A Study On Application Value And Influence Factors Of The UPOINT Phenotype System In Patients With Chronic Prostatitis/Chronic Pelvic Pain Syndrome

Objective:To evaluate a clinical phenotype system (UPOINT) for the patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) to improve the understanding of etiology and to guide therapy. To analyze influencing factors that affecting UPOINT of patients with CP/CPPS. Furthermore, evaluate the addition of sexual dysfunction domain to the UPOINT system.Methods:A cross-sectional study was used.241outpatients with CP/CPPS were recruited from urology department of a tertiary-care hospital in Jinan city. Classify patients by using UPOINT. The social demography, illness features, National Institutes of Health-chronic prostatitis symptom index, International prostate symptom score, Pain catastrophizing scale, Patient Health Questionair-9, International Index of Erectile Function5were used to collect data in the study. All the data were analyzed with SPSS16.0.Results:In our survey,269questionnaires distributed and241effective records were collected, the effective rate was89.6%.1. The age of most CP/CPPS patients was range20-50years in this cohort with a median duration of symptoms of22months (range3-216). The mean total NIH-CPSI score was20.78±5.89, and the IPSS was8.08±4.85, more than50%patients were in the moderate degree.2. The mental health of patients with CP/CPPS is not good enough. The mean score of PCS was18.78±12.63, and PHQ-9was5.90±4.05.10.4%patients scoring≥38, indicative of catastrophizing and more than50%patients were in different degree of depressive symptoms. There was a positive correlation between PCS and PHQ-9(r=0.532, P<0.01), and between PCS and NIH-CPSI Quality of Life(r=0.581, P<0.01).3. The number of patients with positive findings for UPOINT was:58.9%,60.2%、86.3%,26.6%,26.1%,39.8%. The number of patients having positive domains was9.5%of1domain,29.9%of2domains,27%of3domains,21.6%of4domains,12%of5or6domains.4. The number of positive UPOINT domains was correlated with NIH-CPSI and IPSS1=0.605,r2=0.484, P<0.01), and with the increase of the number of positive domains, NIH-CPSI score was increased from15.61±4.24for patients with1positive domain to33.00±2.64for patients with6positive domains(H1=93.515, H2=59.1792, P<0.01). Two-Independent-Sample Rank Test was used for comparison between total NIH-CPSI, pain, urinary and Quality of Life scores in patients positive or negative for each domain. And found four(U, P, N, T) of UPOINT effected on the total NIH-CPSI, also four(P, I, N, T) effected pain score, two(U, P) effected urinary score and three (U, P, N) effected Quality of Life (P<0.05).5. The mean score of IIEF-5was20.75±4.32, and most patients were in a mild degree. There were no different scores of IIEF-5in the mild, moderate and severe degree of NIH-CPSI (H=1.127, P>0.05).6. Compared with UPOINT, UPOINTS has a little weak correlation with NIH-CPSI (r1=0.614, r2=0.650, P<0.01), but relationship with NIH-CPSI Quality of Life was stronger than UPOINT (r1=0.489, r2=0.486, P<0.01).7. The number of UPOINT domains was influenced by many factors:the degree of education, physical exercise, holding urine, medication history, treatment costs, whether went to private hospital or not, had a cold, feel fatigue, pressure, lack of sleep and low efficiency on work or study. Multiple regressions were used to analyze factors that influencing UOPINT. Whether often feel fatigue and pressure or not and treatment costs were influencing factors of the number of UPOINT domains (R2 adj=0.213).Conclusion:Most CP/CPPS patients were young and middle-aged man and with a long duration of symptoms. More than fifty percent patients were in the moderate degree of their symptoms. Patients easily appear different levels of depressive symptoms. The pain made some patients using the negative coping behavior. Different patients had different signs or symptoms of UPOINT. More than90%patients had two or more domains. UPOINT was suitable in China because there was positive correlation between UPOINT and NIH-CPSI, IPSS. Sexual dysfunction was negative influencing factor for patients’ quality of life. As the purpose of UPOINT was not totally cure patients, but improve their symptoms and quality of life. So we proposed that doctors should take an attention on patients’ sexual status. Patients were influenced by many subjective and objective factors. Every patient has their individual features. Therefore we should put different emphases on patients with diverse features when make diagnoses or give treatments to improve their mental status and quality of life.