Polysymptomatic, Polysyndromic Presentation of Patients With Urological Chronic Pelvic Pain Syndrome
Polysymptomatic, Polysyndromic Presentation of Patients With Urological Chronic Pelvic Pain Syndrome
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DOI：
10.1016/j.juro.2012.01.081
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发表时间：
2012-06-01
影响因子：
6.6
通讯作者：
Hong, Barry A.
中科院分区：
文献类型：
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作者：
Lai, H. Henry;North, Carol S.;Hong, Barry A.
目的：躯体化障碍已被描述为泌尿科慢性盆腔疼痛综合征的几种共病功能综合征，例如肠易激综合征。我们调查了一部分泌尿科慢性盆腔疼痛综合征患者是否可能具有躯体化障碍中常见的多症状、多综合征表现模式。材料和方法：共有 70 名男性和女性泌尿科慢性盆腔疼痛综合征患者和 35 名年龄匹配的无该综合征的对照者完成了一份 59 项症状检查表，以评估典型的多症状、多综合征症状模式。使用的 2 个操作工具是 Perley-Guze 衍生症状检查表和用于《诊断和统计手册》第 4 版文本修订躯体化障碍标准的躯体症状算法。 结果：患有泌尿科慢性盆腔疼痛综合征（间质性膀胱炎/膀胱疼痛综合征）的女性患者报告的骨盆外非疼痛症状和疼痛症状明显多于对照女性泌尿科患者（p = 0.0016 和 0.0018，分别）。与女性对照相比，患有泌尿科慢性盆腔疼痛综合征的女性患者更有可能认同多症状、多综合征症状模式（27% vs 0%，p = 0.0071）。相比之下，患有泌尿科慢性盆腔疼痛综合征（间质性膀胱炎/膀胱疼痛综合征和/或慢性前列腺炎/慢性盆腔疼痛综合征）的男性患者并未报告比男性对照更多的盆腔外疼痛（p = 0.89）。患有泌尿科慢性盆腔疼痛综合征的男性患者并不比男性对照组更容易出现多症状、多综合征症状模式。结论：一部分患有泌尿科慢性盆腔疼痛综合征的女性患者存在跨多个器官系统的多种盆腔外症状。该清单对于评估患者的这种多症状、多综合征症状模式可能很有价值，这种症状在躯体化障碍中很常见。认识到这种多症状、多综合征的表现将促使临床医生进一步调查，以确定躯体化障碍是否可能是一小部分患有泌尿科慢性盆腔疼痛综合征且主诉有多种盆腔外症状的患者的潜在诊断。
Purpose: Somatization disorder has been described in several comorbid functional syndromes of urological chronic pelvic pain syndrome, such as irritable bowel syndrome. We investigated whether a subset of patients with urological chronic pelvic pain syndrome may have the polysymptomatic, polysyndromic presentation pattern that is common in somatization disorder.Materials and Methods: A total of 70 male and female patients with urological chronic pelvic pain syndrome and 35 age matched controls without the syndrome completed a 59-item symptom checklist to assess the classic polysymptomatic, polysyndromic symptom pattern. The 2 operational tools used were the Perley-Guze derived symptom checklist and the somatic symptom algorithm used for Diagnostic and Statistical Manual, 4th Edition, Text Revision somatization disorder criteria.Results: Female patients with urological chronic pelvic pain syndrome (interstitial cystitis/bladder pain syndrome) reported significantly more nonpain symptoms and pain symptoms outside the pelvis than control female urology patients (p = 0.0016 and 0.0018, respectively). Female patients with urological chronic pelvic pain syndrome were more likely to endorse a polysymptomatic, polysyndromic symptom pattern than female controls (27% vs 0%, p = 0.0071). In contrast, male patients with urological chronic pelvic pain syndrome (interstitial cystitis/bladder pain syndrome and/or chronic prostatitis/chronic pelvic pain syndrome) did not report more extrapelvic pain than male controls (p = 0.89). Male patients with urological chronic pelvic pain syndrome were not more likely than male controls to have a polysymptomatic, polysyndromic symptom pattern.Conclusions: A subset of female patients with urological chronic pelvic pain syndrome endorses numerous extrapelvic symptoms across multiple organ systems. The checklist may be valuable to assess patients for this polysymptomatic, polysyndromic symptom pattern, which is common in somatization disorder. Recognizing this polysymptomatic, polysyndromic presentation will prompt clinicians to investigate further to determine whether somatization disorder may be an underlying diagnosis in a small subset of patients with urological chronic pelvic pain syndrome who complain of numerous extrapelvic symptoms.