膀胱充盈痛和尿急是泌尿系统慢性盆腔疼痛综合征男女患者的不同特征：一项MAPP研究网络的研究
Painful Bladder Filling and Painful Urgency are Distinct Characteristics in Men and Women with Urological Chronic Pelvic Pain Syndromes: A MAPP Research Network Study.
作者信息
Lai H Henry, Krieger John N, Pontari Michel A, Buchwald Dedra, Hou Xiaoling, Landis J Richard
机构信息
Division of Urologic Surgery, Department of Surgery and Department of Anesthesiology, Washington University School of Medicine, St. Louis, Missouri.
Department of Urology, School of Medicine, University of Washington, Seattle, Washington.
出版信息
J Urol. 2015 Dec;194(6):1634-41. doi: 10.1016/j.juro.2015.05.105. Epub 2015 Jul 17.
PURPOSE
We describe bladder associated symptoms in patients with urological chronic pelvic pain syndromes. We correlated these symptoms with urological, nonurological, psychosocial and quality of life measures.
MATERIALS AND METHODS
Study participants included 233 women and 191 men with interstitial cystitis/bladder pain syndrome or chronic prostatitis/chronic pelvic pain syndrome in a multicenter study. They completed a battery of measures, including items asking whether pain worsened with bladder filling (painful filling) or whether the urge to urinate was due to pain, pressure or discomfort (painful urgency). Participants were categorized into 3 groups, including group 1-painful filling and painful urgency (both), 2-painful filling or painful urgency (either) and 3-no painful filling or painful urgency (neither).
RESULTS
Of the men 75% and of the women 88% were categorized as both or either. These bladder characteristics were associated with more severe urological symptoms (increased pain, frequency and urgency), a higher somatic symptom burden, depression and worse quality of life (3-group trend test each p<0.01). A gradient effect was observed across the groups (both>either>neither). Compared to those in the neither group men categorized as both or either reported more frequent urological chronic pelvic pain syndrome symptom flares, catastrophizing and irritable bowel syndrome, and women categorized as both or either were more likely to have a negative affect and chronic fatigue syndrome.
CONCLUSIONS
Men and women with bladder symptoms characterized as painful filling or painful urgency had more severe urological symptoms, more generalized symptoms and worse quality of life than participants who reported neither characteristic, suggesting that these symptom characteristics might represent important subsets of patients with urological chronic pelvic pain syndromes.
目的
我们描述了泌尿外科慢性盆腔疼痛综合征患者的膀胱相关症状。我们将这些症状与泌尿外科、非泌尿外科、心理社会因素及生活质量指标进行了关联分析。
材料与方法
在一项多中心研究中，研究参与者包括233名患有间质性膀胱炎/膀胱疼痛综合征或慢性前列腺炎/慢性盆腔疼痛综合征的女性和191名男性。他们完成了一系列测量，包括询问膀胱充盈时疼痛是否加重（充盈性疼痛）或排尿冲动是否由疼痛、压力或不适引起（紧迫性疼痛）的项目。参与者被分为3组，包括第1组——充盈性疼痛和紧迫性疼痛（两者皆有），第2组——充盈性疼痛或紧迫性疼痛（二者其一），第3组——无充盈性疼痛或紧迫性疼痛（两者皆无）。
结果
75%的男性和88%的女性被归类为两者皆有或二者其一。这些膀胱特征与更严重的泌尿外科症状（疼痛加剧、尿频和尿急增加）、更高的躯体症状负担、抑郁及更差的生活质量相关（三组趋势检验，各p<0.01）。在各组间观察到一种梯度效应（两者皆有>二者其一>两者皆无）。与两者皆无组的参与者相比，被归类为两者皆有或二者其一的男性报告有更频繁的泌尿外科慢性盆腔疼痛综合征症状发作、灾难化思维和肠易激综合征，而被归类为两者皆有或二者其一的女性更可能有消极情绪和慢性疲劳综合征。
结论
具有充盈性疼痛或紧迫性疼痛特征膀胱症状的男性和女性，与报告无这些特征的参与者相比，有更严重的泌尿外科症状、更广泛的症状及更差的生活质量，这表明这些症状特征可能代表了泌尿外科慢性盆腔疼痛综合征患者的重要亚组。
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