Menorrhagia and Uterine Volume Associated with Lower Urinary Tract Symptoms in Patients with Adenomyosis  

作　　者：Ting Li Xiao-Xuan Xu Yi Dai Jun-Ji Zhang Jing-He Lang Jin-Hua Leng 

机构地区：[1]Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100730, China

出　　处：《Chinese Medical Journal》2017年第13期1552-1556,共5页中华医学杂志（英文版）

摘　　要：Background： Adenomyosis is a gynecological disorder with symptoms most presenting as dysmenorrhea and heavy menstrual bleeding. However, the presence of lower urinary tract symptoms （LUTS） among women with adenomyosis remains unclear. This study was designed to determine the prevalence of LUTS and factors related to the severity of these symptoms in this population. Methods： From July 2016 to November 2016, a total of 298 untreated symptomatic adenomyosis patients and 280 age-matched controls were enrolled. Demographics, LUTS, pain symptoms, ultrasouographic uterine size, and serum CA125 level were recorded. LUTS were evaluated using the International Prostate Symptom Score （IPSS） questionnaire. Factors related to the severity of LUTS were detected using the logistic regression analysis presented as odds ratio （OR） and 95% confidence interval （CI）. Results： Compared with the control group, patients with adenomyosis had a greater IPSS total （4 [2-8] vs. 2 [0-3], Z = -8.159, P 〈 0.001 ）, IPSS storage （2 [1-4] vs. [[0 2], Z = -7.361 [P 〈 0.001）, and I PSS voiding （2 [0-4] vs. 0 [0-1], Z = -7.[94, P 〈 0.001）. Of the patients with adenomyosis, 30.2% had moderate-to-severe lower urinary tract symptoms （IPSS 〉8）. The most prevalent LUTS were daytime frequency （40.9%）, lbllowed by nocturia （24.8%）, weak stream （24.2%）, and incomplete emptying （23.5%）. In study group, patients with an IPSS total score ≥8 had higher proportion of menorrhagia （51.1% vs. 30.8%, χ2 = 11. 162 P = 0.025） and larger uterine volumes （183.3 [109.8-273.8] cm3 vs. 148.5 [96.4-262.7] cm3, Z=- 1.441, P = 0.150） compared to patients with an IPSS total score 〈8. On multivariate logistic regression analysis, patients with menorrhagia were associated with an increased risk of an IPSS total score 〉8 （OR： 2.309, 95% CI： 1.310-4.070, P= 0.004）, an IPSS storage subscore 〉4 （OR： 2.422, 95% CI： 1.395-4.206, P= 0.002）, and an IPSS voiding subscore 〉5 （OR： 1.971, Background： Adenomyosis is a gynecological disorder with symptoms most presenting as dysmenorrhea and heavy menstrual bleeding. However, the presence of lower urinary tract symptoms （LUTS） among women with adenomyosis remains unclear. This study was designed to determine the prevalence of LUTS and factors related to the severity of these symptoms in this population. Methods： From July 2016 to November 2016, a total of 298 untreated symptomatic adenomyosis patients and 280 age-matched controls were enrolled. Demographics, LUTS, pain symptoms, ultrasouographic uterine size, and serum CA125 level were recorded. LUTS were evaluated using the International Prostate Symptom Score （IPSS） questionnaire. Factors related to the severity of LUTS were detected using the logistic regression analysis presented as odds ratio （OR） and 95% confidence interval （CI）. Results： Compared with the control group, patients with adenomyosis had a greater IPSS total （4 [2-8] vs. 2 [0-3], Z = -8.159, P 〈 0.001 ）, IPSS storage （2 [1-4] vs. [[0 2], Z = -7.361 [P 〈 0.001）, and I PSS voiding （2 [0-4] vs. 0 [0-1], Z = -7.[94, P 〈 0.001）. Of the patients with adenomyosis, 30.2% had moderate-to-severe lower urinary tract symptoms （IPSS 〉8）. The most prevalent LUTS were daytime frequency （40.9%）, lbllowed by nocturia （24.8%）, weak stream （24.2%）, and incomplete emptying （23.5%）. In study group, patients with an IPSS total score ≥8 had higher proportion of menorrhagia （51.1% vs. 30.8%, χ2 = 11. 162 P = 0.025） and larger uterine volumes （183.3 [109.8-273.8] cm3 vs. 148.5 [96.4-262.7] cm3, Z=- 1.441, P = 0.150） compared to patients with an IPSS total score 〈8. On multivariate logistic regression analysis, patients with menorrhagia were associated with an increased risk of an IPSS total score 〉8 （OR： 2.309, 95% CI： 1.310-4.070, P= 0.004）, an IPSS storage subscore 〉4 （OR： 2.422, 95% CI： 1.395-4.206, P= 0.002）, and an IPSS voiding subscore 〉5 （OR： 1.971,

关 键 词：ADENOMYOSIS International Prostate Symptom Score Lower Urinary Tract Symptoms 

分 类 号：O212.1[理学—概率论与数理统计] S858.237.2[理学—数学]