American Urological Association (AUA)

118 IDENTIFYING CHRONIC PROSTATITIS/ CHRONIC PELVIC PAIN SYNDROME FOR EPIDEMIOLOGIC STUDIES J. Quentin Clemens, Lara Hilton, Marika Suttorp, Sandra Berry. The purpose of this study was to assess the sensitivity and specificity of the definition in the NIHChronic Prostatitis Symptom Index (NIHCPSI) used by J. Curtis Nickel and colleagues1) to identify the presence of symptoms indicative of chronic prostatitis/ chronic pelvic pain syndrome (CP/CPPS and subsequently used by many other researchers to report the prevalence of CP/CPPS symptoms. The study showed the sensitivity of the definition to be 70% while the specificity was 91% when compared with BPH patients, and 99% when compared with controls. It was therefore concluded that the Nickel et al case definition seems to have excellent specificity for the purpose of distinguishing CP/CPPS from BPH and controls. The sensitivity is also reasonably high, particularly if you take into account the fact that CP/CPPS is a clinical syndrome without an objective diagnostic marker. 1)Nickel JC, Downey J, Hunter D and Clark J: Prevalence of prostatitis-like symptoms in a population based study using the National Institutes of Health chronic prostatitis symptom index. J Urol2001; 165: 842. Abstract # 119 DESCRIPTIVE EPIDEMIOLOGY OF UROLOGIC PAIN SYMPTOMS IN MEN AND WOMEN Jessica Brewer, Carol Link, Paul Eggers, John Kusek, John McKinlay This longitudinal study examined the epidemiology of symptoms suggestive of IC/PBS and CP/CPPS. The reason for this was that while it is commonly assumed that most non-malignant urologic conditions worsen as people age, data from cross-sectional studies indicate – rather unexpectedly that the prevalence of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and interstitial cystitis/painful bladder syndrome (IC/PBS) is lower as people grow older. In this study, symptoms suggestive of IC/PBS were defined as pain increasing as the bladder fills and/or pain relieved by urination (fairly often, usually, almost always) for at least 3 months. Symptoms suggestive of CP/CPPS were defined as perineal and/or ejaculatory pain and a Chronic Prostatitis Symptom Index pain score of 4+. The authors present the prevalence, remission, and incidence of IC/PCS and CP/CPPS over 4.7 year period. It was concluded that symptoms suggestive of CP/CPPS and IC/PBS are not reported in over 3⁄4 of the sample after almost five years. The authors therefore recommend that factors that may promote remission of symptoms need to be examined and identified. 119 DESCRIPTIVE EPIDEMIOLOGY OF UROLOGIC PAIN SYMPTOMS IN MEN AND WOMEN Jessica Brewer, Carol Link, Paul Eggers, John Kusek, John McKinlay This longitudinal study examined the epidemiology of symptoms suggestive of IC/PBS and CP/CPPS. The reason for this was that while it is commonly assumed that most non-malignant urologic conditions worsen as people age, data from cross-sectional studies indicate – rather unexpectedly that the prevalence of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and interstitial cystitis/painful bladder syndrome (IC/PBS) is lower as people grow older. In this study, symptoms suggestive of IC/PBS were defined as pain increasing as the bladder fills and/or pain relieved by urination (fairly often, usually, almost always) for at least 3 months. Symptoms suggestive of CP/CPPS were defined as perineal and/or ejaculatory pain and a Chronic Prostatitis Symptom Index pain score of 4+. The authors present the prevalence, remission, and incidence of IC/PCS and CP/CPPS over 4.7 year period. It was concluded that symptoms suggestive of CP/CPPS and IC/PBS are not reported in over 3⁄4 of the sample after almost five years. The authors therefore recommend that factors that may promote remission of symptoms need to be examined and identified. Abstract # 605 THE MANAGEMENT OF KETAMINE ASSOCIATED URINARY TRACT PATHOLOGY Angela Cottrell, David Gillatt, Pete Weinstock, Rachel Ayres, Cathy Stannard, Fergus Law The urologic consequences of use of the anaesthetic drug ketamine as a recreational drug, which is increasing in popularity, received much attention during this year’s AUA annual meeting with presentations from different parts of the world. Bladder problems caused by recreational ketamine use are now considered one of the confusable diseases when excluding other possible causes of IC/PBS-like symptoms. There is every indication that this form of drug abuse is on the increase since it is a relatively cheap way of getting a “high”. Ketamine is an anaesthetic that when used as a recreational drug induces a state of dissociation, similar to the effects produced by phencyclidine (PCP). Ketamine is known to cause amnesia, impaired motor function, high blood pressure and respiratory problems in addition to severe painful urination, smaller bladder capacity, frequency, urgency, incontinence, and blood in the urine. According to Cottrell and colleagues from Bristol (the South West of the UK) who are now seeing an increasing number of individuals with this problem, case series around the world have described 605 THE MANAGEMENT OF KETAMINE ASSOCIATED URINARY TRACT PATHOLOGY Angela Cottrell, David Gillatt, Pete Weinstock, Rachel Ayres, Cathy Stannard, Fergus Law The urologic consequences of use of the anaesthetic drug ketamine as a recreational drug, which is increasing in popularity, received much attention during this year’s AUA annual meeting with presentations from different parts of the world. Bladder problems caused by recreational ketamine use are now considered one of the confusable diseases when excluding other possible causes of IC/PBS-like symptoms. There is every indication that this form of drug abuse is on the increase since it is a relatively cheap way of getting a “high”. Ketamine is an anaesthetic that when used as a recreational drug induces a state of dissociation, similar to the effects produced by phencyclidine (PCP). Ketamine is known to cause amnesia, impaired motor function, high blood pressure and respiratory problems in addition to severe painful urination, smaller bladder capacity, frequency, urgency, incontinence, and blood in the urine. According to Cottrell and colleagues from Bristol (the South West of the UK) who are now seeing an increasing number of individuals with this problem, case series around the world have described