Bird Lisa M, Olaker Veronica R, Pope Rachel J
Division of Female Sexual Health, Urology Institute and Department of Obstetrics and Gynecology, University Hospitals, Cleveland, OH.
Case Western Reserve University, Cleveland, OH.
J Low Genit Tract Dis. 2025 Oct 1;29(4):376-379. doi: 10.1097/LGT.0000000000000903. Epub 2025 Jul 8.
The purpose of this study was to identify factors with uniquely high prevalence in vulvodynia-Ehlers-Danlos syndrome comorbid patients in order to identify patients who may need referral and to better understand management of this population.
This cross-sectional study was conducted in January 2025 using the TriNetX Platform Global Collaborative Network Database with statistical comparison of vulvodynia-Ehlers-Danlos comorbid cohort and vulvodynia non-Ehlers-Danlos cohort. Bonferroni correction was performed due to analysis of 100 demographic, associated condition, and treatment factors with statistical significance at p = .0005.
Five hundred seventy vulvodynia-Ehlers-Danlos patients and 49,457 vulvodynia non-Ehlers-Danlos patients were identified with a mean age of 39 and 48 ( p < .0001), respectively. Vulvodynia-Ehlers-Danlos comorbid patients had more frequent chronic pain, musculoskeletal, neurologic, gynecologic, immune, and psychiatric conditions. Vulvodynia-Ehlers-Danlos patients had higher rates of most nonsurgical interventions but similar vaginal estrogen ( p = .0412) and vulvar surgery rates ( p = .4249). Vulvodynia-Ehlers-Danlos patients had signs of more frequent medical contact with more post-op visits, vaccines, and inpatient admissions ( p < .0001). Study limitations are those inherent to the TriNetX database, with ability to see associations but not causation.
Clinicians treating genital pain have a role in the treatment of vulvodynia-Ehlers-Danlos patients given the array of prevalent pelvic conditions. Clinicians should keep the high rate of muscular, neurologic, and immune conditions in mind when evaluating the vulvodynia etiology in this population, as well as the higher rate of gynecologic comorbidities, which could result in hormone-mediated etiology from chronic estrogen use. With a higher rate of mood disorders, mental health inquiry is also important.
本研究的目的是确定在外阴痛-埃勒斯-当洛综合征合并症患者中具有独特高患病率的因素，以便识别可能需要转诊的患者，并更好地了解该人群的管理。
本横断面研究于2025年1月使用TriNetX平台全球协作网络数据库进行，对外阴痛-埃勒斯-当洛合并症队列和非埃勒斯-当洛外阴痛队列进行统计比较。由于对100个人口统计学、相关疾病和治疗因素进行分析，p = 0.0005时有统计学意义，因此进行了Bonferroni校正。
确定了570例外阴痛-埃勒斯-当洛患者和49457例非埃勒斯-当洛外阴痛患者，平均年龄分别为39岁和48岁（p < 0.0001）。外阴痛-埃勒斯-当洛合并症患者有更频繁的慢性疼痛、肌肉骨骼、神经、妇科、免疫和精神疾病。外阴痛-埃勒斯-当洛患者大多数非手术干预的发生率较高，但阴道雌激素（p = 0.0412）和外阴手术率（p = 0.4249）相似。外阴痛-埃勒斯-当洛患者有更频繁就医的迹象，术后就诊、疫苗接种和住院次数更多（p < 0.0001）。研究局限性是TriNetX数据库固有的，能够看到关联但不能确定因果关系。
鉴于一系列常见的盆腔疾病，治疗生殖器疼痛的临床医生在外阴痛-埃勒斯-当洛患者的治疗中发挥作用。临床医生在评估该人群外阴痛病因时应牢记肌肉、神经和免疫疾病的高发生率，以及较高的妇科合并症发生率，这可能导致长期使用雌激素引起激素介导的病因。由于情绪障碍发生率较高，心理健康询问也很重要。
