Is a Sexual Dysfunction Domain Important for Quality of Life in Men with Urological Chronic Pelvic Pain Syndrome? Signs UPOINT to Yes

Purpose: Clinical phenotyping to guide treatment for urological chronic pelvic pain syndrome is a promising strategy. The UPOINT (urinary, psychosocial, organ specific, infection, neurological/systemic and tenderness of the pelvic floor) phenotyping system evaluates men and women on 6 domains. However, this study focused on men only. Due to the high prevalence of sexual dysfunction in men with urological chronic pelvic pain syndrome, debate exists about the usefulness of adding an (S) (sexual dysfunction) domain to UPOINT. We examined the usefulness in terms of quality of life and delineated urological chronic pelvic pain syndrome subcategories using UPOINT(S) domains. Materials and Methods: We assessed 162 men using UPOINT criteria and after adding the sexual dysfunction domain. Using multiple regression analysis UPOINT(S) criteria were then compared to quality of life, as measured by the SF-36 (R) health outcome survey and Chronic Prostatitis Symptoms Index. Sample subgroups were assessed using k--means cluster analysis. Results: The total number of UPOINT(S) domains correlated with SF--36 and Chronic Prostatitis Symptoms Index scores. Using regression analysis the 2 significant predictors of SF--36 scores were the psychosocial and sexual domains. Men with sexual dysfunction had significantly worse quality of life than men without the condition. In addition, 6 potentially clinically meaningful subgroups were identified using cluster analysis. Sexual dysfunction was differentially present in these groups. Conclusions: Adding a sexual dysfunction domain to UPOINT may help improve quality of life in men treated for urological chronic pelvic pain syndrome.