Is urinary incontinence associated with lichen sclerosus in females? A systematic review and meta-analysis.
Is urinary incontinence associated with lichen sclerosus in females? A systematic review and meta-analysis.
复制标题
女性尿失禁与硬化性苔藓有关吗？系统综述和荟萃分析。
DOI：
10.1002/ski2.13
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发表时间：
2021-03
影响因子：
--
通讯作者：
Simpson, R
中科院分区：
文献类型：
--
作者：
Kirby, L;Gran, S;Kreuser-Genis, I;Owen, C;Simpson, R
硬化性苔藓是一种瘢痕性慢性炎症性疾病，好发于男性和女性生殖器皮肤。LS的病因是有争议的，但越来越多的证据表明，封闭暴露的敏感上皮细胞的尿液参与生殖器LS的发病机制在男性。这一理论尚未在女性中得到有力的研究。本综述和Meta分析研究了女性尿失禁（UI）与生殖器苔藓LS之间是否存在相关性。我们对MEDLINE、Embase和CINAHL进行了全面检索，以确定评估LS女性UI患病率的观察性研究。使用DerSimonian和Laird随机效应模型估计与对照组相比的总体合并患病率和风险比。评估了异质性。共有8项研究符合纳入标准，5项研究被纳入Meta分析。三项研究被评为中等质量，五项研究被评为较差。LS中UI的合并患病率为0. 35（95%置信区间[CI] 0. 13 - 0. 58，I 2 = 98. 4%）。LS患者发生UI的危险比为0.97（95% CI 0.5 3 ~ 1.75，I2 = 87.5%）。LS患者和无LS患者的UI似乎无差异。研究受到临床和方法学质量的限制，异质性很高。需要设计良好的前瞻性研究。
Lichen sclerosus (LS) is a scarring chronic inflammatory disease with a predilection for genital skin in both sexes. The aetiology of LS is controversial, but evidence increasingly suggests that the occluded exposure of susceptible epithelium to urine is involved in the pathogenesis of genital LS in males. This theory has not yet been robustly investigated in females. This review and meta‐analysis examined whether there is an association between urinary incontinence (UI) and genital lichen LS in females. We performed a comprehensive search of MEDLINE, Embase and CINAHL to identify observational studies assessing the prevalence of UI in females with LS. DerSimonian and Laird random‐effects models were used to estimate the overall pooled prevalence and risk ratio compared to controls. Heterogeneity was assessed. In total, eight studies met the inclusion criteria and five studies were included in a meta‐analysis. Three studies were graded as moderate quality and five were poor. The pooled prevalence for UI in LS was 0.35 (95% confidence interval [CI] 0.13–0.58, I 2 = 98.4%). The risk ratio of UI in LS was 0.97 (95% CI 0.53–1.75, I 2 = 87.5%). There appears to be no difference between patients with LS and those without LS in terms of UI. Studies are limited by clinical and methodological quality and heterogeneity is high. Well‐designed prospective studies are needed.