Gardella Barbara, Porru Daniele, Ferdeghini Francesca, Martinotti Gabellotti Eva, Nappi Rossella Elena, Rovereto Bruno, Spinillo Arsenio
Department of Obstetrics and Gynecology, IRCCS Fondazione Policlinico San Matteo, University of Pavia, Pavia, Italy.
Eur Urol. 2008 Nov;54(5):1145-51. doi: 10.1016/j.eururo.2008.01.079. Epub 2008 Feb 6.
The prevalence of interstitial cystitis/painful bladder syndrome (IC/PBS) among gynecologic patients attending vulvar disease or pelvic pain clinics is higher than expected. The evaluation of gynecologic characteristics in patients with IC/PBS could be important to delineate a better therapeutic strategy.
We compared clinical gynecologic characteristics including localized and generalized vulvodynia and sexual activity of 47 women with a definite diagnosis of IC/PBS versus 47 negative controls.
The prevalence of both generalized or localized vulvodynia was 85.1% (40 of 47) in the patients and 6.4% (3 of 47) in the control group (p<0.0001 by Fisher exact test). The mean visual analogue score on generalized or localized vulvodynia evaluated with the cotton swab test was 6.1+/-2.6 (SD) among women with IC/PBS and 0.6+/-1.7 in the control group (p<0.0001 with Mann-Whitney U test). Pain during intercourse was described as unbearable by 15 women with IC/PBS (31.9%) and 2 controls (4.3%; p=0.001 by Fisher exact test). Sexual function was significantly impaired in women with IC as measured by the median total score of the Female Sexual Function Index in comparison with controls (13.8 vs. 28.7; p<0.0001).
Patients with a definite diagnosis of IC/PBS appear to have a high risk of vulvodynia with the associated negative implications for sexual activity. The establishment of a multidisciplinary approach with the involvement of the gynecologist appears to be a logical requisite for a correct treatment strategy for these patients.
在外阴疾病或盆腔疼痛诊所就诊的妇科患者中,间质性膀胱炎/膀胱疼痛综合征(IC/PBS)的患病率高于预期。评估IC/PBS患者的妇科特征对于制定更好的治疗策略可能很重要。
我们比较了47例确诊为IC/PBS的女性与47例阴性对照的临床妇科特征,包括局限性和广泛性外阴痛以及性活动情况。
患者中广泛性或局限性外阴痛的患病率为85.1%(47例中的40例),对照组为6.4%(47例中的3例)(Fisher精确检验,p<0.0001)。在IC/PBS女性中,用棉拭子试验评估的广泛性或局限性外阴痛的平均视觉模拟评分是6.1±2.6(标准差),对照组为0.6±1.7(Mann-Whitney U检验,p<0.0001)。15例IC/PBS女性(31.9%)将性交时的疼痛描述为难以忍受,2例对照(4.3%)有此描述(Fisher精确检验,p=0.001)。与对照组相比,用女性性功能指数的中位数总分衡量,IC女性的性功能明显受损(13.8对28.7;p<0.0001)。
确诊为IC/PBS的患者似乎有较高的外阴痛风险,对性活动有相关负面影响。建立由妇科医生参与的多学科方法似乎是这些患者正确治疗策略的合理必要条件。