Diagnostic value of structured anamnesis for phenotype identification in chronic pelvic pain syndrome: A practice-oriented retrospective study.

Actas urologicas espanolas Pub Date : 2025-09-12 DOI:10.1016/j.acuroe.2025.501858

E Vicente Palacio, P Bosch Knape, S Tarragón Gabarro, C Centeno Álvarez, L de Verdonces Román, A Sanchez I Puy, B Juaneda Castell, S Cuadrench Solorzano, E Sotelo Burillo, L M Marco Pérez, L Sabiote Rubio, D Salinas Duffo, J A Peña González

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引用次数: 0

Abstract

Objective: To assess whether chronic pelvic pain presents specific qualitative traits, as described by patients, that can guide identification of its underlying clinical phenotype.

Materials and methods: A retrospective study including 157 patients (81 men, 76 women), interviewed systematically by a single evaluator using a structured 10-item table aimed at identifying three possible phenotypes. The correlation between the predicted phenotype (based solely on anamnesis) and the final phenotype (established through physical examination, treatment response, and clinical evolution) was analyzed. Sensitivity (Se), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV), and area under the curve (AUC) were calculated by phenotype and sex. The diagnostic relevance of each question was assessed, and statistical significance was tested using the Chi-square test.

Results: In women, the proportion of predicted phenotypes confirmed as final was: 64.5% bladder, 19.7% myofascial, 30.2% neuropathic. In men: 8.6% bladder, 81.5% myofascial, 23.5% neuropathic. Women-bladder: Se 0.92, Sp 0.74, PPV 0.90, NPV 0.72, AUC 0.82. Myofascial: Se 0.44, Sp 0.93, PPV 0.79, NPV 0.75, AUC 0.76. Neuropathic: Se 0.36, Sp 0.98, PPV 0.89, NPV 0.79, AUC 0.51. Men-bladder: Se 0.57, Sp 0.83, PPV 0.21, NPV 0.96, AUC 0.81. Myofascial: Se 0.75, Sp 0.75, PPV 0.93, NPV 0.41, AUC 0.75. Neuropathic: Se 0.29, Sp 1.00, PPV 1.00, NPV 0.80, AUC 0.64.

Conclusions: A structured anamnesis may help identify the clinical phenotype underlying chronic pelvic pain (bladder, myofascial, or neuropathic).

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结构记忆对慢性盆腔疼痛综合征表型鉴定的诊断价值：一项以实践为导向的回顾性研究。

目的：评估慢性盆腔疼痛是否表现出特定的定性特征，如患者所述，可以指导识别其潜在的临床表型。材料和方法：一项回顾性研究，包括157名患者（81名男性，76名女性），由一名评估者使用结构化的10项表进行系统访谈，旨在确定三种可能的表型。分析预测表型（仅基于记忆）与最终表型（通过体格检查、治疗反应和临床进展建立）之间的相关性。根据表型和性别计算敏感性（Se）、特异性（Sp）、阳性预测值（PPV）、阴性预测值（NPV）和曲线下面积（AUC）。评估每个问题的诊断相关性，并使用卡方检验进行统计学显著性检验。结果：在女性中，最终确定的预测表型比例为：64.5%为膀胱型，19.7%为肌筋膜型，30.2%为神经性。男性：8.6%膀胱，81.5%肌筋膜，23.5%神经性病变。女性膀胱：Se 0.92, Sp 0.74, PPV 0.90, NPV 0.72, AUC 0.82。肌筋膜：Se 0.44, Sp 0.93, PPV 0.79, NPV 0.75, AUC 0.76。神经性：Se 0.36, Sp 0.98, PPV 0.89, NPV 0.79, AUC 0.51。男性膀胱：Se 0.57, Sp 0.83, PPV 0.21, NPV 0.96, AUC 0.81。肌筋膜：Se 0.75, Sp 0.75, PPV 0.93, NPV 0.41, AUC 0.75。神经性：Se 0.29, Sp 1.00, PPV 1.00, NPV 0.80, AUC 0.64。结论：结构化记忆可能有助于确定慢性盆腔疼痛（膀胱、肌筋膜或神经性）的临床表型。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Actas urologicas espanolas

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