Department of Urology/Pelvic Health, Wake Forest Baptist Health, Winston-Salem, North Carolina, USA.
Can J Urol. 2020 Jun;27(3):10257-10262.
Interstitial cystitis/bladder pain syndrome (IC/BPS) and endometriosis are coexistent diagnoses in 48%-65% of women with chronic pelvic pain (CPP), suggesting that dual screening may be warranted. To further investigate the clinical relationship and risk factors between these two conditions, we performed a retrospective review of our large IC/BPS patient data registry.
We evaluated IC/BPS patients who were prospectively enrolled into our registry who completed validated questionnaires and underwent therapeutic hydrodistension, during which anesthetic bladder capacity (BC) and Hunner's lesion (HL) status were recorded. Demographic/medical history were reviewed. IC/BPS patients with co-occurring endometriosis diagnosis versus those without were compared using descriptive statistics as well as multivariate regression analyses to determine predictors of co-occurring disease.
Of 431 IC/BPS participants, 82 (19%) were also diagnosed with endometriosis. These women were significantly younger, had increased prevalence of non-low BC (> 400 cc), and decreased prevalence of HL (p < 0.05). Patients with co-occurring endometriosis also had increased prevalence of irritable bowel syndrome (IBS), CPP, fibromyalgia, and vulvodynia (p < 0.05). On multivariate analysis, non-low BC (OR 4.53, CI 1.004-20.42, p = 0.049), CPP (OR 1.84, CI 1.04-3.24, p = 0.04), and fibromyalgia (OR 1.80, CI 1.03-3.14, p < 0.04) were significantly associated with a diagnosis of endometriosis.
Patients with IC/BPS and co-occurring endometriosis were significantly more likely to carry a non-bladder centric IC/BPS phenotype as well as several comorbid, systemic pain diagnoses. This study characterizes features of a target IC/BPS phenotype that could potentially benefit from endometriosis and systemic pain syndrome screening.
间质性膀胱炎/膀胱疼痛综合征（IC/BPS）和子宫内膜异位症在 48%-65%的慢性盆腔疼痛（CPP）女性中同时存在诊断，这表明可能需要进行双重筛查。为了进一步研究这两种疾病之间的临床关系和危险因素，我们对我们的大型 IC/BPS 患者数据登记处进行了回顾性研究。
我们评估了前瞻性纳入我们登记处的 IC/BPS 患者，他们完成了有效的问卷调查，并接受了治疗性水扩张，在此过程中记录了麻醉膀胱容量（BC）和 Hunner 病变（HL）的状态。回顾了人口统计学/病史。使用描述性统计以及多元回归分析比较了同时患有子宫内膜异位症诊断的 IC/BPS 患者与无子宫内膜异位症诊断的患者，以确定同时患病的预测因素。
在 431 名 IC/BPS 参与者中，有 82 名（19%）还被诊断出患有子宫内膜异位症。这些女性明显更年轻，非低 BC（> 400 cc）的患病率更高，HL 的患病率更低（p < 0.05）。同时患有子宫内膜异位症的患者也更常见肠易激综合征（IBS）、CPP、纤维肌痛和外阴痛（p < 0.05）。多元分析显示，非低 BC（OR 4.53，CI 1.004-20.42，p = 0.049）、CPP（OR 1.84，CI 1.04-3.24，p = 0.04）和纤维肌痛（OR 1.80，CI 1.03-3.14，p < 0.04）与子宫内膜异位症的诊断显著相关。
患有 IC/BPS 和同时患有子宫内膜异位症的患者更有可能表现出非膀胱为中心的 IC/BPS 表型，以及几种合并的全身性疼痛诊断。本研究描述了一种潜在的 IC/BPS 表型特征，这种表型可能受益于子宫内膜异位症和全身性疼痛综合征的筛查。
