Interstitial Cystitis is Associated with Vulvodynia and Sexual Dysfunction-A Case-Control Study
Interstitial Cystitis is Associated with Vulvodynia and Sexual Dysfunction-A Case-Control Study
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DOI：
10.1111/j.1743-6109.2011.02251.x
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发表时间：
2011-06-01
影响因子：
3.5
通讯作者：
Spinillo, Arsenio
中科院分区：
文献类型：
--
作者：
Gardella, Barbara;Porru, Daniele;Spinillo, Arsenio
介绍：性交困难和性功能障碍在泌尿系统疾病的妇女中很常见。间质性膀胱炎（IC）和外阴痛之间的共病研究似乎与了解这些情况下产生疼痛的机制有关。目的：进行一项病例对照研究，以评估IC妇女的外阴痛和性功能障碍。方法：47名新诊断的妇女，（美国国立卫生研究院[NIH]/美国国立糖尿病、消化和肾脏疾病研究所[NIDDK]标准）的IC与188名年龄匹配的阴性对照。每位女性都完成了半结构化访谈和女性性功能指数（FSFI）。妇科检查，以评估外阴痛（棉拭子检测）和生殖健康（外阴镜检查，巴氏涂片，文化，阴道健康指数评分[VHIS]）performed.Main Outcome Measures.患病率外阴痛，性功能，和社会人口统计学/妇科变量显着相关IC.Results.Spontaneous或激发外阴痛的IC病例，分别为23.4%和74.5%。性功能明显受损（中位总FSFI评分：IC病例16.85 +/- 8.73 vs.对照组27.34 +/- 6.41; P < 0.0001），23.4%的IC病例与9%的对照组在研究前一年没有性活动（趋势卡方= 38.2，P < 0.0001）。与对照组相比，IC女性VHIS高度受损（P < 0.0001）。与IC显著相关的变量是绝经的诊断（比值比[OR] = 31.2，95%置信区间[CI] = 8.1-120.5），既往（OR = 4.6，95% CI = 1.74-12.1）或当前（OR = 6.9，95% CI = 2.1-22.1）口服避孕药，组织学确诊子宫内膜异位症（OR = 3.7，95%CI = 1.1-12.7）结论：我们发现最近诊断为IC的女性外阴痛患病率增加;这两种情况似乎对女性的性功能有深远的影响。一个潜在的作用，性欲依赖性机制到外阴和膀胱疼痛的并发症提出，但需要进一步的研究。Gardella B，Porru D，Nappi RE，Dabriya MD，Chiesa A，and Spinillo A.间质性膀胱炎与外阴痛和性功能障碍相关：一项病例对照研究J Sex Med 2011;8：1726-1734.
Introduction.Dyspareunia and sexual dysfunction are common in women with urological disorders. The study of comorbidity between interstitial cystitis (IC) and vulvodynia seems to be relevant to understand the mechanism generating pain in these conditions.Aim.To conduct a case-control study for evaluating vulvodynia and sexual dysfunction in women with IC.Methods.Forty-seven women with new diagnosis (National Institutes of Health [NIH]/National Institute of Diabetes and Digestive and Kidney Diseases [NIDDK] Criteria) of IC were compared with 188 age-matched, negative controls. Each woman completed a semi-structured interview and the Female Sexual Function Index (FSFI). A gynecological examination to assess vulvodynia (cotton swab testing) and genital health (vulvoscopy, Pap smear, culture, and vaginal health index score [VHIS]) was performed.Main Outcome Measures.Prevalence of vulvodynia, sexual function, and sociodemographic/gynecological variables significantly associated with IC.Results.Spontaneous or provoked vulvodynia was reported by 23.4% and 74.5% of IC cases, respectively. Sexual function was significantly impaired (median total FSFI score: IC cases 16.85 +/- 8.73 vs. controls 27.34 +/- 6.41; P < 0.0001) in sexually active women, and 23.4% of IC cases as compared to 9% of controls reported no sexual activity in the year preceding the study (chi 2 for trend = 38.2, P < 0.0001). VHIS was highly impaired in women with IC in comparison with controls (P < 0.0001). Variables significantly associated with IC were a diagnosis of menopause (odds ratio [OR] = 31.2, 95% confidence interval [CI] = 8.1-120.5), past (OR = 4.6, 95% CI = 1.74-12.1) or current (OR = 6.9, 95% CI = 2.1-22.1) oral contraceptive use, and a histologically confirmed diagnosis of endometriosis (OR = 3.7, 95% CI = 1.1-12.7).Conclusion.We found an increased prevalence of vulvodynia among women with recently diagnosed IC; both conditions seem to have profound consequences on women's sexual function. A potential role for sex hormone-dependent mechanisms into the comorbidity of vulvar and bladder pain is proposed, but further research is warranted. Gardella B, Porru D, Nappi RE, Dacco MD, Chiesa A, and Spinillo A. Interstitial cystitis is associated with vulvodynia and sexual dysfunction-A case control study. J Sex Med 2011;8:1726-1734.