Chung Christopher P, Sargent Rachel E, Chung Nadia T, Lacey James V, Wakabayashi Mark T
Division of Gynecologic Oncology, Department of Surgery, City of Hope Medical Center, Duarte, California.
Division of Gynecologic Oncology, Department of Surgery, City of Hope Medical Center, Duarte, California.
Biol Blood Marrow Transplant. 2016 Feb;22(2):378-379. doi: 10.1016/j.bbmt.2015.09.021. Epub 2015 Sep 30.
We conducted a retrospective review to assess the prevalence of graft-versus-host disease (GVHD)-associated gynecologic conditions among bone marrow transplantation (BMT) patients at City of Hope Medical Center. We calculated the associations among the estimated risks of various gynecologic complications, including vaginal stenosis, by performing chi-square tests and t-test statistics. Between 2010 and 2014, 180 patients were referred to the gynecologic clinic after their BMT. One hundred twenty-four patients (69%) had GVHD; among these patients, 51 (41%) experienced dyspareunia and 43 (35%) had vaginal stenosis. GVHD patients were significantly more likely to have vaginal stenosis (P < .0001), more likely to have used a vaginal dilator (P = .0008), and less likely to have urinary incontinence (UI) than those without GVHD (P < .001). There was no difference in developing pelvic organ prolapse (POP) in patients with or without GVHD (P = .4373). GVHD was a common complication after allogenic BMT. Patients with BMT were more likely to have vulvovaginal symptoms, such as dyspareunia and pelvic pain. Patients with GVHD are at high risk for vaginal stenosis requiring the use of a vaginal dilator. However, they are at low risk for developing UI and POP.
我们进行了一项回顾性研究,以评估希望之城医疗中心接受骨髓移植(BMT)的患者中与移植物抗宿主病(GVHD)相关的妇科疾病的患病率。我们通过进行卡方检验和t检验统计,计算了包括阴道狭窄在内的各种妇科并发症的估计风险之间的关联。2010年至2014年期间,180名患者在接受BMT后被转诊至妇科门诊。其中124名患者(69%)患有GVHD;在这些患者中,51名(41%)经历性交困难,43名(35%)患有阴道狭窄。与未患GVHD的患者相比,患GVHD的患者发生阴道狭窄的可能性显著更高(P <.0001),使用阴道扩张器的可能性更高(P =.0008),发生尿失禁(UI)的可能性更低(P <.001)。患或未患GVHD的患者发生盆腔器官脱垂(POP)的情况没有差异(P =.4373)。GVHD是异基因BMT后的常见并发症。接受BMT的患者更有可能出现外阴阴道症状,如性交困难和盆腔疼痛。患GVHD的患者发生阴道狭窄并需要使用阴道扩张器的风险很高。然而,他们发生UI和POP的风险较低。