Abstract: PD26-01
Sources of Funding: None

Introduction

Men with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) are two times more likely to report mental health diagnoses such as anxiety and depression. Additionally, men reporting a history of sexual abuse are at increased risk for symptoms of CP/CPPS. Male veterans with mental health diagnoses are also at increased risk of lower urinary tract symptoms. We hypothesize that an association exists between CP/CPPS and post-traumatic stress disorder (PTSD) in young male veterans, and that these veterans may be more likely to report a history of sexual trauma or be subject to invasive urologic procedures.

Methods

We reviewed VA administrative data from October 1, 2010 to September 30, 2015 for male veterans, ages 18-45 diagnosed with PTSD (ICD-9 code 309.81). Medical records were then examined for pelvic pain diagnoses including chronic pelvic pain (789.09; 338.29, 608.9, 625.5, 788.99, 788.99, 596.9, 599/599.8, 625.5), chronic prostatitis (601.0, 601.1, 601.9, 600.90-1, 600.0-1; 601.8, 602.8) and pain associated with voiding (788.1, 788.6). Veterans with diagnoses of spinal cord injury and neurogenic bladder were excluded. Records were examined for ICD-9 diagnoses of history of sexual trauma (general, military or any) and CPT codes for cystoscopic, urodynamic, bladder outlet and prostatic ultrasound procedures. Data were obtained for a preparatory-to-research pull.

Results

Our initial database query yielded approximately 392,000 veterans with a diagnosis of PTSD and 1.3 million veterans without documented PTSD. Veterans with PTSD were more likely to have a diagnosis of CP/CPPS than their non-PTSD counterparts (18.5% vs. 8.7%, p<0.001). Veterans with PTSD were more likely to have a history of military sexual trauma (2.8% vs. 0.5%, p<0.001) or non-military sexual trauma (0.4% vs. <0.1%, p<0.001) compared to veterans without PTSD. Young veterans with PTSD were also more likely to have a cystoscopy (0.8% vs. 0.5%, p<0.001) and/or undergo urodynamics (1.0% vs. 0.5%, p<0.001) versus those without PTSD. Rates of transrectal ultrasound-guided prostate procedures and bladder outlet procedure were not significantly different between the two groups.

Conclusions

Young male veterans with PTSD are twice as likely to carry a diagnosis of CP/CPPS. Those with PTSD and CP/CPPS are six times more likely to report a history of sexual trauma and are twice as likely to undergo a certain urologic procedures. We recommend improved assessment for sexual trauma and consideration of referral to mental health providers by uroIogists treating young male veterans with CP/CPPS.

Funding

None