Tan Lek-Hong, Tsai Li-Hsien
Department of Urology, China Medical University Hospital, Taichung 404327, Taiwan.
Medicina (Kaunas). 2025 May 14;61(5):890. doi: 10.3390/medicina61050890.
: Lower urinary tract symptoms (LUTSs) are prevalent among patients with uterine myoma (UM); however, these health issues have not been systematically evaluated. To address this research gap, this systematic review and meta-analysis synthesizes existing findings on the prevalence estimates and odds ratios for LUTSs in patients with UM. : A systematic literature search using PubMed and Embase was conducted for articles published between 1 January 2000 and 24 September 2023. The search and review processes followed the PRISMA and MOOSE guidelines. This study was registered in PROSPERO (CRD42023474156). Data on the prevalence and odds ratios of LUTSs-including storage symptoms (frequency, urgency, nocturia), voiding symptoms, and urinary incontinence (UI) subtypes such as stress incontinence (SUI), urgency urinary incontinence (UUI), and mixed urinary incontinence (MUI)-were extracted. Pooled prevalence estimates and odds ratios were calculated using random-effects meta-analysis. Subgroup analyses and univariate meta-regression were conducted to examine associations with age, BMI, parity, WHO region, and risk of bias. The impact of UM size was assessed using standardized mean differences. : Of the 572 articles screened, 20 met the inclusion criteria. The overall pooled prevalence of LUTSs in UM patients was 49% (95% CI, 26-72%), with substantial heterogeneity across studies (I = 99.8%). The pooled prevalence for urinary frequency, urgency, nocturia, voiding dysfunction, and overall UI, SUI, UUI, and MUI ranged from 15% to 54%. SUI and UUI were significantly associated with UM (OR = 2.0, 95% CI: 1.2-3.3; OR = 1.5, 95% CI: 1.1-2.0, respectively). Hysterectomy was not associated with an improvement in overactive bladder (OAB) symptoms (OR = 1.9, 95% CI: 0.6-5.7). A larger UM size was not linked to worsening LUTS. Fourteen studies (70%) had some concerns about the risk of bias, while six studies (30%) had a low risk of bias. Egger's test showed no significant publication bias ( = 0.19). : Approximately half of patients with UM experience LUTSs or UI. The findings emphasize the need to consider urinary symptoms in UM management. Further research is warranted to reduce heterogeneity and explore treatment-specific outcomes.
下尿路症状（LUTSs）在子宫肌瘤（UM）患者中普遍存在；然而，这些健康问题尚未得到系统评估。为填补这一研究空白，本系统评价和荟萃分析综合了关于UM患者LUTSs患病率估计值和比值比的现有研究结果。：使用PubMed和Embase对2000年1月1日至2023年9月24日发表的文章进行了系统的文献检索。检索和综述过程遵循PRISMA和MOOSE指南。本研究已在PROSPERO（CRD42023474156）注册。提取了LUTSs的患病率和比值比数据，包括储尿症状（尿频、尿急、夜尿）、排尿症状以及尿失禁（UI）亚型，如压力性尿失禁（SUI）、急迫性尿失禁（UUI）和混合性尿失禁（MUI）。使用随机效应荟萃分析计算合并患病率估计值和比值比。进行亚组分析和单变量荟萃回归以检验与年龄、体重指数、产次、世界卫生组织区域和偏倚风险的关联。使用标准化均数差评估UM大小的影响。：在筛选的572篇文章中，20篇符合纳入标准。UM患者中LUTSs的总体合并患病率为49%（95%CI，26 - 72%），各研究间存在显著异质性（I² = 99.8%）。尿频、尿急、夜尿、排尿功能障碍以及总体UI、SUI、UUI和MUI的合并患病率在15%至54%之间。SUI和UUI与UM显著相关（OR = 2.0，95%CI：1.2 - 3.3；OR = 1.5，95%CI：1.1 - 2.0）。子宫切除术与膀胱过度活动症（OAB）症状的改善无关（OR = 1.9，95%CI：0.6 - 5.7）。较大的UM大小与LUTS恶化无关。14项研究（70%）对偏倚风险存在一些担忧，而6项研究（30%）偏倚风险较低。Egger检验显示无显著的发表偏倚（P = 0.19）。：大约一半的UM患者经历LUTSs或UI。研究结果强调在UM管理中需要考虑泌尿系统症状。有必要进行进一步研究以减少异质性并探索特定治疗的结果。
