Vulvar lichen sclerosus in women is associated with lower urinary tract symptoms

Christmann-Schmid, Corina; Hediger, Melanie; Gröger, Sabine; Krebs, Jörg; Günthert, Andreas R.

doi:10.1007/s00192-017-3358-8

Cited by 14 publications

(10 citation statements)

References 15 publications

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“…In agreement with previous studies, 17 , 27 lower urinary tract symptoms were more common in our LS patients. Similar rates of lower urinary tract symptoms have been described in women with biopsy-proven LS and vulvar diseases without LS.…”

Section: Discussionsupporting

confidence: 94%

Comorbidity of Urogynecological and Gastrointestinal Disorders in Female Patients With Lichen Sclerosus

Hieta

Kurki

Orte

et al. 2023

J Low Genit Tract Dis

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Objective: Lichen sclerosus (LS) is a chronic inflammatory disease with a significant impact on quality of life. The aim of this cross-sectional casecontrol study was to characterize concomitant urogynecological and gastrointestinal disorders in female patients with LS.Methods: A medical records search between 2004 and 2012 yielded 455 women and girls (mean age 64 years) with LS. The study cohort was compared with a 10-fold age-and sex-matched control cohort. Gynecological cancers and their precursors; gynecological, urinary, and gastrointestinal disorders; and pain syndromes were evaluated. Results:The well-known association between LS and increased risk of vulvar cancer and its precursors was also found in our study (relative risk [RR] = 100.0; p < .001 and high-grade squamous intraepithelial lesions RR = 110.0; p < .001, respectively), but we also found an increased risk for cervical cancer (RR = 6.0; p = .005) and endometrial cancer (RR = 2.9; p < .001). Gynecological pain syndromes such as dyspareunia (RR = 20.0; p < .001) and interstitial cystitis (RR = 5.0; p < .001) and urinary incontinence (RR = 4.8; p < .001) were also increased. Among gastrointestinal disorders, we found increased risk for celiac disease (RR = 6.8; p < .001), diverticular intestine diseases (RR = 1.9; p < .001), functional intestinal disorders (RR = 2.3; p = .003), and anal and rectal fissures (RR = 2.4; p = .046). Conclusions:We found that female patients with LS have an increased risk for gynecological cancers as well as for several urogynecological and gastrointestinal disorders. Increased awareness is required to identify and treat these concomitant disorders.

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Section: Discussionsupporting

confidence: 94%

Comorbidity of Urogynecological and Gastrointestinal Disorders in Female Patients With Lichen Sclerosus

Hieta

Kurki

Orte

et al. 2023

J Low Genit Tract Dis

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“…The odds of developing lower urinary tract symptoms have been reported as being four times higher in women with VLS than in those without VLS, 8‐10 but our study found that urinary incontinence and interstitial cystitis were not associated with lichen sclerosus in a multiple regression analysis that also included age. Given the well‐described correlation between urinary symptoms and age, it is possible that previous associations could be attributable to an older‐age bias in the VLS population.…”

Section: Discussioncontrasting

confidence: 76%

The prevalence of self‐reported medical comorbidities in patients with vulvar lichen sclerosus: A single‐center retrospective study

Hesson

Haefner

et al. 2020

Intl J Gynecology & Obste

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Objective To compare the demographics and self‐reported medical comorbidities of patients with vulvar lichen sclerosus (VLS) with those of women with other vulvar conditions. Methods Intake questionnaires for patients presenting to the University of Michigan Center for Vulvar Diseases between 1996 and 2019 were entered into a de‐identified database (n = 1983). Responses to questions about thyroid disease, urinary symptoms and signs, gastrointestinal conditions, and pain conditions were collected. Results A total of 1983 women, including 865 patients with VLS and 1118 patients without VLS were enrolled. Pearson's χ2 analysis showed that age, hypertension, anorectal fissures, peptic ulcer disease/gastroesophageal reflux disease, urinary incontinence, fibromyalgia, thyroid disease, kidney problems, liver problems, and cancer were significantly associated with VLS when compared between the VLS and non‐VLS groups (P < 0.01). However, multiple regression analysis demonstrated that only age, thyroid disease, and anorectal fissures were strongly associated with VLS (P < 0.01). Conclusion Increasing age, thyroid disease, and anorectal fissures were significantly associated with VLS. The association between anorectal fissures and VLS likely represents a sequela of the disease rather than a true comorbidity.

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“…In one cross‐sectional study involving four cohorts of patients, 14 a group was extracted from the overall study population for analysis according to inclusion criteria. Cohorts A and B could not be included because patients were assessed for presence of general LUTS with a single yes/no question, therefore specific detail regarding UI was not available for extraction.…”

Section: Resultsmentioning

confidence: 99%

Is urinary incontinence associated with lichen sclerosus in females? A systematic review and meta‐analysis

Kirby

Gran

Kreuser‐Genis

et al. 2021

Skin Health and Disease

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Background Lichen sclerosus (LS) is a scarring chronic inflammatory disease with a predilection for genital skin in both sexes. The aetiology of LS is controversial, but evidence increasingly suggests that the occluded exposure of susceptible epithelium to urine is involved in the pathogenesis of genital LS in males. This theory has not yet been robustly investigated in females. Objectives This review and meta‐analysis examined whether there is an association between urinary incontinence (UI) and genital lichen LS in females. Methods We performed a comprehensive search of MEDLINE, Embase and CINAHL to identify observational studies assessing the prevalence of UI in females with LS. DerSimonian and Laird random‐effects models were used to estimate the overall pooled prevalence and risk ratio compared to controls. Heterogeneity was assessed. Results In total, eight studies met the inclusion criteria and five studies were included in a meta‐analysis. Three studies were graded as moderate quality and five were poor. The pooled prevalence for UI in LS was 0.35 (95% confidence interval [CI] 0.13–0.58, I2 = 98.4%). The risk ratio of UI in LS was 0.97 (95% CI 0.53–1.75, I2 = 87.5%). Conclusion There appears to be no difference between patients with LS and those without LS in terms of UI. Studies are limited by clinical and methodological quality and heterogeneity is high. Well‐designed prospective studies are needed.

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Vulvar lichen sclerosus in women is associated with lower urinary tract symptoms

Abstract: The odds of developing LUTS (self-reported) are four times higher in women with LS than in those without. The predominant type of LUTS in women with and without LS is OAB.

Cited by 14 publications

References 15 publications

Comorbidity of Urogynecological and Gastrointestinal Disorders in Female Patients With Lichen Sclerosus

Comorbidity of Urogynecological and Gastrointestinal Disorders in Female Patients With Lichen Sclerosus

The prevalence of self‐reported medical comorbidities in patients with vulvar lichen sclerosus: A single‐center retrospective study

Is urinary incontinence associated with lichen sclerosus in females? A systematic review and meta‐analysis

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