台灣地區間質性膀胱炎對是否子宮摘除之世代研究
張崑敏、李明輝1,2、吳聖良3、林宣宏2、吳惠卿1,2
衛生福利部豐原醫院 婦產科; 1衛生福利部豐原醫院 泌尿科; 2中臺科技大學;
3澳洲格里菲斯大學
A cohort study of interstitial cystitis/bladder pain syndrome (ic/bps) and hysterectomy in taiwan:
A nationwide population-based,
Propensity score–matched cohort study
Kun-Min Chang 1,2 *Ming-Huei Lee 2,3, Shang-Liang Wu4, Hsuan-Hung Lin2, Hsiu-Ying Lin 5, Huei-Ching Wu2,3
1Department of Obstetrics and Gynecology, Feng Yuan Hospital, Ministry of Health and welfare, Taichung, Taiwan, Republic of China; 2Central Taiwan University of Science and Technology, Taichung, Taiwan, Republic of China; 3Department of Urology, Feng Yuan Hospital, Ministry of Health and welfare, Taichung, Taiwan, Republic of China; 4Centre for Environment and Population Health, Griffith University, Australia; 5Department of anaesthesiology, Feng Yuan Hospital, Ministry of Health and welfare,, Taichung, Taiwan, Republic of China
Purpose:
Symptoms of Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS) are often confused with uterine conditions. Gynecologists may therefore recommend hysterectomy for these patients. We investigate if IC/BPS increases the risk of hysterectomy in a large nationwide cohort study.
Materials and Methods:
We performed a retrospective cohort study of Longitudinal Health Insurance Database 2010 with newly diagnosis of female IC/BPS from 2002 through 2013. After limiting our sample to female patients with IC/BPS diagnosis (ICD-9 code 595.1 at least once during the study period), we identified the IC/BPS cohort. We then excluded female patients who had been received hysterectomy (ICD-9 procedures codes, 68.4、68.41、68.49、68.51、68.59) before IC diagnosis. We defined the logit of predicted probability of hysterectomy as a propensity score using the confounding factors including age and five comorbidities. Subjects with IC/BPS were matched on a one-to-one basis with subjects without IC/BPS by propensity score. The primary outcome was the event of hysterectomy after the entry dates. The hazard ratio (HR) of hysterectomy in the IC/BPS cohort was compared with the non-IC/BPS cohort by Cox regression after adjusting for confounding factors.
Results:
After matched by propensity score, we identified an IC/BPS cohort with 1507 female subjects and a matched non-IC/BPS cohort with 1507 female subjects. The hazard ratio (HR) of hysterectomy in non-IC/BPS cohort compare with IC/BPS cohort is 2.932 (95% CI=2.018-4.261, p=.000) after controlling the age and five comorbidities by Cox regression analysis
Conclusions:
Our results imply us that the incidence of hysterectomy was lower, instead of higher, in PBS/IC female patient after PBS/IC diagnosed in these matched subjects. That is, PBS/IC is a protective factor of hysterectomy for Taiwan female. The incidence of hysterectomy of PBS/IC female patient before PBS/IC diagnosed should be further investigated to clarify the relationship between PBS/IC and hysterectomy.