Rezaeimehr Mohammad R, Zargham Mahtab, Jahanabadi Zahra, Afsar Firozeh, Rahnama'i Mohammad S, Sharbafchi Mohammad R, Mazdak Hamid
Department of Urology, school of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
Department of Urology, Isfahan Kidney Transplantation Research Center, Al-Zahra Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
Neurourol Urodyn. 2022 Jan;41(1):357-364. doi: 10.1002/nau.24831. Epub 2021 Nov 17.
This study focused on women with chronic lower urinary tract symptoms (LUTS) who simultaneously suffered from obsessive-compulsive disorder (OCD) to evaluate the association between micturition abnormality and OCD.
A cohort case study was conducted on 128 women with chronic LUTS who visited the academic clinic from 2012 to 2018. The participants with a history of OCD were grouped together, whereas the other group consisted of those with no psychiatric issues. Data were analyzed using the Kolmogorov-Smirnov test and also the nonparametric Kruskal-Wallis and χ tests.
The participants with OCD had a lower mean age (41.7 vs. 48.8 years) and longer symptom duration than the control group. Moreover, voiding phase problems were more prevalent among OCD patients (mean voiding score: 9.3 vs. 6.9). Urge urinary incontinence (UUI) was the most common type of urinary incontinence in OCD patients, and the most important urodynamic study finding was bladder outlet obstruction (45% and 17% in the OCD and control groups, respectively). Voiding disorders resulted in chronic renal failure in two patients (3.12%). It was shown that bladder outlet obstruction (odds ratio (OR) 4.43, 95% confidence interval [CI] 1.53-12.78, p = 0.006] was the strongest predictor of OCD and stress urinary incontinence (OR 0.20, 95% CI 0.07-0.53, p < 0.001) was the best protector against OCD.
The findings revealed that chronic LUTS was related to voiding dysfunction and urodynamic abnormality in OCD patients. These disorders may be categorized as somatoform disorder that requires appropriate treatments.
本研究聚焦于同时患有慢性下尿路症状(LUTS)和强迫症(OCD)的女性,以评估排尿异常与强迫症之间的关联。
对2012年至2018年到学术诊所就诊的128例慢性LUTS女性进行队列病例研究。有强迫症病史的参与者归为一组,另一组为无精神问题者。使用柯尔莫哥洛夫-斯米尔诺夫检验以及非参数克鲁斯卡尔-沃利斯检验和χ检验进行数据分析。
患有强迫症的参与者平均年龄较低(41.7岁对48.8岁),症状持续时间比对照组更长。此外,排尿期问题在强迫症患者中更为普遍(平均排尿评分:9.3对6.9)。急迫性尿失禁(UUI)是强迫症患者中最常见的尿失禁类型,最重要的尿动力学研究发现是膀胱出口梗阻(强迫症组和对照组分别为45%和17%)。排尿障碍导致两名患者(3.12%)出现慢性肾衰竭。结果显示,膀胱出口梗阻(优势比(OR)4.43,95%置信区间[CI] 1.53 - 12.78,p = 0.006)是强迫症最强的预测因素,而压力性尿失禁(OR 0.20,95% CI 0.07 - 0.53,p < 0.001)是预防强迫症的最佳保护因素。
研究结果表明,慢性LUTS与强迫症患者的排尿功能障碍和尿动力学异常有关。这些障碍可能归类为躯体形式障碍,需要适当治疗。