中年婦女間質性膀胱炎與子宮摘除的關係
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
Interstitial cystitis/bladder pain syndrome has association with hysterectomy in middle age female
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: Symptoms of interstitial cystitis/bladder pain syndrome (IC/BPS) are often confused with uterine conditions. Gynecologists may therefore recommend hysterectomy which was inappropriate for these patients. This study investigated whether IC/BPS increases the risk of hysterectomy in a large nationwide retrospective cohort study.
Materials and Methods: From a national insurance database, we identified women diagnosed with IC/BPS between 2002 and 2013. Those with a history of hysterectomy before IC/BPS diagnosis were excluded. All women were stratified into three subgroups (younger, middle, older age) based on the propensity scores of 15 confounding factors, including age and comorbidities. All were followed until the end of 2013 to detect the event of hysterectomy. The hazard ratio (HR) of hysterectomy in the IC/BPS cohort was compared with the non-IC/BPS cohort among the three subgroups by Cox regression after adjusting for confounding factors.
Results: In addition to the representative middle age, subgroup 2 had similar rates of comorbidities as the general population. The study was both externally and internally valid. The risk of hysterectomy in the IC/BPS cohort (n= 536) was significantly higher than in the non-IC/BPS cohort (n = 103846) in subgroup 2 (HR= 1.701, 95 % CI 1.056–2.740).The mean time to hysterectomy after diagnosis of IC/BPS was 2.97 years. In this nationwide study, we found that IC/BPS has a causal impact on hysterectomy in the middle-age subgroup in LHID 2010. The possibility of a woman having IC/BPS should be evaluated prior to hysterectomy to avoid inappropriate surgery.
Conclusions: IC/BPS has a causal impact on hysterectomy in middle age female; the possibility of IC/BPS should be evaluated prior to hysterectomy to avoid inappropriate surgery.