Department of Urology, University Vita-Salute San Raffaele, Milan, Italy; ResearchDoctorate Program in Urology, Magna GraeciaUniversity, Catanzaro, Italy.
J Sex Med. 2013 Sep;10(9):2265-73. doi: 10.1111/jsm.12242. Epub 2013 Jul 22.
Uncomplicated recurrent urinary tract infections (rUTIs) associated with uropathogenic Escherichia coli (UPEC) are common among healthy, reproductive-aged women. Provoked vestibulodynia (PVD) is a major reason of sexual pain in premenopausal women.
The aim of this paper is to assess prevalence and predictors of secondary PVD in a cohort of Caucasian-European, heterosexual, sexually active, reproductive-aged women seeking medical help for rUTIs as their primary complaint.
Clinical and psychometric variables for 60 consecutive patients with rUTIs were considered. Patients were assessed with a thorough medical and sexual history, a number of psychometric instruments, and a specific physical examination. Urinalysis and self-collected urine cultures from the previous 12 months were also examined.
Descriptive statistics and logistic regression models were used to test the associations between secondary PVD and sociodemographic and clinical variables.
Mean age was 34.2 years (median 33 years; range 21-42). Secondary PVD was found in 36 of 60 patients (60%). Women with PVD had a higher prevalence of urinary tract infections (UTIs) over the previous 12 months (χ(2) : 4.54; P = 0.03) and suffered more frequently from UPEC-related rUTIs (χ(2) : 5.92; P = 0.01) than those without PVD. Moreover, women with PVD showed significantly lower scores on Female Sexual Function Index domains (all P ≤ 0.01), as compared with PVD-negative women. UPEC-related rUTIs (odds ratio [OR]: 3.1; P = 0.01), six or more UTIs over the previous 12 months (OR: 2.8; P = 0.01), and treatment with three or more antibiotics throughout the same period (OR: 2.1; P = 0.04) emerged as independent predictors of PVD.
Three of five Caucasian-European, heterosexual, sexually active women of reproductive age complaining of rUTIs as their primary disorder also suffer from secondary PVD. Uncomplicated UPEC-related rUTIs are more frequently associated with secondary PVD than are UTIs caused by different uropathogens.
与尿路致病性大肠杆菌（UPEC）相关的单纯复发性尿路感染（rUTI）在健康的育龄期女性中很常见。诱发性外阴痛（PVD）是绝经前女性性疼痛的主要原因。
本研究旨在评估一组寻求医疗帮助治疗 rUTI 的白种欧洲裔、异性恋、有性行为、育龄期女性中，继发 PVD 的患病率和预测因素，rUTI 是其主要主诉。
考虑了 60 例连续 rUTI 患者的临床和心理计量学变量。对患者进行了详细的病史询问和体格检查，同时还使用了一些心理计量学工具。还检查了过去 12 个月的尿分析和自行采集的尿液培养。
使用描述性统计和逻辑回归模型来测试继发 PVD 与社会人口统计学和临床变量之间的关联。
平均年龄为 34.2 岁（中位数 33 岁；范围 21-42 岁）。60 例患者中有 36 例（60%）继发 PVD。与无 PVD 的患者相比，有 PVD 的患者在过去 12 个月中 UTI 的患病率更高（χ²：4.54；P=0.03），且更常发生 UPEC 相关 rUTI（χ²：5.92；P=0.01）。此外，与 PVD 阴性女性相比，有 PVD 的女性在女性性功能指数各领域的评分明显较低（均 P≤0.01）。与 UPEC 相关的 rUTI（比值比 [OR]：3.1；P=0.01）、过去 12 个月中发生 6 次或以上 UTI（OR：2.8；P=0.01）和在同一时期使用 3 种或以上抗生素治疗（OR：2.1；P=0.04）是 PVD 的独立预测因素。
在抱怨 rUTI 作为主要疾病的 5 名白种欧洲裔、异性恋、有性行为的育龄期女性中，有 3 名女性也患有继发 PVD。与由其他尿路病原体引起的 UTI 相比，单纯 UPEC 相关 rUTI 更常与继发 PVD 相关。
