Many men and women with chronic pelvic pain suffer significant discomfort without knowing the cause. This has led urology researchers at Washington University School of Medicine to join with colleagues at the medical school and other institutions to investigate a range of possible sources. Ultimately, the researchers hope their discoveries may lead to better treatment.
The researchers are part of the Multidisciplinary Approach to the Study of Urologic Chronic Pelvic Pain (MAPP) Research Network established by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The network’s focus is taking a broad approach to the study of interstitial cystitis, a chronic inflammatory bladder condition which occurs predominantly in women, and chronic prostatitis, chronic inflammation of the prostate in men.
“Chronic pelvic pain can result from a myriad of causes,” says chief of urology Gerald Andriole Jr., MD. “There is a lot of evidence that patients change their perception so they become more sensitive to pain stimuli in other parts of the body.”
Studying five aspects of chronic pelvic pain
Andriole, as principal investigator of the Washington University MAPP Project, and H. Henry Lai, MD, as co-investigator, are leading an effort to study five aspects of chronic pelvic pain:
- an animal model investigating spinal cord pain signaling molecules, with Washington University anesthesiologist Robert Gereau, PhD;
- a neuroimaging study with Timothy Ness, MD, PhD, of the University of Alabama;
- psychological effects with Washington University psychologist Barry Hong, PhD;
- possible infectious causes with Thomas Hooton, MD, of the University of Miami and Washington University microbiologist Scott Hultgren, PhD; and
- epidemiology with Siobhan Sutcliffe, PhD, of the Department of Surgery’s Division of Public Health Sciences.
Lai is leading an effort to enroll patients in the study, who give urine and blood samples and also answer questions online. Under Sutcliffe’s guidance, Washington University is leading a number of sites looking at specific factors that cause flare-ups.
“The epidemiologic aspect is a significant one,” says Lai. “We do not know what causes symptoms in these patients or what makes the symptoms get better or worse. This will clearly help us better define the disease and the patient subgroups.”