Hormonal manipulation in women with chronic, cyclic irritable bladder symptoms and pelvic pain
Hormonal manipulation in women with chronic, cyclic irritable bladder symptoms and pelvic pain
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DOI：
10.1067/mob.2002.123729
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发表时间：
2002-06-01
影响因子：
9.8
通讯作者：
Smalldridge, J
中科院分区：
文献类型：
--
作者：
Lentz, GM;Bavendam, T;Smalldridge, J
目的：慢性膀胱疼痛症状是泌尿科医生和妇科医生诊断和治疗的挑战。本研究的目的是评估妇女月经周期相关的变化，在他们的间质性膀胱炎的症状，治疗他们与激素的操作，并遵循他们长期。研究设计：妇女谁被称为三级保健中心与间质性膀胱炎和月经周期恶化的症状的情况下进行了评估，在一项回顾性研究。15名妇女接受了腹腔镜检查，随后立即进行膀胱镜检查和膀胱水扩张。然后用醋酸亮丙瑞林或口服避孕药治疗患者。症状持续时间为1至26年。10名患者（67%）同时发现间质性膀胱炎和腹膜子宫内膜异位症。15例患者中有5例（33%）患有间质性膀胱炎，但未发现子宫内膜异位症。9例接受醋酸亮丙瑞林治疗的女性中有8例症状改善，6例接受口服避孕药治疗的女性中有5例症状改善。患者平均随访55 month.CONCLUSION：诊断性腹腔镜检查应考虑与膀胱水扩张的妇女盆腔疼痛和刺激性膀胱症状，prepreperialally加剧。子宫内膜异位症常出现在具有这些复杂症状的患者中。这是第一个报告的激素治疗慢性，周期性膀胱刺激症状，改善似乎发生，即使子宫内膜异位症没有确定腹腔镜检查。
OBJECTIVE: Chronic, painful bladder symptoms are diagnostic and therapeutic challenges for urologists and gynecologists. The aims of this study were to evaluate women with menstrual cycle-related changes in their interstitial cystitis symptoms, to treat them with hormonal manipulation, and to follow them long term.STUDY DESIGN: The cases of women who were referred to a tertiary care center with interstitial cystitis and menstrual cycle exacerbation of symptoms were evaluated in a retrospective study. Fifteen women had undergone laparoscopy that was followed immediately by cystoscopy and bladder hydrodistension. Patients were then treated with leuprolide acetate or oral contraceptive pills.RESULTS: Patient age ranged from 23 to 48 years. The duration of symptoms ranged from 1 to 26 years. Ten patients (67%) had findings of both interstitial cystitis and peritoneal endometriosis. Five of 15 patients (33%) had interstitial cystitis, but no endometriosis was found. Symptoms improved for 8 of 9 women who were treated with leuprolide acetate and for 5 of 6 women who were treated with oral contraceptive pills. Patients were followed up for an average of 55 months.CONCLUSION: Diagnostic laparoscopy should be considered together with hydrodistension of the bladder for women with pelvic pain and irritative bladder symptoms that are exacerbated premenstrually. Endometriosis is often present in patients with these complex symptoms. This is the first report of hormonal treatment for chronic, cyclic irritative bladder symptoms; improvement appears to occur even when endometriosis is not identified by laparoscopy.