title: Rates of self-reported urinary, gastrointestinal, and pain comorbidities in women with vulvar lichen sclerosus.
abstract: OBJECTIVE
  The study aimed to determine the prevalences of comorbid disorders in women with vulvar lichen sclerosus.
  
  
  METHODS
  A retrospective review of self-administered questionnaires regarding the health history of 308 women with lichen sclerosus seen at a vulvar clinic between 2006 and 2011 was performed. Responses to questions about urinary (overactive bladder [OAB], urinary incontinence [UI], and stress UI), gastrointestinal (inflammatory bowel diseases, constipation, and irritable bowel syndrome), thyroid dysfunction and pain (interstitial cystitis, fibromyalgia, temporomandibular joint disorder, and vulvar pain) disorders were collected. The percentage of subjects self-reporting each comorbidity was compared with the published prevalence in the general population using a single-value binomial test.
  
  
  RESULTS
  Subject demographics (data presented as median [range] or percentage): age, 56.4 years (20.0-92.5); body mass index, 27.5 kg/m2 (17.4-53.1); parity 2 (0-10); white, 92.9%; and biopsy proven 65.6%. Prevalences of self-reported comorbidities in our subjects are as follows: OAB, 15.3%; UI, 38.6%; stress UI, 27.9%; inflammatory bowel diseases, 1.9%; constipation, 32.5%; irritable bowel syndrome, 19.5%; thyroid dysfunction, 33.1%; interstitial cystitis, 2.6%; fibromyalgia, 9.1%; temporomandibular joint disorder, 13.0%; and vulvar pain, 83.1%. The prevalence of each disorder is significantly different from that in the general population, with all p values ≤ .02.
  
  
  CONCLUSIONS
  Vulvar lichen sclerosus is associated with numerous bladder, bowel, and pain comorbidities. The prevalences of all of these disorders are higher in our subjects than the general population except OAB, which we find at approximately one third of the general population. Patients with lichen sclerosus should be screened for comorbidities that may affect their health and/or quality of life.
authors.affiliation: Division of Urogynecology, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA. mitcberg@umich.edu
authors.forename: Mitchell B
authors.initials: MB
authors.lastname: Berger
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Damico
authors.forename: Stacy B
authors.initials: SB
authors.lastname: Menees
authors.forename: Dee E
authors.initials: DE
authors.lastname: Fenner
authors.forename: Hope K
authors.initials: HK
authors.lastname: Haefner
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D015897:Comorbidity; D018856:Cystitis, Interstitial / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D005356:Fibromyalgia / Q000175:diagnosis / Q000453:epidemiology; D005767:Gastrointestinal Diseases / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis / Q000453:epidemiology; D043183:Irritable Bowel Syndrome / Q000175:diagnosis / Q000453:epidemiology; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis / Q000453:epidemiology*; D010147:Pain Measurement; D015995:Prevalence; D011379:Prognosis; D012016:Reference Values; D012189:Retrospective Studies; D018570:Risk Assessment; D057566:Self Report; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013705:Temporomandibular Joint Disorders / Q000175:diagnosis / Q000453:epidemiology*; D014570:Urologic Diseases / Q000175:diagnosis / Q000453:epidemiology*; D007724:Vulvar Lichen Sclerosus / Q000175:diagnosis / Q000453:epidemiology*; D056650:Vulvodynia / Q000175:diagnosis / Q000453:epidemiology; D055815:Young Adult