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.