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Symptom flares: a clinically important but under-explored challenge for women with chronic pelvic pain
  • +21
  • Lydia Coxon,
  • Celia Lugt,
  • Andrew Horne,
  • Emma Evans,
  • Pedro Abreu-Mendes,
  • Lars Arendt-Nielsen,
  • Qasim Aziz,
  • Christian Becker,
  • Judy Birch,
  • Ana Charrua,
  • Lysia Demetriou,
  • Joana Ferreira-Gomes,
  • Anja Hoffman,
  • Lone Hummelshoj,
  • Michal Krassowski,
  • Claire Lunde,
  • Jane Meijlink,
  • Stacey Missmer ,
  • Danielle Perro,
  • Krina Zondervan,
  • Christine Sieberg,
  • Francisco Cruz,
  • Jens Nagel,
  • Katy Vincent
Lydia Coxon
University of Oxford

Corresponding Author:lydia.coxon@wrh.ox.ac.uk

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Celia Lugt
University of Oxford
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Andrew Horne
The University of Edinburgh
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Emma Evans
University of Oxford
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Pedro Abreu-Mendes
Hospital de Sao Joao
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Lars Arendt-Nielsen
Aalborg Universitet Institut for Medicin og Sundhedsteknologi
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Qasim Aziz
Queen Mary University of London Centre for Neuroscience Surgery and Trauma
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Christian Becker
University of Oxford
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Judy Birch
Pelvic Pain Support Network
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Ana Charrua
Hospital de Sao Joao
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Lysia Demetriou
University of Oxford
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Joana Ferreira-Gomes
Hospital de Sao Joao
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Anja Hoffman
Bayer Pharma AG
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Lone Hummelshoj
Endometriosisorg UK
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Michal Krassowski
University of Oxford
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Claire Lunde
Boston Children's Hospital
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Jane Meijlink
International Painful Bladder Foundation
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Stacey Missmer
Boston Children's Hospital
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Danielle Perro
University of Oxford
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Krina Zondervan
University of Oxford
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Christine Sieberg
Boston Children's Hospital
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Francisco Cruz
Hospital de Sao Joao
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Jens Nagel
Bayer HealthCare AG Pharma und Chemiepark Wuppertal
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Katy Vincent
University of Oxford
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Abstract

Objective: To investigate the prevalence and experience of symptom flares in women with Chronic Pelvic Pain (CPP) as well as their triggers Design: Cross-sectional questionnaire within the Translational Research in Pelvic Pain clinical cohort study. Setting: Women with CPP, with subgroups of women with endometriosis (EAP), interstitial cystitis/bladder pain syndrome (BPS), comorbid endometriosis and interstitial cystitis/bladder pain syndrome (EABP), and those with pelvic pain without endometriosis or interstitial cystitis/bladder pain syndrome (PP). Population or sample: 100 participants across subgroups. Methods: Questionnaire within large cohort study. Main Outcome Measures: The prevalence and characteristics of short, medium and long symptom flares in CPP. Results: 76% of women with CPP experience symptom flares of at least one length (short, medium and/or long). Flares are associated with painful and non-painful symptoms. There is large variation amongst those with CPP for the frequency, duration, symptoms and triggers for these flares. Participants reported flares as stopping them from doing things they would usually do, participants thinking about symptoms of flares as well as flares being bothersome. Conclusions: Flares are prevalent and clinically very important in the context of CPP. More research is needed to elucidate the mechanisms and characteristics underlying flares. Clinical practice should include an enquiry of flares with the aim of finding strategies to lessen their burden. Funding: This project has received funding from the Innovative Medicines Initiative 2 Joint Undertaking under grant agreement No 777500. This Joint Undertaking receives support from the European Union’s Horizon 2020 research and innovation programme and EFPIA Companies.
10 Feb 2024Submitted to BJOG: An International Journal of Obstetrics and Gynaecology
12 Feb 2024Review(s) Completed, Editorial Evaluation Pending
17 May 20241st Revision Received
05 Jun 2024Submission Checks Completed
05 Jun 2024Assigned to Editor
05 Jun 2024Review(s) Completed, Editorial Evaluation Pending
07 Jul 2024Editorial Decision: Accept