Clemens J Quentin, Markossian Talar W, Meenan Richard T, O'Keeffe Rosetti Maureen C, Calhoun Elizabeth A
Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60611, USA.
J Urol. 2007 Oct;178(4 Pt 1):1354-8; discussion 1358. doi: 10.1016/j.juro.2007.05.157. Epub 2007 Aug 16.
We quantified the degree of symptomatic overlap in individuals who reported urological symptoms and compared these patterns between men and women.
A questionnaire was mailed to a random sample of the Kaiser Permanente Northwest membership with no medical record evidence of pelvic malignancy or neurological disease. The questionnaire included the International Prostate Symptom Scale, Interstitial Cystitis Symptom Index and Problem Index, and National Institutes of Health Chronic Prostatitis Symptom Index. The 701 men and 745 women who reported urological symptoms were selected for analysis. The degree of overlap of storage symptoms, voiding symptoms and pain symptoms was assessed. Multiple logistic regression was used to determine symptom predictors.
There was a high degree of overlap among the 3 symptom categories with few observed differences between men and women. Of individuals with storage or voiding symptoms 34% of men and 43% of women also had pain symptoms. Of those with pain 90% of men and 94% of women also had voiding or storage symptoms. Logistic regression results indicated that frequency, urgency and any storage symptoms were statistically more common in women than in men, while a slow stream was more common in men than in women.
As previously reported, there are limited differences in the degree and distribution of lower urinary tract symptoms in men and women. To our knowledge the novel finding of this study is that pain symptoms commonly coincide with voiding and storage symptoms in the 2 genders. This suggests that categorizing patients into disease categories, such as lower urinary tract symptoms or bladder conditions, may ignore the pain components of symptoms. A symptom based classification symptom may more accurately identify and address all patient complaints.
我们对报告有泌尿系统症状的个体的症状重叠程度进行了量化,并比较了男性和女性之间的这些模式。
向西北凯撒医疗集团成员的随机样本邮寄了一份问卷,这些成员没有盆腔恶性肿瘤或神经系统疾病的病历证据。问卷包括国际前列腺症状评分表、间质性膀胱炎症状指数和问题指数,以及美国国立卫生研究院慢性前列腺炎症状指数。选取报告有泌尿系统症状的701名男性和745名女性进行分析。评估储尿症状、排尿症状和疼痛症状的重叠程度。采用多元逻辑回归确定症状预测因素。
这3类症状之间存在高度重叠,男性和女性之间观察到的差异很少。有储尿或排尿症状的个体中,34%的男性和43%的女性也有疼痛症状。有疼痛症状的个体中,90%的男性和94%的女性也有排尿或储尿症状。逻辑回归结果表明,尿频、尿急和任何储尿症状在女性中比在男性中在统计学上更常见,而尿流缓慢在男性中比在女性中更常见。
如先前报道,男性和女性下尿路症状的程度和分布差异有限。据我们所知,本研究的新发现是疼痛症状在两种性别中通常与排尿和储尿症状同时出现。这表明将患者分类为疾病类别,如下尿路症状或膀胱疾病,可能会忽略症状的疼痛成分。基于症状的分类可能更准确地识别和处理所有患者的主诉。