• bladder pain syndrome;
  • chronic pelvic pain syndrome;
  • chronic prostatitis;
  • flare;
  • interstitial cystitis;
  • symptom exacerbation



To provide the first description and quantification of symptom changes during interstitial cystitis/bladder pain syndrome and chronic prostatitis/chronic pelvic pain syndrome symptom exacerbations (“flares”).


Participants at one site of the Trans-Multidisciplinary Approaches to the study of chronic Pelvic Pain Epidemiology and Phenotyping Study completed two 10-day diaries over the 1-year study follow-up period, one at baseline and one during their first flare (if not at baseline). On each day of the diary, participants reported whether they were currently experiencing a flare, defined as “symptoms that are much worse than usual” for at least 1 day, and their levels of urination-related pain, pelvic pain, urgency, and frequency on a scale of 0–10. Linear mixed models were used to calculate mean changes in symptoms between non-flare and flare days from the same participant.


Eighteen of 27 women and 9 of 29 men reported at least one flare during follow-up, for a total of 281 non-flare and 210 flare days. Of these participants, 44.4% reported one flare, 29.6% reported two flares, and 25.9% reported ≥3 flares over the combined 20-day diary observation period, with reported flares ranging in duration from 1 day to >2 weeks. During these flares, each of the main symptoms worsened significantly by a mean of at least two points and total symptoms worsened by a mean of 11 points for both sexes (all P ≤ 0.01).


Flares are common and correspond to a global worsening of urologic and pelvic pain symptoms. Neurourol. Urodynam. 34:188–195, 2015. © 2013 Wiley Periodicals, Inc.