• Irum Javed, Tiange Yu, Jieni Li, Ratna Pakpahan, Melissa Milbrandt, Gerald L Andriole, Jerry L Lowder, H Henry Lai, Graham A Colditz, and Siobhan Sutcliffe.
• Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri.
• J. Urol. 2021 Apr 1; 205 (4): 1133-1138.

PurposeWe sought to determine whether pollen triggers urological chronic pelvic pain syndrome flares.Materials And MethodsWe assessed flare status every 2 weeks for 1 year as part of the Multidisciplinary Approach to the Study of Chronic Pelvic Pain case-crossover analysis of flare triggers (NCT01098279). Flare symptoms, flare start date and exposures in the 3 days before a flare were queried for the first 3 flares and at 3 randomly selected nonflare times. These data were linked to daily pollen count by date and the first 3 digits of participants' zip codes. Pollen count in the 3 days before and day of a flare, as well as pollen rises past established thresholds, were compared to nonflare values by conditional logistic regression. Poisson regression was used to estimate flare rates in the 3 weeks following pollen rises past established thresholds in the full longitudinal study. Analyses were performed in all participants and separately in those who reported allergies or respiratory tract disorders.ResultsAlthough no associations were observed for daily pollen count and flare onset, positive associations were observed for pollen count rises past medium or higher thresholds in participants with allergies or respiratory tract disorders in the case-crossover (OR 1.31, 95% CI 1.04-1.66) and full longitudinal (RR 1.23, 95% CI 1.03-1.46) samples.ConclusionsWe found some evidence to suggest that rising pollen count may trigger flares of urological chronic pelvic pain syndrome. If confirmed in future studies, these findings may help to inform flare pathophysiology, prevention and treatment, and control over the unpredictability of flares.

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