Urologic Chronic Pelvic Pain Syndrome Flares: A Comprehensive, Systematic Review and Meta-Analysis of the Peer-Reviewed Flare Literature

Abstract

Purpose: We sought to systematically review and summarize the peer-reviewed literature on urologic chronic pelvic pain syndrome flares, including their terminology, manifestation, perceived triggers, management and prevention strategies, impact on quality of life, and insights into pathophysiologic mechanisms, as a foundation for future empirical research. Materials and Methods: We searched 6 medical databases for articles related to any aspect of symptom exacerbations for interstitial cystitis/bladder pain syndrome and chronic prostatitis/chronic pelvic pain syndrome. A total of 1486 abstracts and 398 full-text articles were reviewed, and data were extracted by at least 2 individuals. Results: Overall, we identified 59 articles, including 36 qualitative, crosssectional, or case-control; 15 cohort-based; and 8 experimental articles. The majority of studies described North American patients with confirmed diagnoses. "Flare" was a commonly used term, but additional terminology (eg, exacerbation) was also used. Most flares involved significant increases in pain intensity, but less data were available on flare frequency and duration. Painful, frequent,

CD8 T cells are dispensable for experimental autoimmune prostatitis induction and chronic pelvic pain development

“…CPPS/CP is an urological condition that poses a significant healthcare challenge due to its considerable incidence among young and middle-aged men and it significant deleterious impact in the quality of life of patients ( 2 – 6 , 11 , 49 – 51 ). Furthermore, its aetiology remains largely unknown, leading to empirically prescribed therapies that often yield suboptimal clinical outcomes, exacerbating patient discomfort and dissatisfaction ( 1 , 5 , 9 – 11 , 50 , 52 , 53 ). Accumulating evidence suggests that the syndrome is likely a result of dysregulated inflammation manifested through autoimmunity targeting more than one prostate autoantigen, a typical feature of autoimmune diseases.…”

Letter: Urologic Chronic Pelvic Pain Syndrome Flares: A Comprehensive, Systematic Review and Meta-analysis of the Peer-reviewed Flare Literature

“…To the Editor: We read with interest the comments of Kaura et al 1 regarding our recently published article. 2 It is important to recognize that our overall goal was to evaluate the treatment of nonobstructing renal stones for pain by defining a population to which the study's results should be generalizable for most urologists' practices.…”

“…To the Editor: We recently read the comprehensive and insightful review "Urologic Chronic Pelvic Pain Syndrome Flares: A Comprehensive, Systematic Review and Meta-Analysis of the Peer-Reviewed Flare Literature" by Barker et al, 1 which provided an extensive overview of the symptomatology, triggers, and management strategies associated with urologic chronic pelvic pain syndrome (UCPPS) flares. This work highlighted the pressing need for further research into the complex nature of flare manifestation, underlying biological mechanisms, and evidence-based treatments.…”