Enzian和rASRM分类预测子宫内膜异位症性功能障碍症状的比较

IF 3.3 3区 医学 Q1 UROLOGY & NEPHROLOGY
Paula Norinho, Rosa Zulmira Vaz de Macedo, Mariana M Martins, Hélder Ferreira
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引用次数: 0

摘要

背景:众所周知,子宫内膜异位症对性功能有负面影响;然而,有限的研究已经探讨了分类系统是否可以帮助确定与性功能障碍相关的特定解剖位置。由于缺乏关于分类系统的文献,临床医生可以将特定的性功能障碍症状与深度浸润性子宫内膜异位症(DIE)的特定部位联系起来,因此有必要进行这项研究。目的:本研究旨在探讨Enzian和修订的美国生殖医学学会(rASRM)分类系统是否可以根据DIE的定位和程度预测性功能障碍。方法:对组织学证实的女性死亡患者77例进行临床研究。数据收集自使用rASRM和Enzian系统分类的妇科咨询和手术报告。使用女性性功能指数评估性功能。统计分析包括Fisher精确检验、Mann-Whitney检验和Student t检验。结果:主要结果是检查子宫内膜异位症的定位、疾病程度和性功能障碍之间的关系,这是两种分类系统所显示的。结果:性功能障碍与Enzian B分类之间可能存在关联(p = 0.013*),暗示累及骶骨韧带、枢机韧带或骨盆侧壁。性功能障碍与rASRM评分之间未发现显著关联。子宫内膜异位的数量与性功能障碍的存在也存在相关性(p = 0.015*)。然而,值得注意的是,归类为Enzian B的患者可能在其他部位有额外的、未记录的病变,这些病变未通过现有的医疗记录、影像学或手术报告发现。这些未知的病变可能影响了他们的性功能障碍,在我们的分析中代表了一个潜在的混杂因素。临床意义:这些发现提示DIE的定位可能与性功能障碍有关,但在得出手术干预的临床结论之前,还需要进一步的验证。优势与局限性:这是第一个探索分类系统将子宫内膜异位症中的性功能障碍精确定位到特定解剖位置的能力的研究,为DIE对性健康的影响提供了新的见解。然而,转诊来源的可变性、未记录病变的可能性以及性功能障碍病例的小样本量可能限制了这些发现的普遍性。结论:疾病定位,特别是在子宫骶韧带和骨盆侧壁可能与性功能障碍有关,为临床评价提供了潜在的指导。然而,需要进一步的研究来验证这些关联,同时考虑潜在的混杂因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparison of Enzian and rASRM classifications in predicting symptoms of sexual dysfunction in endometriosis.

Background: Endometriosis is known to negatively impact sexual function; however, limited research has explored whether classification systems can help pinpoint specific anatomical locations associated with sexual dysfunction. This study was necessitated by the paucity of literature on classification systems that allow clinicians to associate specific symptoms of sexual dysfunction with particular locations of deep infiltrating endometriosis (DIE).

Aim: This study aimed to investigate whether the Enzian and revised American Society for Reproductive Medicine (rASRM) classification systems can predict sexual dysfunction based on the localization and extent of DIE.

Methods: A clinical study was conducted with 77 women with histologically confirmed DIE. Data were collected from gynecological consultations and surgical reports classified using the rASRM and Enzian systems. Sexual function was assessed using the Female Sexual Function Index. Statistical analyses included Fisher's exact test, Mann-Whitney test, and Student's t-test.

Outcomes: The primary outcome was to examine the relationship between endometriosis localization, disease extent, and sexual dysfunction as indicated by the two classification systems under investigation.

Results: A possible association was identified between sexual dysfunction and Enzian B classification (p = 0.013*), implicating involvement of the sacrouterine ligaments, cardinal ligaments, or pelvic sidewall. No significant association was found between sexual dysfunction and rASRM scores. A correlation between the number of endometriosis locations and the presence of sexual dysfunction was also observed (p = 0.015*). However, it is important to note that patients classified as Enzian B may have had additional, undocumented lesions in other locations not identified through available medical records, imaging, or surgical reports. These unidentified lesions could have influenced their sexual dysfunction, representing a potential confounding factor in our analysis.

Clinical implications: These findings suggest that the localization of DIE may contribute to sexual dysfunction, but further validation is required before drawing clinical conclusions regarding surgical interventions.

Strengths & limitations: This is the first study to explore the ability of a classification system to pinpoint sexual dysfunction in endometriosis to a particular anatomical location, providing novel insights into DIE's impact on sexual health. However, variability in referral sources, the potential for undocumented lesions, and a small sample size for cases of sexual dysfunction may limit the generalizability of these findings.

Conclusion: Disease localization, particularly in the uterosacral ligaments and pelvic sidewall, may contribute to sexual dysfunction, offering potential guidance for clinical evaluation. However, further research is necessary to validate these associations while accounting for potential confounding factors.

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来源期刊
Journal of Sexual Medicine
Journal of Sexual Medicine 医学-泌尿学与肾脏学
CiteScore
6.20
自引率
5.70%
发文量
826
审稿时长
2-4 weeks
期刊介绍: The Journal of Sexual Medicine publishes multidisciplinary basic science and clinical research to define and understand the scientific basis of male, female, and couples sexual function and dysfunction. As an official journal of the International Society for Sexual Medicine and the International Society for the Study of Women''s Sexual Health, it provides healthcare professionals in sexual medicine with essential educational content and promotes the exchange of scientific information generated from experimental and clinical research. The Journal of Sexual Medicine includes basic science and clinical research studies in the psychologic and biologic aspects of male, female, and couples sexual function and dysfunction, and highlights new observations and research, results with innovative treatments and all other topics relevant to clinical sexual medicine. The objective of The Journal of Sexual Medicine is to serve as an interdisciplinary forum to integrate the exchange among disciplines concerned with the whole field of human sexuality. The journal accomplishes this objective by publishing original articles, as well as other scientific and educational documents that support the mission of the International Society for Sexual Medicine.
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