Chung Maurice K, Jarnagin Barry
Midwest Regional Center for Chronic Pelvic Pain, Lima, Ohio 45805, USA.
JSLS. 2009 Jul-Sep;13(3):350-7.
Interstitial cystitis is a clinical syndrome characterized by symptoms of pelvic pain, urinary urgency and frequency, and nocturia. It can be difficult to accurately identify interstitial cystitis because the symptoms overlap many other common gynecologic and urologic conditions. Patients with undiagnosed interstitial cystitis may undergo unnecessary procedures, including hysterectomy.
A PubMed literature search for articles dating back to 1990 was conducted on the topics of interstitial cystitis and hysterectomy. Further references were identified by cross-referencing the bibliographies in articles of interest.
The literature review found that hysterectomy is performed more often in patients with undiagnosed interstitial cystitis than in patients with a confirmed diagnosis. Interstitial cystitis often coexists with conditions like endometriosis, for which hysterectomy is indicated. Many patients subsequently diagnosed with interstitial cystitis continue to experience persistent pelvic pain despite having had a hysterectomy for chronic pelvic pain. Careful history and physical examination can identify the majority of interstitial cystitis cases.
Interstitial cystitis should be considered prior to hysterectomy in women who present with pelvic pain or who experience pelvic pain after a hysterectomy. If interstitial cystitis is diagnosed, appropriate therapy may eliminate the need for hysterectomy.
间质性膀胱炎是一种临床综合征，其特征为盆腔疼痛、尿急、尿频及夜尿症状。准确识别间质性膀胱炎可能存在困难，因为其症状与许多其他常见的妇科和泌尿系统疾病重叠。未确诊间质性膀胱炎的患者可能会接受不必要的手术，包括子宫切除术。
对PubMed上1990年以来有关间质性膀胱炎和子宫切除术的文章进行文献检索。通过交叉引用感兴趣文章中的参考文献来确定更多的参考文献。
文献综述发现，未确诊间质性膀胱炎的患者比确诊患者更常接受子宫切除术。间质性膀胱炎常与子宫内膜异位症等疾病共存，而子宫内膜异位症是子宫切除术的指征。许多随后被诊断为间质性膀胱炎的患者，尽管因慢性盆腔疼痛接受了子宫切除术，但仍持续存在盆腔疼痛。仔细的病史询问和体格检查可识别大多数间质性膀胱炎病例。
对于出现盆腔疼痛或子宫切除术后出现盆腔疼痛的女性，在进行子宫切除术之前应考虑间质性膀胱炎。如果确诊为间质性膀胱炎，适当的治疗可能无需进行子宫切除术。
