Abstract：
OBJECTIVE: To enhance evidence-based knowledge on long-term sequalae in patients with surgically corrected obstructing Müllerian anomalies.
METHODS: This long-term case-control study included patients with menstrual outflow obstruction due to congenital anomalies of the uterus or vagina, who were at least 18 years old, and for whom 2 years had elapsed since the first surgery at the start of this study. The control group consisted of women without current gynecological problems. Patients underwent a surgical correction at the Radboud University Medical Center Nijmegen between 1980 and 2013. Of 78 patients approached, 38 (49%) were included in this study. The control group consisted of 54 females. The main outcome measures were pain and health state. The following questionnaires were used: Visual Analogue Scale pain scores, European Quality of Life-5 Dimensions questionnaire (EQ-5D-3L) and the adapted Endometriosis Health Profile questionnaire (EHP-30).
RESULTS: Patients had higher actual and maximum abdominal pain scores compared with controls (11 vs 0 [P = 0.007] and 48 vs 21 [P = 0.035], respectively). Based on the EQ-5D-3L scores, patients had more pain and discomfort (P = 0.005), more mood problems (P = 0.023), and a poorer subjective health state (P = 0.002) and self-rated health state (P = 0.031). Based on the EHP-30, patients had a significant poorer self-rated health state on four out of five subscales.
CONCLUSIONS: In this study, following surgically corrected menstrual obstruction, patients had statistically significant higher abdominal pain scores and a poorer self-rated health state compared with controls.
METHODS: This long-term case-control study included patients with menstrual outflow obstruction due to congenital anomalies of the uterus or vagina, who were at least 18 years old, and for whom 2 years had elapsed since the first surgery at the start of this study. The control group consisted of women without current gynecological problems. Patients underwent a surgical correction at the Radboud University Medical Center Nijmegen between 1980 and 2013. Of 78 patients approached, 38 (49%) were included in this study. The control group consisted of 54 females. The main outcome measures were pain and health state. The following questionnaires were used: Visual Analogue Scale pain scores, European Quality of Life-5 Dimensions questionnaire (EQ-5D-3L) and the adapted Endometriosis Health Profile questionnaire (EHP-30).
RESULTS: Patients had higher actual and maximum abdominal pain scores compared with controls (11 vs 0 [P = 0.007] and 48 vs 21 [P = 0.035], respectively). Based on the EQ-5D-3L scores, patients had more pain and discomfort (P = 0.005), more mood problems (P = 0.023), and a poorer subjective health state (P = 0.002) and self-rated health state (P = 0.031). Based on the EHP-30, patients had a significant poorer self-rated health state on four out of five subscales.
CONCLUSIONS: In this study, following surgically corrected menstrual obstruction, patients had statistically significant higher abdominal pain scores and a poorer self-rated health state compared with controls.
摘要：
目的：加强对经手术矫正的梗阻性苗勒氏畸形患者的长期后遗症的循证知识。
方法：这项长期病例对照研究包括因子宫或阴道先天性异常而导致月经流出道阻塞的患者，他们至少18岁，并且自本研究开始时的第一次手术以来已经过去了2年。对照组由目前没有妇科问题的妇女组成。患者在1980年至2013年之间在Radboud大学医学中心Nijmegen进行了手术矫正。在接受治疗的78名患者中，38（49％）被纳入本研究。对照组由54名女性组成。主要结局指标为疼痛和健康状况。使用以下问卷：视觉模拟疼痛评分，欧洲生活质量5维度问卷（EQ-5D-3L）和适应的子宫内膜异位症健康概况问卷（EHP-30）。
结果：患者的实际和最大腹痛评分高于对照组（11vs0[P=0.007]和48vs21[P=0.035]，分别)。根据EQ-5D-3L的分数,患者有更多的疼痛和不适（P=0.005），更多的情绪问题（P=0.023），主观健康状况(P=0.002)和自评健康状况(P=0.031)较差。根据EHP-30，在五个子量表中的四个中，患者的自我评估健康状况明显较差。
结论：在这项研究中，手术矫正月经阻塞后，与对照组相比,患者的腹痛评分显著较高,自评健康状况较差.
方法：这项长期病例对照研究包括因子宫或阴道先天性异常而导致月经流出道阻塞的患者，他们至少18岁，并且自本研究开始时的第一次手术以来已经过去了2年。对照组由目前没有妇科问题的妇女组成。患者在1980年至2013年之间在Radboud大学医学中心Nijmegen进行了手术矫正。在接受治疗的78名患者中，38（49％）被纳入本研究。对照组由54名女性组成。主要结局指标为疼痛和健康状况。使用以下问卷：视觉模拟疼痛评分，欧洲生活质量5维度问卷（EQ-5D-3L）和适应的子宫内膜异位症健康概况问卷（EHP-30）。
结果：患者的实际和最大腹痛评分高于对照组（11vs0[P=0.007]和48vs21[P=0.035]，分别)。根据EQ-5D-3L的分数,患者有更多的疼痛和不适（P=0.005），更多的情绪问题（P=0.023），主观健康状况(P=0.002)和自评健康状况(P=0.031)较差。根据EHP-30，在五个子量表中的四个中，患者的自我评估健康状况明显较差。
结论：在这项研究中，手术矫正月经阻塞后，与对照组相比,患者的腹痛评分显著较高,自评健康状况较差.
