膀胱压力和不适症状评估:膀胱过度活动症与间质性膀胱炎/膀胱疼痛综合征患者有何不同?

Assessment of bladder pressure and discomfort symptoms: How do overactive bladder differ from interstitial cystitis/bladder pain syndrome patients?

机构信息

Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine, 4960 Children's Place, Campus Box 8242-02-0022, St. Louis, MO, 63110, USA.

出版信息

BMC Urol. 2023 Mar 30;23(1):53. doi: 10.1186/s12894-022-01164-8.

Abstract

BACKGROUND

To better understand the sensation of bladder "pressure" and "discomfort", and how they are similar or distinct from the "pain" and "urgency" symptoms in IC/BPS and OAB.

METHODS

IC/BPS and OAB patients rated their bladder pain, pressure, discomfort, and urinary urgency on separate 0-10 numeric rating scales (NRS). Their NRS ratings were compared between IC/BPS and OAB, and Pearson correlations were performed.

RESULTS

Among IC/BPS patients (n = 27), their mean numeric ratings of pain, pressure, discomfort, and urinary urgency were almost identical (6.6 ± 2.1, 6.0 ± 2.5, 6.5 ± 2.2, and 6.0 ± 2.8 respectively). The three-way correlations between pain, pressure, or discomfort were very strong (all > 0.77). Among OAB patients (n = 51), their mean numeric ratings of pain, pressure, and discomfort (2.0 ± 2.6, 3.4 ± 2.9, 3.4 ± 2.9) were significantly lower than urgency (6.1 ± 2.6, p < 0.001). The correlations between urgency and pain, and between urgency and pressure were weak in OAB (0.21 and 0.26). The correlation between urgency and discomfort was moderate in OAB (0.45). The most bothersome symptom of IC/BPS was bladder/pubic pain, while the most bothersome symptom of OAB was urinary urgency and daytime frequency.

CONCLUSIONS

IC/BPS patients interpreted bladder pain, pressure, or discomfort as the similar concepts and rated their intensity similarly. It is unclear whether pressure or discomfort provide additional information beyond pain in IC/BPS. Discomfort may also be confused with urgency in OAB. We should re-examine the descriptors pressure or discomfort in the IC/BPS case definition.

摘要

背景

为了更好地理解膀胱“压力”和“不适”的感觉,以及它们与 IC/BPS 和 OAB 中的“疼痛”和“急迫”症状有何相似或不同。

方法

IC/BPS 和 OAB 患者分别对其膀胱疼痛、压力、不适和尿急迫性进行 0-10 数字评分量表(NRS)评分。比较了 IC/BPS 和 OAB 患者的 NRS 评分,并进行了 Pearson 相关性分析。

结果

在 IC/BPS 患者(n=27)中,他们的疼痛、压力、不适和尿急迫性的平均数字评分几乎相同(分别为 6.6±2.1、6.0±2.5、6.5±2.2 和 6.0±2.8)。疼痛、压力或不适之间的三向相关性非常强(均>0.77)。在 OAB 患者(n=51)中,他们的疼痛、压力和不适的平均数字评分(2.0±2.6、3.4±2.9、3.4±2.9)明显低于急迫性(6.1±2.6,p<0.001)。OAB 中急迫性与疼痛和压力之间的相关性较弱(0.21 和 0.26)。急迫性与不适之间的相关性在 OAB 中为中度(0.45)。IC/BPS 最困扰的症状是膀胱/耻骨疼痛,而 OAB 最困扰的症状是尿急迫性和日间尿频。

结论

IC/BPS 患者将膀胱疼痛、压力或不适解释为相似的概念,并对其强度进行了类似的评分。目前尚不清楚压力或不适是否在 IC/BPS 中提供了疼痛之外的额外信息。不适在 OAB 中也可能与急迫性混淆。我们应该重新检查 IC/BPS 病例定义中压力或不适的描述符。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/98bd/10061968/d2c74b7b3d9f/12894_2022_1164_Fig1_HTML.jpg

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