Somatic syndromes and chronic pain in women with overactive bladder.
Somatic syndromes and chronic pain in women with overactive bladder.
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DOI：
10.1002/nau.23060
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发表时间：
2017-04
影响因子：
2
通讯作者：
Dmochowski, Roger
中科院分区：
文献类型：
--
作者：
Reynolds, W. Stuart;Mock, Stephen;Zhang, Xuechao;Kaufman, Melissa;Wein, Alan;Bruehl, Stephen;Dmochowski, Roger
关键词：
痛觉和传入超敏的潜在机制，如中枢敏化，可能会影响膀胱过度活动(OAB)症状。然而，对于OAB症状严重程度、疼痛经历和慢性疼痛综合征共病的存在之间的关系，我们知之甚少。这项研究调查了OAB症状、躯体症状和特定的慢性疼痛状况之间的关系，其中中枢敏感化被认为起主要作用。在一个基于社区的OAB成年女性样本中，我们招募了OAB成年女性来完成问卷，评估尿路症状、疼痛和躯体症状，以及既往的中枢敏感症诊断。我们分析了总体躯体疼痛强度、一般躯体症状和中枢性敏感综合征的诊断对OAB症状困扰和健康相关生活质量的影响。在这项研究的116名女性中，超过一半(54%)的人表示，她们的小便冲动与疼痛、压力或不适有关。参与者报告了广泛的OAB症状和与健康相关的生活质量。OAB症状与躯体症状和总体疼痛强度呈显著正相关。只有7%的女性符合纤维肌痛的诊断标准；然而，与那些没有纤维肌痛的女性相比，这些女性表现出显著的OAB症状负担和OAB生活质量下降。有更严重OAB症状的女性报告说，一般躯体症状负担增加，全身疼痛强度增加，特别是患有纤维肌痛的女性。这些发现表明，疼痛的属性和慢性疼痛状况的并存可能会影响许多女性的OAB症状。
Mechanisms underlying pain perception and afferent hypersensitivity, such as central sensitization, may impact overactive bladder (OAB) symptoms. However, little is known about associations between OAB symptom severity, pain experience, and presence of comorbid chronic pain syndromes. This study examined relationships between OAB symptoms, somatic symptoms, and specific chronic pain conditions in which central sensitization is believed to play a primary role, in a community-based sample of adult women with OAB We recruited adult women with OAB to complete questionnaires assessing urinary symptoms, pain and somatic symptoms, and preexisting diagnoses of central sensitivity syndromes. We analyzed the effects of overall bodily pain intensity, general somatic symptoms, and diagnoses of central sensitivity syndromes on OAB symptom bother and health-related quality of life. Of the 116 women in this study, over half (54%) stated their urge to urinate was associated with pain, pressure, or discomfort. Participants reported a wide range of OAB symptoms and health-related quality of life. There was a significant, positive correlation between OAB symptoms and somatic symptoms as well as overall pain intensity. Only 7% of women met diagnostic criteria for fibromyalgia; yet these women demonstrated significantly increased OAB symptom burden and decreased OAB quality of life compared to those without fibromyalgia. Women with more severe OAB symptoms reported increased general somatic symptom burden and increased overall body pain intensity, especially women with fibromyalgia. These findings suggest that attributes of pain and co-morbidity with chronic pain conditions may impact the experience of OAB symptoms for many women.
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