Lisa takes place in a bizarre, unpleasant world without women. There are grotesquely elongated spider men, writhing flesh pile people, and giant intestine walls, though. So that's something.
Lisa The Painful RPG takes place in a world where there are no women. Only men. Given the extreme subject matter its creator, Austin Jorgensen, could have gone the "funny" route or the "bleak as hell" route. He's gone the latter.