A randomized comparative study of the effects of oral and topical estrogen therapy on the lower urinary tract of hysterectomized postmenopausal women

Long, Cheng‐Yu; Liu, Cheng‐Min; Hsu, Sodio C. N.; Chen, Yung-Hung; Wu, Chia-Fang; Tsai, Eing‐Mei

doi:10.1016/j.fertnstert.2005.06.042

Cited by 80 publications

(60 citation statements)

References 17 publications

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“…This difference might be attributed to the routine local application of estradiol cream in our patients for 1 month before surgical treatment of SUI. Recently, a randomized prospective study demonstrated that estrogen therapy could increase the blood flow around the bladder neck and mid-urethra and relieve the symptoms of overactive bladder and SUI [20] . Vaginal preparations are as effective as systemic therapy at the lower serum estrogen level [20] .…”

Section: Discussionmentioning

confidence: 99%

Tension-Free Vaginal Tape for the Treatment of Stress Urinary Incontinence in Geriatric Patients

Touloupidis

Papatsoris²,

Thanopoulos³

et al. 2006

Gerontology

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Objective: To evaluate the safety and efficacy of tension-free vaginal tape (TVT) for the treatment of stress urinary incontinence (SUI) in geriatric patients. Patients and Methods: Fifty-one women, aged 65–80 (mean 72.3) years, underwent a TVT procedure for genuine SUI from 2001 to 2004. A urodynamic test together with uroflowmetry were performed. The patients’ SUI bother score was assessed using a visual analog scale (VAS). Results: The mean operative time was 25 (range 14–29) min and mean hospitalization time was 1.2 (range 1–2) days. Bladder perforation occurred in 3 cases (5.8%) and was managed conservatively. Pre- and postoperative maximum flow rate were not significantly different (p > 0.05). The patients’ SUI bother score estimated by the VAS was statistically significantly improved (p < 0.0001). After a mean follow-up of 35.6 (range 14–60) months, 49 patients (96%) had no SUI, while 2 patients (3.9%) had persistent SUI. Also, during the follow-up 5 patients (9.8%) were diagnosed with de novo urgency due to detrusor overactivity and 1 patient (1.9%) had persistent dysuria that was resolved with urethrolysis. Conclusions: SUI in elderly women can be safely treated with the TVT procedure in the vast majority of the patients. However, bladder perforation during surgery and de novo urgency postoperatively should be taken into account.

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Section: Discussionmentioning

confidence: 99%

Tension-Free Vaginal Tape for the Treatment of Stress Urinary Incontinence in Geriatric Patients

Touloupidis

Papatsoris²,

Thanopoulos³

et al. 2006

Gerontology

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“…Entre elas destacam-se as alterações do assoalho pélvico 13,14 . O hipoestrogenismo acarreta, em geral, atrofi a das estruturas responsáveis pela estática pélvica.…”

Section: Discussionunclassified

“…Deve-se salientar que a reposição estrogênica em mulheres na pós-menopausa leva a nítido aumento no número de vasos peri-uretrais, os quais foram submetidos à dopplervelocimetria 13,14 . Contudo, não há dados na literatura sobre os efeitos das isofl avonas sobre o assoalho pélvico e a vascularização periuretral.…”

Section: Introductionunclassified

Efeitos das isoflavonas sobre o assoalho pélvico e a vascularização peri-uretral de mulheres na pós-menopausa

Accorsi¹,

Haidar²,

Simões³

et al. 2006

Rev. Bras. Ginecol. Obstet.

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Efeitos das isofl avonas sobre o assoalho pélvico e a vascularização peri-uretral de mulheres na pós-menopausa Resumo Objetivo: avaliar a força muscular do assoalho pélvico e os vasos periuretrais de mulheres na pós-menopausa, antes e após seis meses de uso contínuo de extrato de soja. Métodos: estudo prospectivo com 30 mulheres na pós-menopausa antes e após o uso de extrato de soja (100 mg/dia) durante seis meses consecutivos. Foram investigadas a perda urinária e a força muscular do assoalho pélvico por perineômetro digital e avaliação funcional. Avaliou-se ainda o número de vasos da região peri-uretral pela dopplervelocimetria. Para comparar os resultados antes e após tratamento, utilizou-se o teste pareado t de Student. Resultados: das 30 mulheres analisadas, 20 referiram alguma forma de perda urinária no inicio do experimento. A melhora deste sintoma ocorreu em 15 (75%) mulheres após o tratamento. A medida da pressão vaginal (força muscular do assoalho pélvico) foi 12,9±1,7 e 15,8±1,8 Sauers, respectivamente, antes e após o tratamento (p<0,001). Observou-se aumento da pressão em 22 (73,3%) mulheres no fi nal do estudo. Na avaliação funcional, verifi cou-se que 12 mulheres não sofreram alteração da função muscular do assoalho pélvico, ou seja, 18 (60%) tiveram aumento da força muscular. Pelo exame ultra-sonográfi co (Doppler) obtivemos no início do experimento 2,20±0,15 vasos sanguíneos/campo, passando para 3,4±0,2 vasos sanguíneos/campo ao fi nal do experimento (p<0,001). Em 21 mulheres (70%) registrou-se aumento do número dos vasos peri-uretrais após os seis meses de tratamento. Conclusão: ressalta-se que são resultados preliminares, havendo necessidade de outras investigações com número maior de participantes em estudo duplo-cego, randomizado e controlado por placebo. Contudo, o tratamento com extrato de soja, por seis meses consecutivos, determinaria aumento da força muscular do assoalho pélvico e do número de vasos peri-uretrais em mulheres na pós-menopausa. PALAVRAS-CHAVE:Isofl avonas/uso terapêutico; Soalho pélvico; Pós-menopausa; Uretra/efeitos de drogras/fi siologia/ ultrasonografi a; Fluxometria por laser-doppler Abstract Purpose: to evaluate muscular strength of the pelvic fl oor and the periurethral vessels of postmenopausal women before and after six months of soybean extract treatment. Methods: the study was conducted on 30 postmenopausal women before and after six consecutive months of soyabean extract (100 mg/day) administration. Urinary loss and muscular strength of the pelvic fl oor were investigated through digital perineometer and functional evaluation. Digital color Doppler in the periurethral region was used to count the number of vessels. For statistical analysis, the paired Student t test was applied to compare the results before and after the treatment. Results: twenty women reported urinary incontinence before the treatment period. The amelioration of this symptom was observed in 15 (75%) women after the treatment. Vaginal pressure (muscular strength of the pelvic fl oor) was 12.95±...

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“…Both vaginal preparations 22 and transdermal HRT 23 have been shown to be as effective as oral therapy with respect to vascular changes. Transdermal estrogen may be more effective than the oral form with respect to modifying vascular symptoms of menopause, including incontinence, and may be safer with respect to thrombotic risk, 24 and specific estrogen receptor modulators may increase the vascular benefits while reducing the risk of breast cancer.…”

Section: Hrt and Postmenopausal Voiding Dysfunctionmentioning

confidence: 99%

Should hormone replacement therapy be used in postmenopausal women for voiding dysfunction?

Stothers

2013

CUAJ

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A randomized comparative study of the effects of oral and topical estrogen therapy on the lower urinary tract of hysterectomized postmenopausal women

Cited by 80 publications

References 17 publications

Tension-Free Vaginal Tape for the Treatment of Stress Urinary Incontinence in Geriatric Patients

Tension-Free Vaginal Tape for the Treatment of Stress Urinary Incontinence in Geriatric Patients

Efeitos das isoflavonas sobre o assoalho pélvico e a vascularização peri-uretral de mulheres na pós-menopausa

Should hormone replacement therapy be used in postmenopausal women for voiding dysfunction?

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