《国际疾病分类第 11 次修订版：外阴痛女性的倒退？》
The International Classification of Diseases, 11th Revision: A Step-Back for Women With Vulvodynia?
机构信息
Department of Surgical Sciences, University of Torino, Torino, Italy.
Department of Obstetrics and Gynecology, University of Iowa, Iowa City, IA.
出版信息
J Low Genit Tract Dis. 2020 Jul;24(3):332-333. doi: 10.1097/LGT.0000000000000513.
OBJECTIVE
The aim of the study was to compare the International Classification of Diseases, 11th revision, (ICD-11) with current terminology of vulvodynia, approved by a broad-based consensus of the International Society for the Study of Vulvovaginal Disease (ISSVD), the International Society for the Study of Women Sexual Health (ISSWSH), and the International Pelvic Pain Society (IPPS).
METHODS
The diagnostic criteria and descriptions of vulvodynia as well as the definition and classification of chronic pain in ICD-11 were reviewed and compared with the Consensus Terminology and Classification of Persistent Vulvar Pain and Vulvodynia, endorsed in 2015 by the ISSVD, ISSWSH, and IPPS.
RESULTS
Diagnostic criteria and descriptors of vulvodynia in the ICD-11 are outdated. Moreover, vulvodynia is not identified among chronic pain diagnoses, despite fulfilling the diagnostic criteria of chronic primary pain. Specifically, vulvodynia is a vulvar pain of at least 3-month duration, which is associated with significant emotional distress and functional disability, and is not better accounted for by another specific condition.
CONCLUSIONS
The ICD-11 is not aligned with current vulvodynia diagnostic criteria and terminology, approved by the ISSVD, ISSWSH, and IPPS. Collaboration among the International Association for the Study of Pain Task Force on Classification of Chronic Pain, ICD team, ISSVD, ISSWSH, and IPPS is needed to harmonize terminologies, codes, and clinical approach regarding vulvar pain and vulvodynia classification.
目的
本研究旨在比较国际疾病分类第 11 版（ICD-11）与广泛共识认可的外阴疼痛术语，这些术语由国际外阴阴道疾病研究学会（ISSVD）、国际女性性健康研究学会（ISSWSH）和国际盆腔疼痛协会（IPPS）共同批准。
方法
我们回顾了 ICD-11 中外阴疼痛的诊断标准和描述，以及慢性疼痛的定义和分类，并与 2015 年 ISSVD、ISSWSH 和 IPPS 共同认可的持续性外阴疼痛和外阴痛的共识术语和分类进行了比较。
结果
ICD-11 中外阴疼痛的诊断标准和描述已经过时。此外，尽管符合慢性原发性疼痛的诊断标准，但 ICD-11 中并未将外阴痛列为慢性疼痛诊断之一。具体而言，外阴痛是一种至少持续 3 个月的外阴疼痛，伴有明显的情绪困扰和功能障碍，且无法用其他特定疾病更好地解释。
结论
ICD-11 与 ISSVD、ISSWSH 和 IPPS 批准的当前外阴痛诊断标准和术语不一致。需要由疼痛研究国际协会分类慢性疼痛工作队、ICD 团队、ISSVD、ISSWSH 和 IPPS 之间进行合作，以协调外阴疼痛和外阴痛分类的术语、编码和临床方法。
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