Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.
Am J Obstet Gynecol. 2010 Mar;202(3):286.e1-6. doi: 10.1016/j.ajog.2009.10.866. Epub 2009 Dec 22.
The objective of the study was to compare subjects with interstitial cystitis/painful bladder syndrome (IC/PBS) with controls on prior surgeries.
IC/PBS subjects were compared with matched controls on surgeries and possible surgical indications prior to their index dates.
Adjusted for demographic variables, logistic regression showed subjects exceeded controls in surgeries longer than 12 months and less than 1 month before the index date. However, addition of possible surgical indications showed chronic pelvic pain (CPP) to have a strong association with IC/PBS, whereas associations with surgeries were reduced to nonsignificance.
Although women with IC/PBS were more likely to have experienced prior surgeries than controls, the apparent indications for surgeries, not the surgeries themselves, were stronger risk factors for IC/PBS. In particular, a prior history of CPP had a strong association with IC/PBS. Several features of study design, including extensive medical record review, suggest that prior CPP was not undiagnosed IC/PBS. Further investigation of CPP may yield insight into the pathogenesis of IC/PBS.
本研究旨在比较间质性膀胱炎/膀胱疼痛综合征(IC/PBS)患者与对照组在既往手术方面的差异。
将 IC/PBS 患者与匹配的对照组进行比较,比较其在指数日期之前 12 个月以上和 1 个月以内的手术情况和可能的手术指征。
调整人口统计学变量后,逻辑回归显示,与对照组相比,在指数日期前 12 个月以上和 1 个月以内进行手术的患者比例更高。然而,加入可能的手术指征后,发现慢性盆腔疼痛(CPP)与 IC/PBS 有很强的关联,而与手术的关联则降低至无统计学意义。
尽管 IC/PBS 患者比对照组更有可能接受过既往手术,但手术的明显指征而非手术本身是 IC/PBS 的更强风险因素。特别是,既往 CPP 病史与 IC/PBS 有很强的关联。研究设计的几个特征,包括对医疗记录的广泛审查,表明既往 CPP 并非未确诊的 IC/PBS。进一步研究 CPP 可能有助于深入了解 IC/PBS 的发病机制。