Nguyen Ruby H N, Swanson David, Harlow Bernard L
Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 South 2nd Street, Suite 300, Minneapolis, MN 55454, USA.
J Reprod Med. 2009 Jun;54(6):385-92.
To determine whether antecedent urogenital infections and their frequency are associated with the development of vulvodynia.
Data were obtained from a case-control study of 191 case and 171 control women in the Boston area from 2000 to 2005. Using questionnaire data, we examined self-reported urogenital infections occurring before onset of vulvar pain (cases) and reference age (controls), using unconditional logistic regression accounting for matched variables (current age and residence).
Analysis was restricted to women reporting intercourse before first vulvar pain (cases) or reference age (controls). After adjusting for race, age at first intercourse, coital frequency and number of sex partners, a history of genital warts (adjusted odds ratio [OR] = 3.4, 95% CI 1.3-8.8), trichomoniasis (OR = 5.7, 95% CI 1.1-29, urinary tract infection (OR = 2.0, 95% CI 1.3-3.1) or yeast infection (OR = 2.1, 95% CI 1.3-3.3) were associated with increased estimated risk for vulvodynia. With an increasing number of types of antecedent infections (1, 2 or 3+), ORs = 1.3, 2.6 or 8.3, respectively, were observed.
Our data suggest that diverse urogenital infections may precede onset of vulvodynia, with multiple assaults significantly compounding risk. However, prospective studies documenting urogenital infections and treatment are warranted.
确定既往泌尿生殖系统感染及其发生频率是否与外阴痛的发生有关。
数据来自2000年至2005年在波士顿地区对191例病例和171例对照女性进行的病例对照研究。利用问卷调查数据，我们检查了在出现外阴疼痛（病例组）之前以及参考年龄（对照组）时自我报告的泌尿生殖系统感染情况，采用无条件逻辑回归分析并考虑匹配变量（当前年龄和居住地）。
分析仅限于首次出现外阴疼痛（病例组）或参考年龄（对照组）之前有过性交的女性。在对种族、首次性交年龄、性交频率和性伴侣数量进行调整后，尖锐湿疣病史（调整后的优势比[OR]=3.4，95%可信区间1.3 - 8.8）、滴虫病（OR = 5.7，95%可信区间1.1 - 29）、尿路感染（OR = 2.0，95%可信区间1.3 - 3.1）或酵母菌感染（OR = 2.1，95%可信区间1.3 - 3.3）与外阴痛的估计风险增加相关。随着既往感染类型数量的增加（1种、2种或3种以上），观察到的OR分别为1.3、2.6或8.3。
我们的数据表明，多种泌尿生殖系统感染可能先于外阴痛出现，多次感染会显著增加风险。然而，仍需要进行记录泌尿生殖系统感染及治疗情况的前瞻性研究。
