間質性膀胱炎與子宮內膜異位的關係
陳韋志1、李明輝1.2、吳惠卿1.2
1衛生福利部豐原醫院 泌尿科；2中台科技大學
Endometriosis is a Risk Factor of Interstitial Cystitis/Bladder Pain Syndrome within Short Interval
-A national population-based study
Wei-Chih Chen1, Ming-Huei Lee1,2, Huei-Ching Wu1,2
1Department of Urology, Feng Yuan Hospital, Ministry of Health
and Welfare, Taichung, Taiwan
2Central Taiwan University of Science and Technology, Taichung, Taiwan
Purpose: Interstitial cystitis/bladder pain syndrome (IC/BPS) and endometriosis frequently coexist and elusive. Both diseases share similar symptoms which are common contribute to chronic pelvic pain. This study aimed to evaluate if endometriosis is a risk of IC/BPS.
Materials and Methods: From a national insurance database, we identified women newly diagnosed with endometriosis between 2002 and 2013. Those with a history of IC/BPS before endometriosis diagnosis were excluded. All women were stratified into two subgroups based on the propensity scores of 10 confounding factors, including age and nine comorbidities (irritable bowel syndrome, depressive disorder, anxiety, fibromyalgia, stress incontinence, acute cystitis and chronic urinary tract infection). All were followed until the end of 2013 to detect the event of IC/BPS diagnosis. The hazard ratio (HR) of IC/BPS in the endometriosis cohort was compared with the non-endometriosis cohort among the two subgroups by Cox regression after adjusting for confounding factors.
Results: In addition to the representative average age, subgroup 2 had similar rates of comorbidities as the general population. The study was both externally and internally valid. The risk of IC/BPS in the endometriosis cohort (n=18006) was significantly higher than in the non-IC/BPS cohort (n=389099) in subgroup 2 (HR= 2.091, 95 % CI 1.641–2.663). The mean time to IC/BPS after diagnosis of endometriosis was 3.76 years.
Conclusions: Endometriosis has association with IC/BPS in our database. Caregivers should cautiously evaluate the possibility of IC/BPS in women with diagnosis of endometriosis.