About the MAPP Research Network

In 2008 the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) of the National Institutes of Health (NIH) launched the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network. This study represented a novel, highly collaborative and multidisciplinary research effort designed to better understand the underlying pathophysiology and patient “phenotypes” (i.e., observable biological and clinical characteristics) for the two most prominent chronic urologic pain conditions, Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS) in women and men and Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) in men. Based on their shared symptoms and other similarities, IC/BPS and CP/CPPS are collectively referred to as Urologic Chronic Pelvic Pain Syndrome (UCPPS) in MAPP Network studies.

The MAPP Research Network brought together a unique team of researchers with broad clinical, basic science, neuroscience, biostatistical, and epidemiological research expertise, among many others. Network studies utilized a highly integrated design and research approach that included exploring the interplay between urologic systems and other physiological systems to produce a systemic and holistic characterization of UCPPS. In addition, the MAPP Research Network worked to better understand the relationships between UCPPS and potentially related chronic overlapping pain conditions (COPCs), such as fibromyalgia, irritable bowel syndrome, and chronic fatigue syndrome. All Network studies shared the common goals of informing future clinical trials for UCPPS and ultimately improved clinical care for patients.

Over the course of 14 years the MAPP Research Network conducted two primary clinical protocols: The Trans-MAPP Epidemiology and Phenotyping Study (EPS) spanned the MAPP I phase of 2008-14 and The Trans-MAPP Symptom Pattern Study (SPS) spanned the MAPP II phase from 2014-2022. Numerous associated Ancillary Studies and local studies specific to individual Network sites were also supported through MAPP I and II.

Timeline for the MAPP Research Network’s Cohort Studies

timeline for MAPP 1 and 2 starting July 2008 until June 2022

MAPP Network studies have provided critical new advances that have moved the UCPPS field forward, including through:

  • Describing the natural history and risk factors for UCPPS, as well as associations with COPCs;
  • Identification of distinct and clinically relevant UCPPS patient phenotypes (i.e., symptom profiles);
  • Uncovering new findings of underlying pathophysiology and mechanisms for UCPPS;
  • Providing a greatly expanded evidence base for future studies, including clinical trials, that may lead to improved clinical management strategies for patients;
  • Fostering additional, successful research applications for new basic, translational, and clinical studies of UCPPS, as well as expanding the community of UCPPS investigators and expertise;
  • Producing a legacy of diverse National resources and tools for supporting future studies of UCPPS.

The MAPP Research Network’s Integrated Approach to Systemic UCPPS Phenotyping

The MAPP Research Network’s Integrated Approach to Systemic UCPPS Phenotyping

Major Research Domains and Measures Used for MAPP I and MAPP II Studies

MAPP I EPS Data Domains
Text version of this figure

The figure is a honeycomb of linked hexagons. Each hexagon is one research domain and lists the measures collected in it. Two hexagons are highlighted: ATLAS (new treatment monitoring) and the mHealth mobile app (app for daily survey).

How the figure marks which study a measure belongs to: measures printed in plain text are collected in both MAPP I and MAPP II; measures printed in purple are MAPP I only; measures that are underlined are MAPP II only. That distinction is carried visually in the image and is not reproduced in the lists below. For the authoritative measure-by-study breakdown, use the MAPP I and MAPP II data dictionaries on the Resources page.

  • Urologic: physical and pelvic exams; urine culture results; Sym Q/Flare, RICE, BSI, GUPI, IC-SI/PI, MEDHX, EIL-INF, ICINDEX, family history, clinical histories; CMED; M/F Sear; AUA SI; FSFI, IIEF and UWMSFS; sexual function; flare status; Global Response Assessment.
  • Non-urologic: BPI body map; CHOIR body map; demographics; Pain Detect. Comorbid conditions: CMSI checklist and modules for fibromyalgia, chronic fatigue syndrome, irritable bowel syndrome, migraine, TMJ/TMDSI and vulvodynia. Neuropathic pain: Gracely box scales and McGill. Quality of life: SF12, PANAS, WHO-DAS, IPAQ, WPAI.
  • Psychosocial: mood, measured with HADS, PANAS, PROMIS Fatigue, PROMIS Sleep, Perceived Stress, MASQ and PROMIS Anger; personality, measured with Catastrophizing, IPIP, BPCQ and TIPI; trauma, measured with CTES and RTES.
  • Neuroimaging: standardized multi-modal imaging data collection; resting state fMRI; T1-weighted structural MRI; diffusion tensor imaging (DTI); water ingestion protocol.
  • Quantitative sensory testing (QST): generalized mechanical sensitivity (MAST) system; pressure pain threshold; pain intensity; pressure pain tolerance; algometer test; pinprick test; foot bath.
  • Molecular phenotyping: biomarker candidate and discovery approaches; inflammatory response; metabolomics. Biological samples: biomarker urine, blood plasma, spot urine, flare and non-flare urine, cheek swab DNA.
  • Microbiome: IBIS T-5000 sequencing analysis for bacteria and fungi; blood/plasma; VB1 (urethral); VB2 (mid-stream); microbiome specimens; VB3 (post-prostate massage) urine; flare and non-flare urine; STIM tubes; rectal and vaginal swabs; salivary cortisol.
  • Animal models: selection of UCPPS models for relevance to key human symptoms, namely pain on bladder-filling, pelvic-localized pain, generalized pain, and voiding dysfunction such as frequency.
  • ATLAS: new treatment monitoring.
  • mHealth mobile app: app for daily survey.

Abbreviations [click to view entire list]

Abbreviations used on this page and the measures they refer to
Abbreviation Measure
AUA SI American Urologic Association Symptom Index
BPCQ Beliefs in Pain Control Questionnaire
BPI/45 Brief Pain Inventory-45
CFS chronic fatigue syndrome
CMED current medications
CMSI Complex Medical Symptoms Inventory
CTES Childhood Traumatic Events Scale
DTI diffusion tensor imaging
EIL-INF Early In Life Infection History
Family Hx family history of UCPPS
fMRI functional MRI
FSFI Female Sexual Function Index
GUPI Genitourinary Pain Index
HADS Hospital Anxiety and Depression Scale
IBS irritable bowel syndrome
ICINDEX Interstitial Cystitis Symptom and Problem Index;
ICPI Interstitial Cystitis Problem Index
ICSI Interstitial Cystitis Symptom Index
IIEF International Index of Erectile Function
IPIP International Personality Item Pool
MASQ Multiple Ability Self-Report Questionnaire
MAST multimodal automated sensory testing
MED medical history
M/F SEAR Male/Female Self-Esteem and Relationship Questionnaire
PANAS Positive and Negative Affect Schedule
PROMIS Patient-Reported
QOL quality of life
RICE RAND Interstitial Cystitis Epidemiology survey
RTES Recent Traumatic Events Scale
SF12 12-item Short-Form Health Survey
Sym Q MAPP Symptom Questionnaire
TMJ temporomandibular joint
UWMSFS University of Washington Male Sexual Function Survey

For more information on IC/BPS and CP/CPPS and the Genesis of the MAPP Network see: