Hall Susan A, Link Carol L, Pulliam Samantha J, Hanno Philip M, Eggers Paul W, Kusek John W, McKinlay John B
New England Research Institutes, Watertown, Massachusetts, USA.
J Urol. 2008 Aug;180(2):593-8. doi: 10.1016/j.juro.2008.04.002. Epub 2008 Jun 12.
The etiology of painful bladder syndrome is currently unknown. We investigated the relationship between medical factors and symptoms suggestive of painful bladder syndrome in a population based random sample.
Data were collected from the Boston Area Community Health Survey, an epidemiological study conducted from 2002 to 2005 in a racially and ethnically diverse population (30 to 79 years old) from Boston, Massachusetts. The operational definition of painful bladder syndrome was symptom based. Those reporting pain increasing as the bladder fills and/or pain relieved by urination (fairly often/usually/almost always) for 3+ months were considered to have symptoms suggestive of painful bladder syndrome. We used multivariate logistic regression to estimate odds ratios and 95% confidence intervals (adjusted for demographics, anthropometric and other factors) for the association of comorbidities, surgery and medication use with painful bladder syndrome symptoms.
The prevalence of painful bladder syndrome symptoms was 1.3% in men and 2.6% in women. In men only depression was associated in a multivariate model (OR 4.96; 95% CI 1.65, 14.92). In women associations were observed for depression (OR 3.35; 95% CI 1.93, 5.81), history of urinary tract infections (OR 2.17; 95% CI 1.49, 4.96), chronic yeast infections (OR 3.11; 95% CI 1.29, 7.51), hysterectomy (OR 2.82; 95% CI 1.20, 6.62), calcium channel blockers (OR 4.59; 95% CI 2.71, 9.72) and cardiac glycosides (OR 10.28; 95% CI 1.46, 72.35), while thyroid medications and statins were inversely associated (OR 0.13; 95% CI 0.03, 0.47 and OR 0.24; 95% CI 0.08, 0.76; respectively).
Gynecologic factors and certain medications may be associated with the painful bladder syndrome in women. Our results for medications suggest potentially modifiable risk factors.
目前,疼痛性膀胱综合征的病因尚不清楚。我们在一项基于人群的随机样本中,研究了医学因素与提示疼痛性膀胱综合征的症状之间的关系。
数据来自波士顿地区社区健康调查,这是一项于2002年至2005年在马萨诸塞州波士顿的一个种族和民族多样化人群(30至79岁)中进行的流行病学研究。疼痛性膀胱综合征的操作定义基于症状。那些报告膀胱充盈时疼痛加剧和/或排尿后疼痛缓解(相当频繁/通常/几乎总是)持续3个月以上的人被认为有提示疼痛性膀胱综合征的症状。我们使用多变量逻辑回归来估计合并症、手术和药物使用与疼痛性膀胱综合征症状之间关联的比值比和95%置信区间(针对人口统计学、人体测量学和其他因素进行了调整)。
男性疼痛性膀胱综合征症状的患病率为1.3%,女性为2.6%。在男性中,多变量模型仅显示抑郁症与之相关(比值比4.96;95%置信区间1.65,14.92)。在女性中,观察到抑郁症(比值比3.35;95%置信区间1.93,5.81)、尿路感染史(比值比2.17;95%置信区间1.49,4.96)、慢性酵母菌感染(比值比3.11;95%置信区间1.29,7.51)、子宫切除术(比值比2.82;95%置信区间1.20,6.62)、钙通道阻滞剂(比值比4.59;95%置信区间2.71,9.72)和强心苷(比值比10.28;95%置信区间1.46,72.35)与之相关,而甲状腺药物和他汀类药物与之呈负相关(比值比分别为0.13;95%置信区间0.03,0.47和0.24;95%置信区间0.08,0.76)。
妇科因素和某些药物可能与女性疼痛性膀胱综合征有关。我们关于药物的研究结果提示了潜在的可改变风险因素。