How do patients with interstitial cystitis present?
How do patients with interstitial cystitis present?
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DOI：
10.1016/s0022-5347(05)65517-6
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发表时间：
2001-12-01
影响因子：
6.6
通讯作者：
Teichman, JMH
中科院分区：
文献类型：
--
作者：
Driscoll, A;Teichman, JMH
目的：我们确定了如何间质性膀胱炎的进展，从最初的症状诊断。材料和方法：我们回顾性分析了45例患者的记录，以确定症状发作和诊断的日期，和紧迫性/频率，排尿和疼痛的顺序。我们还记录了交替和以前的诊断，和以前的手术治疗。结果：89%的患者只有1个症状。从最初症状到所有症状的中位时间为2年（平均5.5年）。最常见的既往诊断为泌尿系感染19例，妇科诊断14例，尿道诊断6例。以前的泌尿系感染记录在19例中只有1例，而11例接受子宫切除术和5例诊断为子宫内膜异位症没有病理学documents.Conclusions：早期间质性膀胱炎提出的，通常只有一个单一的症状，紧迫性/频率，排尿或疼痛。临床医生可能无法了解早期间质性膀胱炎的症状，这导致诊断延迟，直到患者症状更加明显。随着时间的推移，多种症状表现出来。细菌性膀胱炎、前列腺炎、子宫内膜异位症和慢性盆腔痛是常见的初始误诊。当缺乏替代诊断的实验室文件或患者对替代诊断的治疗无效时，应考虑间质性膀胱炎。
Purpose: We determined how interstitial cystitis progresses from initial symptoms to diagnosis.Materials and Methods: We retrospectively analyzed the records of 45 patients to determine the dates of symptom onset and diagnosis, and sequence of urgency/frequency, nocturia and pain. We also documented alternate and previous diagnoses, and previous surgical treatments.Results: Of the patients 89% presented with only 1 symptom. Median time from the initial symptom to all symptoms was 2 years (mean 5.5). The most common previous diagnoses were urinary infection in 19 cases, a gynecologic diagnosis in 14 and urethral diagnoses in 6. A previous urinary infection was documented in only 1 of 19 patients, while 11 had undergone hysterectomy and 5 diagnosed with endometriosis had no pathological documentation available.Conclusions: Early interstitial cystitis presents variably and usually with only a single symptom of urgency/frequency, nocturia or pain. Clinicians may fail to appreciate the symptoms of early interstitial cystitis, which leads to delayed diagnosis until the patient is more symptomatic. With time multiple symptoms manifest. Bacterial cystitis, prostatitis, endometriosis and chronic pelvic pain are common initial misdiagnoses. Interstitial cystitis should be considered when laboratory documentation of alternate diagnoses is lacking or when patients fail to respond to therapy for alternate diagnoses.