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间质性膀胱炎女性中良性镜下血尿的患病率:对泌尿生殖系统恶性肿瘤评估的意义

Prevalence of benign microscopic hematuria among women with interstitial cystitis: implications for evaluation of genitourinary malignancy.

作者信息

Stanford E J, Mattox T F, Parsons J K, McMurphy C

机构信息

Center for Advanced Pelvic Surgery, Urogynecology, and Obstetrics/Gynecology, St. Mary's/Good Samaritan Hospital, Centralia, Illinois 62801, USA.

出版信息

Urology. 2006 May;67(5):946-9. doi: 10.1016/j.urology.2005.11.009. Epub 2006 Apr 25.

Abstract

OBJECTIVES

To assess the prevalence of benign microscopic hematuria among a cohort of women with clinical interstitial cystitis (IC).

METHODS

A total of 100 women were prospectively assessed for microscopic hematuria with postvoid sterile catheterization. The evaluation for all patients included urine culture, potassium sensitivity test (PST), cystoscopy with hydrodistension under general anesthesia, and symptom assessment with the Pelvic Pain and Urgency/Frequency (PUF) questionnaire.

RESULTS

The mean age +/- SD was 37 +/- 15 years, with no difference noted in those with or without microscopic hematuria (P = 0.71). Microscopic hematuria was present in 24 (24%) of the 100 women. No patient had gross hematuria, positive urine culture, or cystoscopic findings suspicious for malignancy. The mean PUF score was 17 +/- 6. The PST was positive in 92 (92%) of 100 women, and 8 patients had only cystoscopic findings diagnostic of IC. The likelihood of a positive PST or positive cystoscopic findings among patients with microscopic hematuria was similar to that of patients without microscopic hematuria. The PST results correlated with the cystoscopic findings (P < 0.001). Of 36 patients with positive cystoscopic findings, 28 (78%) had a positive PST, and 28 (30%) of 92 with a positive PST had positive cystoscopy findings.

CONCLUSIONS

In this cohort of women with IC, the prevalence of benign microscopic hematuria was 24%. These data suggest that in women at low risk of genitourinary malignancy who have clinical IC, microscopic hematuria may be an incidental finding.

摘要

目的

评估一组临床诊断为间质性膀胱炎(IC)的女性中良性镜下血尿的患病率。

方法

前瞻性地对100名女性进行无菌导尿后镜下血尿评估。所有患者的评估包括尿培养、钾敏感性试验(PST)、全身麻醉下膀胱水扩张膀胱镜检查以及使用盆腔疼痛和尿急/尿频(PUF)问卷进行症状评估。

结果

平均年龄±标准差为37±15岁,镜下血尿患者与无镜下血尿患者之间无差异(P = 0.71)。100名女性中有24名(24%)存在镜下血尿。没有患者出现肉眼血尿、尿培养阳性或膀胱镜检查发现可疑恶性病变。PUF平均评分为17±6。100名女性中有92名(92%)PST呈阳性,8名患者仅膀胱镜检查结果诊断为IC。镜下血尿患者中PST阳性或膀胱镜检查结果阳性的可能性与无镜下血尿患者相似。PST结果与膀胱镜检查结果相关(P < 0.001)。在36名膀胱镜检查结果阳性的患者中,28名(78%)PST呈阳性,92名PST呈阳性的患者中有28名(30%)膀胱镜检查结果阳性。

结论

在这组IC女性患者中,良性镜下血尿的患病率为24%。这些数据表明,对于临床诊断为IC且泌尿生殖系统恶性肿瘤风险较低的女性,镜下血尿可能是偶然发现。

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