Department of Obstetrics and Gynecology, IRCCS San Matteo Foundation, University of Pavia, Pavia, Italy.
J Sex Med. 2011 Jun;8(6):1726-34. doi: 10.1111/j.1743-6109.2011.02251.x. Epub 2011 Apr 7.
Dyspareunia and sexual dysfunction are common in women with urological disorders. The study of comorbidity between interstitial cystitis (IC) and vulvodynia seems to be relevant to understand the mechanism generating pain in these conditions.
To conduct a case-control study for evaluating vulvodynia and sexual dysfunction in women with IC.
Forty-seven women with new diagnosis (National Institutes of Health [NIH]/National Institute of Diabetes and Digestive and Kidney Diseases [NIDDK] Criteria) of IC were compared with 188 age-matched, negative controls. Each woman completed a semi-structured interview and the Female Sexual Function Index (FSFI). A gynecological examination to assess vulvodynia (cotton swab testing) and genital health (vulvoscopy, Pap smear, culture, and vaginal health index score [VHIS]) was performed.
Prevalence of vulvodynia, sexual function, and sociodemographic/gynecological variables significantly associated with IC.
Spontaneous or provoked vulvodynia was reported by 23.4% and 74.5% of IC cases, respectively. Sexual function was significantly impaired (median total FSFI score: IC cases 16.85 ± 8.73 vs. controls 27.34 ± 6.41; P<0.0001) in sexually active women, and 23.4% of IC cases as compared to 9% of controls reported no sexual activity in the year preceding the study (χ(2) for trend=38.2, P<0.0001). VHIS was highly impaired in women with IC in comparison with controls (P<0.0001). Variables significantly associated with IC were a diagnosis of menopause (odds ratio [OR]=31.2, 95% confidence interval [CI]=8.1-120.5), past (OR=4.6, 95% CI=1.74-12.1) or current (OR=6.9, 95% CI=2.1-22.1) oral contraceptive use, and a histologically confirmed diagnosis of endometriosis (OR=3.7, 95% CI=1.1-12.7).
We found an increased prevalence of vulvodynia among women with recently diagnosed IC; both conditions seem to have profound consequences on women's sexual function. A potential role for sex hormone-dependent mechanisms into the comorbidity of vulvar and bladder pain is proposed, but further research is warranted.
性交困难和性功能障碍在患有泌尿科疾病的女性中很常见。研究间质性膀胱炎 (IC) 和外阴痛之间的共病似乎对于理解这些疾病产生疼痛的机制很重要。
进行一项病例对照研究，评估患有 IC 的女性的外阴痛和性功能障碍。
47 名新诊断为 IC（美国国立卫生研究院/美国国立糖尿病、消化和肾脏疾病研究所 [NIH/NIDDK] 标准）的女性与 188 名年龄匹配的阴性对照进行比较。每位女性完成半结构化访谈和女性性功能指数 (FSFI)。进行妇科检查以评估外阴痛（棉签测试）和生殖器健康（外阴镜检查、巴氏涂片检查、培养和阴道健康指数评分 [VHIS]）。
外阴痛、性功能障碍和与 IC 显著相关的社会人口学/妇科变量的患病率。
自发性或诱发的外阴痛在 IC 病例中分别报告为 23.4%和 74.5%。在有性生活的女性中，性功能明显受损（中位总 FSFI 评分：IC 病例 16.85±8.73 vs. 对照组 27.34±6.41；P<0.0001），与对照组相比，23.4%的 IC 病例报告在研究前一年没有性生活（趋势 χ2=38.2，P<0.0001）。与对照组相比，IC 女性的 VHIS 明显受损（P<0.0001）。与 IC 显著相关的变量是绝经诊断（优势比 [OR]=31.2，95%置信区间 [CI]=8.1-120.5）、过去（OR=4.6，95% CI=1.74-12.1）或当前（OR=6.9，95% CI=2.1-22.1）口服避孕药使用以及经组织学证实的子宫内膜异位症诊断（OR=3.7，95% CI=1.1-12.7）。
我们发现最近诊断为 IC 的女性外阴痛患病率增加；这两种情况似乎对女性的性功能有深远的影响。提出外阴和膀胱疼痛的共病可能与性激素依赖性机制有关，但需要进一步研究。
