journal of Urology. 2012;188(6):2233–2237. doi: 10.1016/j.juro.2012.08.043.
    1. Farmer M. A., Chanda M. L., Parks E. L., Baliki M. N., Apkarian A. V., Schaeffer A. J. Brain functional and anatomical changes in chronic prostatitis/chronic pelvic pain syndrome. The Journal of Urology. 2011;186(1):117–124. doi: 10.1016/j.juro.2011.03.027.
    1. Gupta A., Rapkin A. J., Gill Z., et al. Disease-related differences in resting-state networks: A comparison between localized provoked vulvodynia, irritable bowel syndrome, and healthy control subjects. PAIN. 2015;156(5):809–819. doi: 10.1097/01.j.pain.0000461289.65571.54.
    1. Tu C.-H., Niddam D. M., Chao H.-T., et al. Brain morphological changes associated with cyclic menstrual pain. PAIN. 2010;150(3):462–468. doi: 10.1016/j.pain.2010.05.026.
    1. Tu C.-H., Niddam D. M., Chao H.-T., et al. Abnormal cerebral metabolism during menstrual pain in primary dysmenorrhea. NeuroImage. 2009;47(1):28–35. doi: 10.1016/j.neuroimage.2009.03.080.
    1. Wei S.-Y., Chen L.-F., Lin M.-W., et al. The OPRM1 A118G polymorphism modulates the descending pain modulatory system for individual pain experience in young women with primary dysmenorrhea. Scientific Reports. 2017;7 doi: 10.1038/srep39906.39906
    1. Wei S.-Y., Chao H.-T., Tu C.-H., et al. The BDNF Val66Met polymorphism is associated with the functional connectivity dynamics of pain modulatory systems in primary dysmenorrhea. Scientific Reports. 2016;6 doi: 10.1038/srep23639.23639

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