IC/BPS患者子宫内膜异位症的患病率和临床相关性。

IF 0.8 Q4 OBSTETRICS & GYNECOLOGY Urogynecology (Hagerstown, Md.) Pub Date : 2024-10-18 DOI:10.1097/SPV.0000000000001589
Mary Namugosa, Amr El Haraki, Rory Ritts, Kaylee Ferrara, Gopal Badlani, Robert Evans, Stephen J Walker
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引用次数: 0

摘要

重要性:间质性膀胱炎/膀胱疼痛综合征(IC/BPS)是一种复杂的异质性疾病,对诊断和治疗都构成了巨大的临床挑战。确定非泌尿系统相关症状(包括子宫内膜异位症)有明显重叠的患者亚群,可使治疗方法更有针对性:本研究调查了IC/BPS患者并发子宫内膜异位症的患病率、临床相关性和临床后遗症:这项回顾性队列研究评估了确诊为IC/BPS的女性患者(n = 533)的人口统计学、临床、手术和问卷调查数据。手术史来自患者的电子病历,使用的是现行医疗程序术语(CPT)和国际疾病分类(ICD)代码。通过单变量分析比较了有子宫内膜异位症和无子宫内膜异位症患者的数据,然后进行二元逻辑回归以确定相关变量:在 533 名参与者中,108 人(20.3%)报告有子宫内膜异位症病史。并发子宫内膜异位症的患者更年轻,膀胱容量更大,非泌尿系统相关症状更多。并发子宫内膜异位症的患者不太可能有膀胱切除术(手术切除膀胱)史和过敏史,但更容易出现慢性盆腔疼痛、慢性疲劳、纤维肌痛、偏头痛和盆底功能障碍等合并症。二元逻辑回归发现,子宫内膜异位症与慢性盆腔疼痛之间存在正相关,而同时患有子宫内膜异位症的患者的过敏症与膀胱容量低之间存在负相关:结论:子宫内膜异位症在IC/BPS年轻女性患者中很常见,并且与非膀胱中心型(即系统性疼痛障碍)表型相关。
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Prevalence and Clinical Correlates of Endometriosis in Patients With IC/BPS.

Importance: Interstitial cystitis/bladder pain syndrome (IC/BPS) presents as a complex heterogeneous disorder that poses a significant clinical challenge both for diagnosis and treatment. The identification of patient subgroups with significant overlap in their nonurological associated symptoms, including endometriosis, may enable a more targeted therapeutic approach.

Objective: This study investigated the prevalence, clinical correlates, and clinical sequelae associated with concurrent endometriosis in patients with IC/BPS.

Study design: Demographic, clinical, surgical, and questionnaire data from female patients (n = 533) with a diagnosis of IC/BPS were evaluated in this retrospective cohort study. Surgical history was obtained from patient electronic medical records, using Current Procedural Terminology (CPT) and International Classification of Diseases (ICD) codes. Data from participants with and without concurrent endometriosis were compared using univariate analysis, followed by binary logistic regression to identify associated variables.

Results: Of 533 participants, 108 (20.3%) reported a history of endometriosis. Those with concurrent endometriosis were younger, had a larger bladder capacity, and had a higher number of nonurological associated symptoms. Patients with concurrent endometriosis were less likely to have a history of cystectomy (the surgical removal of the bladder) and report allergies but more prone to report comorbidities such as chronic pelvic pain, chronic fatigue, fibromyalgia, migraines, and pelvic floor dysfunction. Binary logistic regression identified a positive association between endometriosis and chronic pelvic pain, and a negative association between allergies and low bladder capacity for those with concurrent endometriosis.

Conclusions: Endometriosis is common in younger female patients with IC/BPS and is associated with a non-bladder-centric (ie, systemic pain disorder) phenotype.

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