Association between endometriosis and lower urinary tract symptoms
Iwona Gabriel1, Allison F Vitonis2, Stacey A Missmer3
1Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, Massachusetts; Department of Gynecology, Obstetrics and Oncological Gynecology, Medical University of Silesia, Bytom, Poland.
Objective:
To determine if women with endometriosis experience lower urinary tract symptoms (LUTSs) more often than those without.
Design:
Cross-sectional analysis at enrollment in a longitudinal cohort.
Setting:
Enrollment at 2 academic hospitals and from the local community.
Patient(S):
This analysis included 1,161 women with (n = 520) and without (n = 641) surgically confirmed endometriosis who were enrolled in the Women's Health Study: from Adolescence to Adulthood between 2012 and 2018.
Intervention(S):
Not applicable.
Main Outcome Measure(S):
Prevalence of LUTSs, including stress incontinence, urgency and frequency, straining with urination, incomplete bladder emptying, hematuria, dysuria, and bladder pain using standardized questionnaires.
Result(S):
The primary outcomes were that women with endometriosis reported the following more often than those without: difficulty passing urine (7.9% vs. 2%; crude odds ratio [OR], 4.14 [95% confidence interval {CI}, 2.19-7.80]; adjusted OR [aOR], 4.31 [95% CI, 2.07-8.95]); still feeling full after urination (18.8% vs. 4.7%; crude OR, 4.73 [95% CI, 3.08-7.25]; aOR, 4.67 [95% CI, 2.88-7.56]); having to urinate again within minutes of urinating (33.1% vs. 17.0%; crude OR, 2.41 [95% CI, 1.83-3.18]; aOR, 2.49 [95% CI, 1.81-3.43]), dysuria (11.7% vs. 4.9%; crude OR, 2.55 [95% CI, 1.62-4.01]; aOR, 2.38 [95% CI, 1.40-4.02]); and pain when the bladder is full (23.0% vs. 4.9%; crude OR, 5.79 [95% CI, 3.82-8.78]; aOR, 6.04 [95% CI, 3.74-9.76]). For the secondary outcomes, among female participants with endometriosis, we observed that the odds of LUTS did not differ by the revised American Society for Reproductive Medicine stage (I/II vs. III/IV) or duration of endometriosis-associated symptoms.
Conclusion(S):
Women with surgically confirmed endometriosis were more likely to report LUTS than those without.
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