男性前列腺炎和间质性膀胱炎诊断不足

亚特兰大(EGMN) ——密歇根大学的Anne Suskind博士在美国泌尿学会(AUA)年会上报告，男性中的间质性膀胱炎和慢性盆腔疼痛可能比预想的更常见。这项全国性电话调查显示，大约有200万美国男性患有上述疾病之一。

Suskind博士及其同事进行了与RAND IC流行病学研究(RICE)女性调查(迄今最大型的间质性膀胱炎流行病学研究，发现高达6.5%的美国女性可能患有间质性膀胱炎)相似的电话调查。这项以男性为目标的调查中使用了经验证的RICE版定义评估男性问题。慢性前列腺炎定义为国立卫生研究院慢性前列腺炎症状指数数值>5，并伴有射精痛或会阴区疼痛。研究者联系了6,072个家庭，询问男性居民是否愿意接受关于奥巴马总统政绩的调查。如回答为肯定便继续调查，并在政治问题结束时询问关于泌尿系疼痛的问题。

结果显示，最初有296例男性为膀胱症状阳性，其中149例符合间质性膀胱炎或前列腺炎的入选诊断标准。在这149例患者中，52例在最终的分析中被排除。在其余97例受试者中，23%符合间质性膀胱炎/膀胱疼痛综合征的高特异性定义，16%符合慢性前列腺炎/慢性盆腔疼痛综合征的病例定义，8%同时符合上述两种定义。

根据上述结果推导，Suskind博士估计，美国成年男性中有多达200万人符合其中任意一种疾病的诊断定义。进一步分析显示，两种情况之间的重叠比例很低，仅为17%，提示两种疾病在诊断时很容易区分。

Suskind博士披露无相关利益冲突。

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BY MICHELE G. SULLIVAN
Elsevier Global Medical News
Breaking News

ATLANTA (EGMN) – Interstitial cystitis and chronic pelvic pain may be more common in males than assumed.

A national telephone survey shows that about 2 million U.S. men may suffer from either of the disorders, Dr. Anne Suskind said during a poster session at the annual meeting of the American Urological Association.

“We found that anywhere from 1% to 2.5% of men report symptoms suggestive of interstitial cystitis and a similar number report symptoms suggestive of chronic prostatitis or chronic pelvic pain,” said Dr. Suskind, a fellow at the University of Michigan, Ann Arbor. “The degree of overlap is less than 20%”
Dr. Suskind and her colleagues conducted a telephone survey similar to the RAND IC Epidemiology Study (RICE) survey of women. That study – the largest interstitial cystitis epidemiology study ever undertaken – found that up to 6.5% of U.S. women may have the disorder.

The male-targeted survey used versions of the RICE validated definitions to assess problems in men. Chronic prostatitis was considered a value of greater than 5 on the National Institute of Health Chronic Prostatitis Symptom Index, plus ejaculatory or perineal pain.

Researchers contacted 6,072 households, asking if the male resident would be willing to answer a survey about President Obama’s performance. If the answer was yes, the survey ensued, with questions about any urinary tract pain attached at the end of the political questions.

Initially, 296 men screened positive for the bladder symptoms; 149 of these men met inclusionary diagnostic criteria for interstitial cystitis or prostatitis. Of these, 52 were excluded from the final analysis.
Based on the remaining sample of 97 subjects, 23% met the high specificity definition of interstitial cystitis/ bladder pain syndrome, 16% met the case definition of chronic prostatitis/chronic pelvic pain syndrome, and 8% met both definitions.

By extrapolating the numbers to the entire U.S. adult male population, Dr. Suskind concluded that up to 2 million men would meet the diagnostic definition for either of the disorders. A further analysis showed that the overlap between the two conditions was small – about 17% – indicating that they could be easily diagnostically differentiated.

“These conditions appear to be more widespread in men than many of us have believed,” she concluded.
Dr. Suskind reported having no financial disclosures.