慢性子宫内膜炎的治疗进展

慢性子宫内膜炎(CE)临床表现隐匿,易被忽视,CE可导致反复移植失败、异常子宫出血、白带异常等。目前对于CE的诊断方法有组织病理学检查、免疫组化、宫腔镜检查、病原学培养及影像学检测等。CE的治疗方法多种多样,包括口服抗生素治疗、内膜局部搔刮、宫腔灌注治疗,干细胞治疗及中医辅助治疗等。     

Acute cystitis in young women Diagnosis and treatment

A total of 171 women with the symptoms of acute uncomplicated cystitis were studied, and 162 were treated with sulfa drugs. Neither the history nor the urinalysis were infallible in finding those patients who were truly infected or those who would be cured with sulfonamides. A method of diagnosing and treating these patients is proposed that would virtually eliminate the patient's symptoms and infections as swiftly and economically as possible.     

慢性子宫内膜炎在反复种植失败中的研究进展

慢性子宫内膜炎(CE)是一种非特异性的慢性炎症,其组织学特征是子宫内膜间质区存在浆细胞浸润,临床特征是症状轻微且诊断困难,故容易被忽略.近年来,越来越多的研究表明CE的持续存在与反复种植失败(RIF)密切相关.针对CE进行的抗生素治疗和其他综合治疗方案可有效提高RIF患者的种植成功率及活产率.本文就CE与RIF的关系进...     

慢性子宫内膜炎影响女性生殖结局的相关机制探讨

慢性子宫内膜炎(CE)与女性生殖预后密切相关。目前认为CE是一种子宫内膜结构和功能被破坏的持续性炎症过程,由于局部内膜炎性细胞浸润和炎症介质渗出会改变子宫内膜微环境,影响子宫内膜容受性,不利于胚胎着床,可能是反复移植失败、复发性流产的原因之一。多年来CE由于临床症状轻微、缺乏特异性而被临床医生所忽视,因此本文就CE的微生物学、免疫学以及CE可能影响女性妊娠结局的相关机制进行综述,以期为CE相关不孕症的早期诊断及治疗提供理论依据。     

The tomitsid treatment of chronic cystitis in children

The clinical efficiency of tomicid used in the treatment of childhood cystitis was examined by employing clinical, endoscopic, microbiological, and immunological findings. A total of 140 children were examined. These include 78 with chronic obstructive pyelonephritis without cystitis and 62 with chronic cystitis. The urinary bladder was instilled with reference tomicid solution in 18 children with chronic cystitis during 10-12 days. Tomicid was found to produce bactericidal and anti-inflammatory effects. The immunomodulating effect was shown mainly in young children (aged 1-6 years). The lack of toxic and adverse effects of the drug allows one to recommend for use in pediatric urologic practice.     

Pipemidic acid in the prevention of recurring cystitis in women

The efficacy, safety and acceptability of pipemidic acid in the treatment and the prophylaxis of cystitis in women have been evaluated. After curative treatment, patients received prophylaxis using the compound for a duration of 6 months, and were followed up a further 4 month-period without specific therapy. During the prophylaxis period, no relapse was observed in over 85% of the treated patients. In 15% of cases, a pathogen reappeared along with recurrence of the preexisting symptoms. An increase to 29% of the cases was noted after the withdrawal of the treatment over a month study period. The pathogens involved in the cases of relapse during the prophylaxis period were sensitive to pipemidic acid in 1/3 of cases (6/18 cases), and resistant in 2/3 (12/18 cases) of cases. Those involved in relapses during the observation period were sensitive in 1/2 of the cases (8/16 cases), resistant or intermediate in 1/2 of the cases (8/16 cases). Thus, prophylactic treatment with pipemidic acid has a favorable influence on the number of relapses in patients with recurrent cystitis.     

复发性流产慢性内膜炎患者内膜免疫细胞的变化

目的观察复发性流产(RM)患者中慢性子宫内膜炎(CE)患者内膜免疫细胞表达的变化,以期探讨子宫内膜免疫平衡受损的机制。方法回顾性分析2015年10月至2017年2月在深圳中山泌尿外科医院生殖医学中心就诊的177例RM患者的临床资料,按照是否合并CE分为CE组和非CE组,于黄体中期取子宫内膜样本。免疫组化分析两组内膜CD138、CD56、CD8、Foxp3及CD68的表达情况,并运用Vectra~自动病理成像定量分析系统分别计算各阳性细胞占内膜总细胞的比例。结果 RM患者中CE的发生率为10.2%。与非CE组比较,CE组子宫内膜CD56+NK细胞和CD68+巨噬细胞比例无显著变化(P0.05),而CD8+T细胞比例[(6.29±4.26)%vs.(3.45±1.79)%,P=0.003]和Foxp3+Treg细胞比例[(0.18±0.86)%vs.(0.11±0.75)%,P0.001]显著增高。结论在RM人群中,CE可能导致子宫内膜CD8+T细胞和Foxp3+Treg细胞比例上调,但其具体的分子机制还需进一步研究。     

Quality of life among women with interstitial cystitis

PURPOSE: Clinical case series suggest that the impact of interstitial cystitis on quality of life is severe and debilitating, however, little epidemiologic information is available. We examined the impact of interstitial cystitis on quality of life in a population based cohort of United States women. MATERIALS AND METHODS: We collected multidimensional measures of quality of life from 159,419 participants in the Nurses' Health Study I and II using a validated instrument, the Medical Outcome Study Short-Form 36 Health Survey Instrument. This instrument measures physical function, role limitations due to physical and emotional problems, bodily pain, vitality, social function and mental health. Quality of life measures were collected on 99 women with prevalent self reported interstitial cystitis confirmed by medical record review. RESULTS: After adjusting for age and co-morbid conditions, women with interstitial cystitis had significantly lower quality of life scores in 4 of the 7 quality of life dimensions, including role/physical (beta -13.1, p <0.001), bodily pain (beta -9.8, p <0.001), vitality (beta -7.7, p <0.001) and social function (beta -7.2, p <0.001) compared to women without interstitial cystitis. Women with interstitial cystitis experienced less decrement in physical function compared to women with rheumatoid arthritis but more compared to women with hypertension. In addition, they experienced greater differences in vitality and mental health than women with rheumatoid arthritis or hypertension. CONCLUSIONS: The quality of life among women with interstitial cystitis was especially limited in the psychosocial dimensions, such as vitality and mental health. Future research on interstitial cystitis should incorporate multidimensional measures of quality of life, especially with respect to response to the various treatments.     

Clinical studies on acute uncomplicated cystitis in women]

A total of 499 female patients with acute uncomplicated cystitis were observed and analyzed clinically for age distribution, characteristics of symptoms, bacterial culture of urine, behavioral aspects of recurrent cystitis and others. The patients were between 3 years and 88 years old (average: 43 years) and the majority of patients were from 20 to 69 years old. From 81.1% of the patients Escherichia coli was detected, followed by Staphylococcus spp (11.2%). The major symptoms were pain on urination (421 cases), urinary frequency (421 cases) and residual urine sensation (418 cases). The major causes of cystitis as reported by the patient were fatigue (131 cases), infrequent voiding (114 cases) and exposing the body to coldness (103); only 42 patients reported a relationship between sexual intercourse and cystitis. The patients who had been suffering from "honeymoon cystitis" were significantly inclined to be suffering from acute uncomplicated cystitis again in comparison with those who had not suffered from honeymoon cystitis. There was suggested to be a relationship between sexual intercourse and recurrent cystitis.     

Diagnosis of interstitial cystitis/bladder pain syndrome in women with chronic pelvic pain: a prospective observational study

Introduction and hypothesis

This study assesses the prevalence of interstitial cystitis (IC)/bladder pain syndrome (BPS) in women with chronic pelvic pain (CPP).

Methods

This was a prospective study of 150 women undergoing laparoscopy as investigation for CPP in an Endometriosis and Pelvic Pain unit. Preoperative questionnaires [demographic details, pelvic pain symptoms, the Pelvic Pain and Urgency/Frequency (PUF) and O’Leary-Sant (OLS) Symptom and Problem Index scores] were completed, and concurrent standardized cystoscopy with hydrodistention performed at laparoscopy. The primary outcome measures the proportion of IC in this group, defined by presence of glomerulations with CPP and urinary symptoms (urinary frequency, nocturia, urgency). The secondary outcome measures the proportion of BPS [defined by the European Society of the Study of Interstitial Cystitis (ESSIC)].

Results

IC was diagnosed in 48/150 (32%) individuals, and 80/150 (53%) had BPS. There were no significant differences in symptomatology or questionnaire results between groups with and without IC. Women with BPS had higher PUF (17.2 vs 12.9, p?p?=?0.001) and Problem (7.5 vs 4.2, p?Conclusions The prevalence of IC/BPS varies depending on the definition used. This study showed IC in 32% of women with CPP based on symptoms and presence of glomerulations. BPS as defined by ESSIC was diagnosed in 53%. History and questionnaires did not correlate with positive cystoscopic findings.