Oestriol in the treatment of postmenopausal urgency: a multicentre study

Cardozo, Linda; Rekers, H.; Tapp, A.; Barnick, Christian; Shepherd, Angela; Schüßler, B.; Kerr-Wilson, R.; Geelan, J. van; Barlebo, H.; Walter, Steen

doi:10.1016/0378-5122(93)90028-g

Cited by 118 publications

(53 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Estrogen therapy has been claimed to reduce bladder sensitivity [30][31][32], although the evidence is not conclusive [33,34], but in this study no difference between those taking and those not taking estrogens was found.…”

Section: Discussioncontrasting

confidence: 50%

Age-associated changes in detrusor sensory function in women with lower urinary tract symptoms

Collas

Malone‐Lee

1996

Int Urogynecol J

View full text Add to dashboard Cite

This study examined changes in bladder sensation which occur with age in women. 1381 women (age range 20-95 years, mean 54.9) with symptoms of lower urinary tract dysfunction underwent urodynamic study. The bladder capacity at which they first became aware of the desire to void was taken as a quantitative measure of bladder sensation. Maximum bladder capacity fell in the eighth and ninth decades (H = 95.84, df = 7, P = 0.00), but by contrast bladder capacity at first desire to void rose progressively in association with age, both in the group as a whole (H = 17.13, df = 7, P = 0.017) and in a subgroup with detrusor instability (n = 952, H = 15.42, df = 7, P = 0.032). This rise in capacity points to a decrease in bladder sensation in association with age. This is not due to neurological disease, anti-muscarinic drugs or oestrogens, as the median capacity at first desire to void of these three subgroups did not differ significantly from that of the group as a whole.

show abstract

Section: Discussioncontrasting

confidence: 50%

Age-associated changes in detrusor sensory function in women with lower urinary tract symptoms

Collas

Malone‐Lee

1996

Int Urogynecol J

View full text Add to dashboard Cite

show abstract

“…It is plausible that oral CEE has a differential effect on the continence mechanism compared with other estrogens. However, the effect sizes reported for the smaller studies of these other estrogens suggest either a negative effect (for example, 2.7 incontinence episodes per day on estriol vs 1.3 incontinence episodes per day on placebo [36]) or an effect so small to be clinically unimportant. In one study, the percentage of women reporting the use of pads was 53% for estradiol vs 50% for placebo [37].…”

Section: Limitations Of the Evidencementioning

confidence: 86%

Estrogen therapy and urinary incontinence: what is the evidence and what do we tell our patients?

Waetjen

Dwyer

2006

Int Urogynecol J

View full text Add to dashboard Cite

Loss of estrogen associated with menopause has been considered as a factor responsible for the increasing urinary incontinence prevalence in women as they age. Indeed, incontinence is commonly categorized as a symptom of urogenital atrophy. The presence of alpha and beta estrogen receptors throughout the urogenital tract suggests that estrogen has a role in the continence mechanism, and many observational studies have supported positive physiological effects. Estrogen has been shown to increase urethral closure pressure [1-3], increase urethral blood flow [4], increase alpha-adrenergic receptor sensitivity [5,6], and improve cellular maturation in both the urethra and vagina [7]. Based on these observational studies and a few clinical trials [8], medical management of urinary incontinence in postmenopausal women has included the use of both systemic and vaginal estrogen.A 2003 Cochrane review identified 38 clinical trials evaluating the effectiveness of estrogen for the treatment of incontinence [8]. Twenty eight randomized or quasirandomized trials were reviewed, with the authors concluding that estrogen can improve or cure incontinence. However, the randomized, double-blinded, placebo-controlled trials with adequate allocation concealment have examined the effects of estrogen or estrogen and progestin on urinary incontinence and suggest that estrogen should not be used in the prevention or relief of stress and urge incontinence. In these studies, treatment with estrogen was no better than placebo. Indeed, the longest [9] and largest [10] of these trials demonstrated a statistically significant increased risk of developing incontinence or a worsening of incontinence after the initiation of estrogen.Both the Heart Estrogen and progestin Replacement Study (HERS) and the Women's Health Initiative (WHI) were large randomized, double-blinded placebo-controlled trials evaluating the effects of estrogen for the prevention of heart disease. Both trials have now published secondary analyses assessing the effects of estrogen on self-reported urinary incontinence symptoms. The participants in HERS were randomly assigned to standard doses of oral conjugated equine estrogen (CEE) and medroxyprogesterone acetate (MPA) or placebo daily and followed for 4 years. In the 1,525 women who reported incontinence at baseline, CEE-MPA, the odds ratio for worsening incontinence was 1.5 among women with incontinence. In a follow-up study of women in HERS who were continent at baseline, the odds ratio for developing new stress incontinence was 1.7 and urge incontinence was 1.5 [11]. Results from the large WHI study were similar. After 1 year, standard doses of CEE with and without MPA increased the incidence of symptoms of stress and urge incontinence. The risk was greatest for stress incontinence (odds ratio for CEE-MPA was 1.8 and for CEE alone was 2.2). CEE-MPA had no significant effect on the development of urge incontinence but CEE alone increased the odds of new urge incontinence by 1.3. Women who reported incontinence at the commen...

show abstract

“…Compliance was confirmed by an increase in the maturation index of the vaginal epithelial cells in the active treatment group. Estriol produced subjective and objective improvements in urinary symptoms, but this was not significantly better than with placebo [73].…”

Section: Estrogensmentioning

confidence: 99%

Pharmacological Management of Detrusor Instability

2001

Self Cite

View full text Add to dashboard Cite

Urinary incontinence and lower urinary tract dysfunction remain an important cause of morbidity, affecting at least 14% of women over the age of 30 years. Whilst the etiology and pathophysiology of detrusor instability remains to be elucidated drug therapy remains important in the management of women with the irritative symptoms of urgency, frequency and urge incontinence. The number of drugs which have been developed illustrates the point that none are ideal, often having systemic adverse effects limiting their therapeutic usage and affecting compliance. This review aims to assess the current pharmacological management of detrusor instability as well as examining recent progress in the development of new agents, some of which may prove to be efficacious.

show abstract

Oestriol in the treatment of postmenopausal urgency: a multicentre study

Cited by 118 publications

References 17 publications

Age-associated changes in detrusor sensory function in women with lower urinary tract symptoms

Age-associated changes in detrusor sensory function in women with lower urinary tract symptoms

Estrogen therapy and urinary incontinence: what is the evidence and what do we tell our patients?

Pharmacological Management of Detrusor Instability

Contact Info

Product

Resources

About